HomeMy WebLinkAbout1999-011871 - gas fireplace PERMIT
'- C1TY OF ORONO
2750 Kelley Parkway - P.O. Box 66 PERMIT TYPE:
Crystal Bay, Minnesota 55323 Permit Number: - _.=Y�.�._ .... .....
(612) 249-4600 Date Issued: .. �_ �-���:' _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPUCANT%PERMITEE SIGNATURE ISSUED BY:SIGNATUR
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT � � �
Box 66 (2750 Kelley Parkway) ��� >
.�, • Crystal Bay, MN 55323 _ � t,.:W�'��`
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GENERAL INFOR1�iATION ��
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be ��p`
reviewed and a permit will be issued within 2 working days: . �
2. Permit cards wIll be sent by retum mail after a review is completed. PERMITS ARE NOT VALID i
UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
�:: POSTED ON THE JOB SITE. �
3. Mechanical Desi�ns - Complete calculations, details and specifications ue required for each heating, f '
�; ventilation, humidification-dehumidification, and air conditioning installation including heat loss/heat gai.n ����.�
�� calculation, design 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 249-4600. 24-hour notice required. �
7. House Heating Test Record must be submitted before final. � I
�
` ' Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. �
� INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600. i
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Please check one: New Addition Repair Replace �
Residential Commercial '
Jos srrE: 5�b3 �..�tI��G rawo z�P: 55��5� �I
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Owner's Name: (711Gt R11-r.,�'M Yl� �(5(�h Telephone Number: �I2 4�51 74- i
Mailing Address: �3 G1r� L.LIYI�i City: �VOI��I Zip: �� i
Contractor's Name: Telephone Number: !
Mailing Address• � City: Zip: ;,;
SYSTEM DESCRIPTION r =
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HEATING SYSTEMS I �,
Quantity: - --�
Make: l Gt�DY �
, Model: (�N D}t 3� I
Fuel: NA'�1�tYa(
- Flue Size: - '
Input BTUs: �
oiztput BTUs: 2�,ODO �'�
CFM: �
.�;
. ��,;
COOLING SYSTEMS ' �
� Quantity: },
Make: �+ if
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Model: �- -:
Tons: , ����,_
H. Power . '
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� ; ' `^` t �� , ,� • .. � :'. r'�-� a 'r s $• �� µ _
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WOOD BURNING EOIT�MENT �`'
� -- Wood stove with flue ��� ^ - - - - - - - --.�- -n
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� Wood combination or add-on - � ' ;�, ��� i
` Factory fireplace with flue ��.
� t • Factory Fireplace (s) Freestanding Masonry
Wood Stove (s} � Franklin, other � � >,�
� � Brand Name � Model No. ;
Mfgr's Min., Clearances, side , rear , min. flue dia.
VENTILATION �
No. Kitchen Exhaust ducted recirculating cfm ,*^.
- -- - No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm R ' '
,
- FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) =r;
Installation Removal .
- -, Fuel oiL• gallons underground inside outside >R
LP Gas: gallons �
Other Gas opening
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
�' 1300.DD x .0125 $
(contract price) �
� 2. State Surchar�e. ** Add the State Building Code Division `
Surcharge to each permit. x .0005 $ �
or $.50, whichever is greater (contract price)
3. Posta�e and Handlin� (Only mail-in applicafions) $ 1.50 � '
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �
* CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount chazged for the pernutted
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 installation aze 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.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is r�
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees fo do
all work in strict accordance with the ordinances of the City and the regulations of the Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
- and correct. �
- A licant's Si ature: r ���� , Date: � �� ��
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Approved By: � Date:
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DATE TIME
CITY OF ORONO CALLED IN ���
INSPECTION NOTICE SCHEDULED .� `s � �U��
PERMIT NO. II � 7 COMPLET o S� Z..' �U
ADDRESS �� G�i�� � � �
OWNER ��'��`-'� CONTR.
TELEPHONE NO. '�I�� �� 7`7�
� DESCRIPTION
L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA 19 LAKESHORE/WETLANDS
� �
Q 03 INSULATION 24/25 WOOD BURNE FIREPLAC� 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J BING FINAL � 36 FOUNDATION/REMOVAL
OWN ICONTRACTOR TO MEET YOU:� ES_NO
� COM ENTS:
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d ❑WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
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� ❑ CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O �1 CORRECT WORK,CALL FOR REINSPECTfON TEMPORARY
� ���BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �; pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site:
�
Inspector.� �ce�� �S
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN i�-�-y� ���j b
INSPECTION NOTICE SCHEDULED �z_��
PERMITNO. l� <Y7� COMPLETED I�'22-0C' � •� � �
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ADDRESS .� c`�.� �G��-f�_. ,� �-n-2-�
OWNER -��*m.aL�.ti� CONTR. �L'�Ax� �4�f' �r ��;1/�-
TELEPHONE NO. � �� - ��C G O
� DESCRIPTION �-� � �� � i'l�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
.Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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fl COMMENTS:
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d �JVORK SATISFACTORY:PROCEED �ROJECT COMPLETE
� C CORRECT WORK&PROCEED �C�SUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �%CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contra tor on site:
Inspector.,/l���� ��►''
White Copy/lnspector's File Canary CopylSite Notice
GAS WORK ORDER
1072 Payne Ave. STANDARD 410 W. Lake St.
St. Paul, MN 55101 Minneapolis, MN 55408
651/772-2449 b H E AT I N G � 612/824-2656
& AIR CONDITIONING �
A Blue Dor` Service Co. EQUIPMENT INFORMATION
i
LAST i` �c G���'��, FIRST -� r . �' TYPE
ADDRESS ��� �C �''� �� MAKE
CITY ����� ZIP ^� MODEL" ��� � ;� ;)
HM PH��� - ���' /�`t' . `' WK PH SERIAL �� /,L�2Z ��
TECH i� , . ,,l DATE ����.�'" �� INP ' - ��R�
ORSAT TEST RECORD
CO2 '� � % METERED INPUT '/�rJ ` ;,1�' Cfh CHIMNEY TYPE
O2 ��' % LIMIT SETTING �� ° FLUE SIZE �=�✓G..� �-- " 111.
;
CO % PILOT OUTAGE sec CONNECTOR SIZE in.
NET STACK TEMP � �' � TOTAL CHIMNEY INPUT btuh
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