HomeMy WebLinkAbout2017-01348 - gas fireplace , � CITY OF ORONO * 2 0 1 7 — PJ 1 3 4 8 *
2750 KELLEY PARKWAY DATE ISSUED: 10/18/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952 249-4616
ADDRESS : 990 PARTENWOOD RD
PIN : 08-117-23-12-0006
LEGAL DESC : PARTENWOOD 2ND ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,323.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
GAS INSERT AND GASLINE
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.66
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 TOTAL 53.66
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 53.66
OWNER
ENGELSMA,BRUCE&MARY
990 PARTENWOOD RD
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. 1'his permit is for only the work described and dces
not grant permission for additional or related work which requ'ves separate
permits. All provisions of Iaws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction suthorized 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.'Chis pertnit may be
revoked at any time for due cause.
•
F�u��c I `-� /D�/B ��?
Applicant Permitee Signature Date Issued By S' ture Date
10-17-' 17 10:57 FROM- T-963 P0004/0007 F-337
�� ��� C�Z�S� �oot
FOFi�[T USE ONLY
��}� Ci oT Orono " -, i �
�y P.O Box 66 DAtE RCCCIVC(I: i�^, �eRil1l� (���� � �' _� .
275Q rCelley Parkway � !-
Crystal Bay,MN 55323 Approved By� Amount$: l_ � �'
Phon�(952)249-4640 Pax(952)249-4b16
y �
e� �
{.���s����,�' CITY OF 0�201�T0—MEC�TAN'YCAY,�ER�XT
(All COmmccci�l peCmi�s mus[be apploVed by the 13uilding Offmial or In:pector and/or Fire Mar�hsll)
GE1��tAL XNZ'ORMATI�N
1. You may apply for meehanieal permits by mail or in persvn at the City of�ices. Applications will
be reviewed and a permit wilI be issued wiEhin two'warking days.
2. Permit cards will be sent by re[urn mai(after a review is completed. PERMiT5 ARE NpT
VALID UNTIL YOU RECET'VE,A,P�TtIvffT. WORYC MUST NOT BEGIiV UNTIL THE
PERMIT CARD 7S POST�ri pN'xH�.�Oi�STT�.
3. Mechsnica!Dtsi�ns—Complete calculations,details and speci�icaCions art required for cach
heating,ventilation,humidifcAtion-dehumidification,aad air conditioning installation including
heat loss/heat gain catculation,design ttmperatures,equipment ratin�s and ident'rfrcation as to
type,;manufacturer and model. Data shall bc presented on form provided.
4, When any pew canstruction or remodeling is in�olvcd,a separate building permit must be
obtained_
S. All work must be done in aGCorda+lCe Wrth the Urliform Mechanical Code/Statc Building Code
requirements.
G. All r�vork must bc inspccted(rough-in and final). Call(452)2a9-4600.
(24-48 hour notice required)
7. �ousc�Teating Test Recorfl must be submitted before f'rnal.
T'Y'pE O�pE�tMYT
(Check AlI That A ply)
_:-�.. . v � N„_,.Y.�.. ..,.
��Zes�dentia� []�Com�er�ia�(Ap�rova4 Rec�u�rcd�
❑�Ne� ❑�A.ddiEi.ona� ❑{�tepaiesj ��R�_place�
Job Site/Orx+ner Ynformation:
�Si��Ad.�re.s.`s / � L�T'�Ob►. I�-��
- ----�-=--._�
Ovv�er� 'g�v�,C.'�2, ,�i►'���'� M�ilin� �ddress� .�°''�' �-� �l�
_--,� - —
,
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Hom Phon�: ��� ���"���(ternate Phone:
"c—.T----�
Contractor Tnforination:
Contr�ctor: FIRESIDE HEARTH & WOM� Contact T'erson: a"��
Address: 2700 Fairview Ave N State Bond#:BC662656, MB662572, PC662571
�j�,: Rosevilfe, MiV Zip:55113 Expiration Date:
�hone: 651-633-2561 Alternate�hone: �,QJ 1`L6��$r ��Q�Y
❑ Ynsurar�ce—Current:
1
10-17—'17 10:57 FROM— T-963 P0005/0007 F-337
. .
� IvI�CHA1vICA�;S'YSTEI�S BEINC'x 1NSTALLED . . �
Note:All Creothermal Systems will now require a Site Plan&Review by our Building Official.
YS 7'Y�YS G�OT�IERMAL? ❑'Y'es ❑No �
��axxrre s�tsr��s
Quantity:
Make:
Model:
Fuel:
Flue Sizc:
Ynput$TUs:
Output BT'Us:
CFM:
COOLIIVC S'S�ST�IVIS
Quantiry: ,_
Make:
Model:
Tons:
H.Power
�IREPLACE.S � /+�S ��1N��
� G�:;P�F.torY�L�Cs�..�'n$�i�'"�' �c�dName:� ;T l�:f'� ';�:----�
❑ ooii�$iii�n Fire�1
���?�� ., .. _�..,_._ ; ,-�-�
Q �:qoil,StQvc�,.,. , _ _ �V!'oael No;. (i��.��.::'��,�.
