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HomeMy WebLinkAbout2018-00442 - gas fireplace CITY OF ORONO II 111FHIH * 2750 KELLEY PARKWAY * 21 8 - 0 0 2 DATE ISSUED: 04/11 1/22 018 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 200 BEDERWOOD DR PIN : 05-117-23-12-0027 LEGAL DESC : AUDITOR'S SUBD.NO.203 : LOT MB BLOCK MB PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 4,200.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. KOZY HEAT-SLAYTON 36-GAS FIREPLACE INSTALL ONLY GASLNE BY OTHERS APPLICANT MECHANICAL 52.50 WACONIA COMFORT STATE SURCHARGE MECH(VALUATION) 2.10 201 W MAIN STREET MAIL-IN FEE 2.00 WACONIA,MN 55387- TOTAL 56.60 (952)442-3473 Payment(s) Minnesota State License#:mech-MB003544 CREDIT CARD 5162 56.60 OWNER AZAD,ALISHAH 200 BEDERWOOD DR LONG LAKE,MN 55356- 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. it,C6 ,'10 t.) A-G-IS'r0i )/ i/ r Applicant Permitee Signature Date Issued By Si ature Date 04/10/2018 15:19 FAX 9524422451 sgs U1001 US1 ONLY City of Orono o� (�l� • ���W P.O.Box 66 Date Receive : 11)// �!� U Permit# b 156 2750 Kelley Parkway D Crystul Buy,MN 55323 Approved By: _ , Amount S:,..4,743)! Phone(952)249.4600 Fax(952)249-4616 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 RUCI-:IVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARL)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 he 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) [Backflow Device: ❑ AVB ❑ PVB] ❑ New 9 Additional ❑ Repairs ❑ Replace Job Site/Owner Information: ,a�� J Site Address: _0 Q ll` �' r O a a 0v- Owner: A I Ickv AZ&.I Mailing Address: City: a r 010 Zip: S S Y5(e Home Phone: . - Alternate Phone: Contractor Information:�W Contractor: a-L(M I'i Contact Person: Address: 62-0 ( Writt(h State Bond it: Q© City; Gt tt 1 t A Zip:S5387Expiration Date: a r W Phone: 615?-1-1q)..' 3q73 Alternate Phone: (5a- gIP/—3S0 S Insurance—Current: cktl Zeiki Y1J'•LlVtA"^l---, 1 04/10/2018 15:19 FAX 9524422451 sgs ll 002 MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now require a Site Plan&Review by our Building Oficial, IS THIS GEOTHERMAL? ❑Yes ❑No HEATING SYSTEMS Quantity: _ Make: —_ Model: —._._.,._. Duel: _ �_.._....— Flue Size: Input 13TUs: .� Output BTUs: --..._._......-- -_ CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: 11.Power FIREPLACES Gas Factory Fireplace Brand Name: k0 Z y ❑ Wood Burning Fireplace ,1 ❑ Wood Stove Model No.: [ ❑ Wood Stove with Flue/Masonry p12— tvIth aY* 17 VENTILATION ��rt F1" ❑ No. Kitchen Exhaust duct recirculating __ cftn ❑ 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 ❑ Underground © Inside ❑Outside LP Gas: gallons Other: 1 GAS LINE ONLY G z c 1 1 f n..a. 191/ 4 orf ❑ Outdoor Grill ❑ Other/List What&Where: 04/10/2018 15:19 FAX 9524422451 sgs R1003 PERMIT FEE CALCULATIONS 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) SO31r0 (contract - x.U125$ S . (contract price (minimum 550.00) 2. STATE SURCHARGE V x.0005 $ °�' (contract price) 3. POSTAGE(It HANDI.IN(1(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �•47' ci ■ * 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, ogees 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: "IAA-A:" Date: �/t d / ' "` 3