HomeMy WebLinkAbout2011-00905 - gas fireplace CITY OF ORONO PERMIT NO.: 2011-00905
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 08/22/2011
(952)249-4600 FAX: (952)249-4616
ADDRESS : 850 OLD CRYSTAL BAY RD S
PIN : 09-117-23-12-0005
LEGAL DESC : FRENCH CREEK WOODS
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,000.00
NOTE: 1 HEAT N GLO GIRARD I35
APPLICANT MECHANICAL 50.00
WESTAIHEATING STATE SURCHARGE MECH(VALUATION) 1.50
11184 RIVER ROAD NE
HANOVER,MN 55341 MAIL-IN FEE 2.00
(763)498-8071 MISC FEE 0.00
TOTAL 53.50
OWNER
ELLWEIN,MICHEAL&ELIZABETH
850 OLD CRYSTAL BAY RD S
WAYZATA,MN 55391-
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.'
Applicant Permitee Signature Date
Issued :y Si_1;ture to Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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FOR CITY USE ONLY
,¢OA City of Orono
O. O P.O.Box 66 Date Received: Permit#
2750 Kelley Parkwayi Crystal Bay,MN 55323 Approved By: Amount$:
4�44,L amiido Phone(952)249-4600 Fax(952)249-4616
`ra�eio� CITY OF 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 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 OF PERMIT
(Check All That Apply)
Residential ❑Commercial(Approval Required)
❑New ❑Additional D Repairs Replace
Job Site/Owner Information: n (' Q �) �� aSite Address: 0 SQ i D�- liI "'�-- lifr
Owner: 11 ()AO MA V1 Mailing Address: 241/1.1-> Lk• CdriAle
City: O'I'UVO Zip: t5 22--
Home Phone: Alternate Phone: tot 2-- 3O U -01 t;tio
Contractor Information:
Contractor: A Q-kiL Contact Person: M tun (_..
Address:
104 \ftI fti NE State Bond#: 1 OS 10(M01
City: OZtiA✓ Zip: ' t Expiration Date: 0 I (a i 12-
Phone:
LPhone: 1O- "f qU' )O'i( Alternate Phone:
[1 Insurance-Current:
1
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Note:All Geothermal Systems will now re uire 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
FIREPLACES //''
Gas Factory Fireplace Brand Name: —(1'la.I O
❑ Wood Burning Fireplace ,, n
❑ Wood Stove Model No.: (( • 35
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
O No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marshall ijproposing to abandon tank in place)
O Installation 0 Removal
Fuel Oil: gallons ❑ Underground 0 Inside 0 Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
❑ 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 $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
.Dol 4°— x.0125$ 61
(contract price) (minimum$50.00)
2. STATE SURCHARGE
3000 x.0005 $ ',
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 53
• * 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.
,..,?� .,. .; r u .: .. _._`- e, n,: ...,
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 certi -s that all statements made on this application are complete, true and
correct.
Applicant's Signa -: II' 111 Date: 911 8 r 11
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Bond ID: 103708181 Effective Date: 8/19/2011
TRAVELERS
CASUALTY & SURETY CO OF AMERIC Expiration Date: 08/19/2012
Set- CJ DATA TIME ' 17
CITY OF ORONO CALLED IN ` `
INSPECTION NOTICE ...--SCHEDULED 9-6-l1 y 0 C
PERMIT NO.0)6 I l—00 9OCOMPLETED
ADDRESS 850 Old C'A, ,d S'.
OWNER TELEPHONE NO. 763 -490-80 7
CONTRACTOR w-e4tC � Api.
DESCRIPTION `711.eCI-' L`
tm0 FOOTING 0 PLUMBING FINAL 0 EXCAV/GRADING/FILLING
Q 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS
y ❑ FRAMING 0 MECHANICAL FINAL
Q ❑ TREE REMOVAL
0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
Q 0 RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT
v 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP
0 DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
v 0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL
IC Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
ccl COMMENTS:
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IQ CIWORK SATISFACTORY:PROCEED 1OJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 CI CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CI CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site: r , f 133 C
Inspector. �/V (/J/� J
White Copy/Inspector's File Canary Copy/Site Notice