,__� , ..._:. _. �T '
Q _oad 5tovt�rvith,F1�%Ms�O?!�'�
VENTILATION
�] No. Kitchen�,xhaust duct recirculating cfm
❑ N'o. Bath Exhaust(must ha've duct outside) cfm
� No. Other Fans: Locations cfm
FUEL STORA(C� (Mitst be a,pproved by Fire Ma�sltoll if p%posing to nba,rdon ta�rk in place.)
❑ Tnstallation (] kemoval
�uel Oil: gallons ❑ Undcrground �]Ynsidc ❑Outsidt
�.�'Cras: gallons
Other:
GAS LINE ONLY
[] Outdoor Crrill ❑ Other/List'What&Wherc:
2
10-17-'17 10:57 FROM- T-963 P0006/0007 F-337
.
� �ERMIT,FEE CALCULATION�S):; '
;13AS�D Q��:-2002 STA'TE STp.TUE
❑ Ycs,this section applies
The replacement of a Rosidential fxture or aaPliance that meets all thrve of the following requirements:
1. boes not require modifieation to clectrical or gas service.
2. Has a total eost of$500.00 or less;exeludine tho cost of the fixfure or appliance:and
3. rs improved,installed or replar,�d by the homeowner or liecnsed contraetor_
Skip next secGion,if this applies; Cost of Permit $ 15.00
State Sureharge $ 5.00
Mail-In Fee(Tf Applicable) S 2.00
Total Pernnit�ee $
PERMIT FEE CALCULATION S)=JOBS QV�R$500.00.. . �'.::
If above does not apply;follow guidelines below:
1. CONTRACT PTtYC�; �'is 1.25%of contract priee with a(Minimum Fee of$50.00)
� ��� —r–�,.-�,._,.---�-�- ,..�,-
_ i�,.b12s;-$-<:��;''>, �., ; .,..,='`� ��::::�
�r�ct��c� �m+u�m ssQ.:,�
2. STATE SURCHARC� � ��'�l
x,;,00Q�w���;_$ � r�P.
eQ1� 'ce
3, pOSTACa�$&HAN'bY,YN'�(Only on Mail-In Applications) Q$
4. TOTA�,p��XT���(Add Lines 1-3 Above) r�:�'`::�'�`°;'""��"���' �:�
■ * CONTRACT PRICE or JOB COST means the actual or astimatad dollar amount chargcd for thc
permitted work including materials,labor,profit,and other fixzcl costs. Tt is the amount to be eharged
to the customer for tht'work dont. If any matcrial,equipment,labor or instalIations are furnished by
the owner,tenant or any other parry,the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. In the evcnt that thcre is a dispute on the
amount of the Job cost,thz City may request thc submission of a signed eopy of the aetusl contract.
MECHANICAL PERMIT APP�,ICATYOI�:AG�2EEMENT
The ttndersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in sfict accordance with the ordinanees of the City and the regulations of the State of
Minnesota, and eertifies that all statements m.ade this appiication are complete, true and
correct.
�
Applicant's Signature: � �at,a:� L ��l�'���
�. .....
3
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V� DATE TIME
OF ORONO cnLLED IN � �
INSPECTION NO SCHEDULED
PERMR NO. �0 I y�COMPLETE �
ADDRESS � W6�
O�MINER TELEPHONE NO. �� 7 � ���
r
CONrRACT�OR
� DE8CRIPTION � � � � �� '� �
1y ❑ FOOTING ❑ DEMO-FINAL 0 SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAVKiRADIN(iIFILLIN(i
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑COMPLAINT
Q ❑ FINAI ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OM1N6�lfTRACfOR TO MEET 1fOU:_Y88_NO
� COMMENT�
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� �p19RK SATISFACTORIf:PROCEED ❑PROJECT(�MPLETE
W ❑OORRECT MIORIC t PROCEED ❑ISSUE CERTIRCATE OF OCC�IPY1NC1/
� ❑OORRECT WOF�(.CALL FOR REINSPECTION TEMPORARY
V BEFOqECGVERINO PEAMANENT
O()OFIFiECTUN3AFE00ND1T10NWITHIN �1R3. ❑pHpTOTAKEN
INSPECTOR YVILL RETiniN
O STOP Of�EA P08TED.CALL INSPECTOR ❑qTATION 1.4SUED
O INSPECiION REQIJIRED.CI1LL TO AF�iAN(iE ACCESS.
caN ror n�e next tnspecaon 24 nours tn ad�►snos. (952) 249-4600
on site:
�nspector�_
YVhN�Cop�An�1�'S FlN Ca^�ry Cop�f81N Notla
�iW �
DATE TIME
CITY OF ORONO cnLLED IN � �
INSPECTION N T CE SCHEDULED �_,�!_
PERMIT NO. • � � COMPL �
ADDRESS
OWNER n TELEPHONE NO. a"� —
CONTRACTOR r I ��D�/
� DESCRIPTION / • P �—'
t~i� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�Q ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
��FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
4Q1 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNERICONTRACTOR TO MEET 11�U:_YES_NO
c� COMMENTS:
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� ❑WORKSATISFACTOR`F.PROCEED �WECTCOMPLETE
W O CORRECT VYORK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COMERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION RE(]UIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 2a hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector: �'
YVhite Copyllnspector's File Cenary CopylSke Notke