HomeMy WebLinkAbout2004-P08111 - gas fireplace PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PQ Box 66 P08111
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: 10/22/2004
SITE ADDRESS: 25 Orono Orchard Rd N
Long Lake,MN 55356
PID: 35-118-23-33-0004
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechamcal Permits Permit Sub-type(s): Gas Fireplace
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 69.93
Valuation: $ 5,594.00
State Surcharge Fee: $ 2.80
TOT FEE: $ 72.73
APPLICANT:• Automatic G. age Door&Fireplace,Inc. OWNER: Michael&Deborah Benedict
8900-109th ve N-#1000 25 Orono Orchard Rd N
Champlin, 55316 Long Lake,MN 55356
THE UNDERSIGNED HEREBY ' QUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WO r IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING COD REQUIREMENTS.
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APPLICANT PERMITEE SIe ATURE SUED BY SIGNATUR E
Copies: 1-File(Siznitures Requir• ,1-Applicant,1-Monthly Reports, 1-Assessing, 1-Finance Page 1
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CITY OF ORO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kel ey Parkway)
Crystal Bay, MN 5323
GENERAL INFORMATION
1. You may apply fr mechanical permits by mail or in person at the City offices.Applications will be
reviewed and a p rmit will be issued within two working days.
2. Permit cards will'ae 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 Desi s-Complete calculations,details and specifications are required for each heating,
ventilation,humi 'fication-dehumidification,and air conditioning installation including heat loss/heat
gain calculation,d sign temperatures,equipment ratings and identification as to type, manufacturer and
model. Data shall be presented on form provided.Identification of and specifications for water heating
equipment shall also be 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-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions
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Complete all items othis application. Compute the permit fee. Sign and date the certification.
INCOMPLETE AP ICATIONS WILL NOT BE PROCESSED. If you have questions,call
(952) 249-4600. 11
Please check one: gi F ew ❑ Addition El Repair ❑ Replace El Residential ❑ Commercial
JOB SITE: j 0/ evv0 0. ,e01 h.) Zip: S 5:3S'7.0
Owner's Name: u - ,,- Phone Number: IqS9
- '1S'-F{(o 00
Mailing Address: fp,,..,,„ �Q., acre_ City: itio �.,& Zip: S s-39/
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Contractor's Name: •.....„ f : Phone Number: 7(.,3-S'1 a -D S�S—
Mailing Address: , . ''CAO .%7, ', J City: •/ r,Zip: 55-3 t(;c1,
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SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make:
Model: I- .006-1—
Fuel:
QTFuel: IVCAk-
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
tfGas factory fireplace
Wood burning factory fireplace with flue
❑ Wood Stove
❑ Wood stove with flue
Brand Name _ a0 Q QQxtJe-- Model No.
VENTILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No: Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHAL)
❑ Installation or ❑ Removal
❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside
❑ LP Gas: gallons
❑ Other Gas opening
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PERMIT FEE CALCULATION(S)
2002 State Statuti ❑ Yes This Section Applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1) Dies 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; Cost of Permit $ 15.00
State Surcharge$ .50
Mail-In Fee $ 1.50
If above does not aply,follow guidelines below:
1. Contract Price is .0125%of job with a Minimum Fee of($35.00)
5 5c1(,box.0125
(contract price) (minimum$35.00)
2. State Surcha ** Add the State Building Code Division a Minimum Fee of($.50)
x.0005 $
(contract price) (minimum$.50)
3.Postage and Handling(Only mail-in applications) $ 1.50
4.TOTAL PERMIT FEE(Add lines 1-3 above) $
*CONTRACT PRICE s r JOB COST means the actual or estimated dollar amount charged for the permitted work including
materials,labor,profit, . d other fixed costs.It is the amount to be charged to the customer for the work done.If any material,
equipment,labor,or insi.11ation is furnished by the owner,tenant or any other party the reasonable market value of such items
must be added to the est mated 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 ma, request the submission of a signed copy of the actual contract.
**The STATE SURC • 'GE is.0005 of the contract price under$1,000,000 or$.50-whichever is greater.For valuations over
$1,000,000 call the Dep. ment of Inspectional Services for the price.
The undersigned hereby•pplies to the City for issuance of a Mechanical Permit,agrees to do all work in strict accordance with
the ordinances of the Ci , and the regulations of the Minnesota State Building Code,and certifies that all statements made on this
application are complete true and correct.
Applicant's Signature: °'( I"�'r " e/r�Cvn Date: /V/aa�C3 V
Approved By: Date:
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