HomeMy WebLinkAbout2017-01413 - gas fireplace CITY OF ORONO 1 WI IF [I 1111 LII
*
2750 KELLEY PARKWAY * 2 0 1 7 - 0 1 4 1 3
DATE ISSUED: 11/01/2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4750 CREEKWOOD TR
PIN : 30-118-23-33-0003
LEGAL DESC : PAINTERS WOODS
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 5,352.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
GAS FIREPLACE INSERT AND GAS INSERT
ESCAPE-I35
APPLICANT MECHANICAL 66.90
STATE SURCHARGE MECH(VALUATION) 2.68
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE TOTAL 71.58
ROSEVILLE,MN 55113
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 71.58
OWNER
JELLISON,MR.&MRS.
4750 CREEKWOOD TR
MAPLE PLAIN,MN 55359
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
(-1/14-A1-4.1)
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Applicant Permitee Signature Date ssued B •ignature Date
cc��10-31-'17 15:36 FROM- T-069 P0001/0004 F-454
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P.O.2750.BoxKelley Parkway 66 Date Reeei eg/ Permit
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Crystal Bay,MN 55323
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Phone(952)249-4600 Fax(952)249-4616 ,
CITYOF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTII,YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That Apply)
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Job Site/Owner Information:
NUM L175 o Cr e. -v dz T:CAI .
Mita Y--eA Y\ S c,Lr`t i Te 15 W r ) 541►'"`� CL '51
Honiara) 611%151 Y17/ Alternate Phone:
Contractor Information:
Contractor: FIRESIDE HEARTH & HOME Contact Person: P4.r1---eA -
Address: 2700 Fairview Ave N State Bond#:gC662656, MB662572, P0662571
City: Roseville, MN Zip:55113 Expiration Date: ► A r-�
Phone: 651-633-2561 Alternate Phone: l.� l--(�n �3�v�
❑ Insurance—Current:
1
10-31—'17 15:36 FROM— 1-069 P0002/0004 F-454
MECHANICAL SYSTEMS BEING INSTALLED
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes ❑No
HEATING SYSTEMS
Qi at.t:ty.
Make:
Model!
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
Geis /)4,w 6 l
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15
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VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil; _ gallons O Underground ❑Inside 0 Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
10-31—'17 15:36 FROM— T-069 P0003/0004 F-454
PEk2Ivi1TFEE CALCULATION(S)
BASED OFF-.2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture-or-appliance that meets all three-of the following requirein nts.
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excluding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Pee $
PERMIT FEE CALCULATION(S)—JOBS OVER$500.00 •
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is L25%of contract price with a(Minimum Fee of$50.00)
452
Kcdn@�t.FSl�Fy minimum sa�)
2. STATE SURCHARGE .55Z2
(pg
x00005
((cgntt c.i#190)
3. POSTAGE&HANDLING(Only on Mail-In Applications) @ Ml6Ni r,._....�
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ r
■ CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material,equipment,labor or installations are furnished by
the owner,tenant or any other party,the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
amount-of the-ob cosl he-Gi _a uestthe-submission-ofa si ed-co of the actual-contract.
MECHANICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made o . - application are complete, true and
correct.
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Applicant's Signature: / @atei) /Q -3I-17
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CITY OF ORONO CALLED IN l
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OWNER I 0 i►'4 -035J TE'EPHONE NO ,/2 9-?4,0 dalP
CONTRACTOF� 7T71 . i
3: DESCRIPTION
tL ❑ FOOTING 0 DEMO- NAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
y ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL ElWATER HOOK-UP 0 FOLLOW-UP
W 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU: YES_NO
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W 0 WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE
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0 CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
LI CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. 9/
White Copy/Inspector's File Canary Copy/Site Notice