HomeMy WebLinkAbout2003-P06970 - gas fireplace PERMIT
.�ITY OF ORONO permit Number:
2750 Kelley Parkway- PO Box 66 P06970
Crystal Bay, Minnesota 55323 Permit Type: Me�h��al Pe��
(952) 249-4600 Date Issued: iii3i2oo3
SITE ADDRESS: 2655 Pheasant Rd
Fxcelsor,MN55331
P I D: 21-117-2 3-2 3-0005
DESCRIPTION:
Proposed Use: Residential
Pernrit Class: General
Pemut Type: Mechanical Pemuts Permit Sub-type(s): Gas Fireplace
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 2,497.00
State Surcharge Fee: $ 1.25
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.75
APPLICANT' Automatic Garage Door&Fireplace(See C OWNER: James&Cheryl Johnson
� 9210 Wyoming Ave.No. 2655 Pheasant Rd
Brooklyn Park,MN 55445 Excelsior,MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENT'S SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
`'h(a,�.Q —�'��
APPLICANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Atrolicant 1-Monthlv Reports, 1-Assessin¢, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PE�����ED
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323 ��nV u 3 2003
GENERAL INFORMATION ��T��F ORO(�(0
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 RECENE A PERMIT. WORK MUST NOT BEGiN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical DesiQns-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, Pquipment ratings and identification as to type, manufacturer and
model. Data shall ne presented on form providea. 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
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
(952) 249-4600.
Please check one: ❑ New ❑ Addition ❑ Repair �Replace [�Residential ❑ Commercial
JOB SITE: �Cp55 � Q � �oc.�c1 z�P: 5�33r1
Owner's Name: !�,L�rnQ�3- C�,,..,,,I? ;�-�i,,,,.,r,�,Phone Number: ��- y�+ � ��y a,
Mailing Address: ��,�.4� � City: Zip:
Contractor's Name: ��,�,�-F'�;,,�„-,,,E� Phone Number: `��n3-3i 5-")S�b
Mailing Address�.Ip l,%C�� Q�,.� t.� City:�j��:,,��-,-, F'u.t,c.-, Zip: 55�-1�/5
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SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity: I
Make: �t�Q�,],Cyr
Model: S��`r�-3d
Fuel: ��
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
ModeL•
Tons:
H.Power
FIREPLACES
�Gas factory fireplace — �� -9s:—�
❑ Wood burning factory firepUlace with ue
❑ Wood Stove
❑ Wood stove with flue
Brand Name P�C�v�r�> Model No. 5\�`�-���.�L�
VEIi]TILATIC�N
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 FIIZE MARSHAL)
❑ Installation or ❑ Removal
❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside
❑ LP Gas: gallons
[�Other �11,,.,-hc:,.c-�.n �� Gas opening
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PERMIT FEE CALCULATION(S)
2002 State Statute ❑ Yes This Section Applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1) Does not require modification to electrical or gas service.
2) Has a total cost of$500.00 or less; excludin�the cost of the fixture or appliance:
and
3) Is improved, installed ar 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 apply, follow guidelines below:
1. Contract Price* is .0125% of job with a Minimum Fee of($35.00)
� �'������ x .0125 $ ���:��Q
(contract price) (minimum$35.00)
2. State Surchar�e. ** Add the State Building Code Division a Minimum Fee of($ .50)
x .0005 $ 1 .� J
(contract price) (minimum$.50)
3. Posta�e and Handlin�(Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ��,��j
*CONTRACT PRICE or JOB COST means[he 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 instailation is fumished by the owner,tenant er any other party the reasonable market value of such items
must be added[o 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.000�of the contract price under$1,000,000 or$.50-whichever is greater.For valuations over
$I,000,000 cail the Department of Inspectional Services for the price.
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 Minnesota State Building Code,and certifies that all statements made on this
appfication are complete,tr�e and correct.
Applicant's Signature: �1\,i�1 ��n�.rYr-�,�,-r� Date: � G �3�
Approved By: Date:
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