HomeMy WebLinkAbout2018-00169 - gas fireplace CITY OF ORONO I I � I II I I I I I I I II� i � l � II
2750 KELLEY PARKWAY DATE ISSUED: 02/16/2018
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 765 BOULDER DR
PIN : 33-118-23-11-0134
LEGAL DESC : STONEBAY
: LOT 1&2 BLOCK 1
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 1,890.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
UHT GAS FIREPLACE
APPLICANT MECHANICAL 50.00
FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 0.95
2700 FAIRVIEW AVE MAIL-IN FEE 2.00
ROSEVILLE,MN 55113 TOTAL 52.95
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 52.95
OWNER
Stonebrook Development LLC
17149 LINCOLN ST NE
HAM LAKE,MN 55304-
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.
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Applicant Permitee Signature Date Issu B; Signature Date
02-16-'18 12:50 FROM- 1-535 P0001/0004 F-976
51(qs3g_ 0001
R ITY USE ONLY
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City of Orono �O� ��/n )
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Date Receives / r prmit it V�2750 Kelley parkway Crystal Bay.11N 55323 Approved By: AmountS'Phone(952)2494600 Fax(952)249-4616
CITY OF ORONO-MECHANICAL PERMIT
OSHp1 (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL.INFORMATION
I, 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 UNTIL 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 O} PERMIT
(Check All That Apply)
Rgsldentia ❑COmmeiclal(Aprtiyal Rggutri4
X.g.R . ❑ chit;;( ❑liVi ❑gReplac75)
Job Site/Owner Information:Betitkie.47 b
(Qyyrier)W 60c, `"tg)\A. ilir cMatlli;ig Address
Hon- Plaone:• 92- .�GI� 3"1 S-OS a Alternate Phone:
Contractor Information:
Contractor: FIRESIDE HEARTH & HOME Contact Person: ;:."4' Pot/li-
Address: 2700 Fairview Ave N State Bond#:BC662656, MB662572, PC662571
City: Roseville, MN Zip 55113 Expiration Date:
Phone: 651-633-2561 Alternate Phone: ,r`!::")#651-638-3312
❑ Insurance-Current:
I
02-16—'18 12:50 FROM— T-535 P0002/0004 F-976
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
Quantity: _
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power w
( IREPI;ACES)
.._...
Gas Factory Fireplace) . rand Mame:
❑ Wood Burning Fireplace)
❑ Wood Stove)_ (Model No.) )
❑ Wood Stove with Flue/Masonry)
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 El Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
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02-16—'18 12:50 FROM— 1-535 P0003/0004 F-976
PERMIT)FEE 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 requirements:
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 S 5,00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION(S)—JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
/ OD
x 6125$ r --�
((96,tta6 bilid �minimuiu 0 4a
2. STATE SURCI-IARCE r
1 � 406574
3. POSTAGE&HANDLING(Only on Mail-In Applications) ($)
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) u j
■ ' 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 job cost, the City may request the submission of a signed copy 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 on this application are complete, true and
correct.
Applicant's Signature / -;• Date:. �/ //�
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