HomeMy WebLinkAbout2010-00228 - gas fireplace CITY OF ORONO PERMIT NO.: 2oiaoo22s
2750 KELLEY PARKWAY
A
ORONO, MN 55356- DATE ISSUED: 04/14/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2600 PHEASANT RD
PIN : 21-117-23-23-0023
LEGAL DESC : PHEASANT LAWN
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 2,000.00
NOTE: HEAT N GLO 6000 CL GAS FIREPLACE
APPLICANT 1VIECHANICAL 50.00
FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 1.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 MAIL-IN FEE 2.00
(651)633-2561 MISC FEE 0.00
Minnesota State License#:20512060 TOTAL 53.00
OWNER
HADDEN,TIMOTHY&JULIANN
2600 PHEASANT RD
EXCELSIOR,MN 55331-
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.
l l C�/�,' `�l>`�`�' l l
Applicant Permitee Signature Date Issued By ' ature ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV .
.
FOR CITY USE ONLY
¢��: City of Orono
O O p'O'B°x 66 Dafe Received: Permit#
2750 Ke�ley Parkway
. � t'�s• !� Crystal Bay,MN 55323 Approved By: Amount S:
;"' ;� . o�� 952 249-4600
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CITY OF ORONO—MECHANICAL PERMIT
(Ali 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 1S POSTED ON THE JOB S1TE.
3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation inctuding
heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on forcn 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 finai.
TYPE OF PERMIT
(Check All That A 1 )
�Residential �Commercial(Approvat Required)
�New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: ��Q v?� �{�ea�,c�n � �� .
Owner: ��i r.(�Jl i ^ Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: Contact Person: • s,inc.
� dba Fireside Hearth & Home
Address: State Bond#: �icense 2os12oso
Rosevilfe, MN 55113
City: Zip: Expiration Date: 651/633-2561
Phone: Alternate Phone:
❑ Insurance—Current:
1
MECHANICAL SYSTEMS BEING INSTALLED
, Note: All Geothermal Systems will now require 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: �t K�r�(a�O
Wood Burning Fireplace
B Wood Stove Model No.: �plrYl� C�.
❑ Wood Stove With Flue
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall ijproposing to abandon tank in plac�)
❑ Instailation � Removal
Fuel Oil: galions ❑ Underground � Inside �Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill (� Other!List What& Where:
2
�
� PERMIT FEE CALCULATION(S)
BASED OFF -2002 STATE STATUE
❑ Yes,this section applies
'The replacement of a Residential fixture or ap lp lanCe that meets all three of the following requirements:
1. Dces not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine 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 Surchazge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION S -JOBS OVER$500.00
lf above dces not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
/��� . � x.0125$ ,sd.v[�
(contract pnce) (minimum 550.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surchazge(Minimum Fee of S_50)
�(N!0•� x.0005 $ �. �U
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S ,s3-Vv
■ * 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 fumished 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 Building Department at(952)249-4600 for the price.
MECHANICAL PERMIT APPLICATION AGREEMENT
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 certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: �.�� Date: �/ v
Reset Form
3
� D T TIME �/
CITY OF ORONO CALLED IN � ��
INSPECTION OTICE SCHEDULED �( — � �
PERMIT NO. �' D�� COMPLETED
ADDRESS a6d0 (�/C�G��-�.� �
OWNER TELEPHONE NO.��2 'S9� r2�JZ'2
CONTRACTOR L� -S
>; DESCRIPTION �
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��ECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContractor on site:
Inspector. �✓ iy�_S
White Copylinspector's File Canary CopylSite Notice
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p F�/D TIME
CITY OF ORONO CALLED IN � �
INSPECTION I�QTI�E_„�p, SCHEDULED
PERMIT NO.�J� GTJ Y MPLETED
ADDRESS
OWNER � TEL ONE NO. �� �
CONTRACTOR ��/�'�'-"
>; DESCRIPTION ��
�
l4 ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
�
O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTfONRE�UIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice