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CITY OF ORONO II 11 II1111 <br /> 111 II 1111 II 11 II <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/16/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 364 WESTLAKE ST <br /> PIN : 05-117-23-23-0043 <br /> LEGAL DESC : HILLSIDE PARK <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 28,400.00 <br /> NOTE: 1 HEATILATOR HEIR 42T <br /> I HEAT N GLO RED4O-NM <br /> I HEAT N GLO SLR-C <br /> I HEATILATOR CNXT4236IT <br /> I HEAT N GLO SALARI 536-ST <br /> APPLICANT MECHANICAL 355.00 <br /> STATE SURCHARGE MECH(VALUATION) 14.20 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 MISC FEE 0.00 <br /> (651)633-2561 TOTAL 371.20 <br /> Minnesota State License#: mech-20512060 Payment(s) <br /> CHECK 2004506 371.20 <br /> OWNER <br /> Identisys, Inc. <br /> SHIELDS TRUSTEES,JANELLE K&MICHAEL R <br /> 7630 COMMERCE WAY <br /> EDEN PRAIRIE, MN 55344- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> 34/ <br /> Applicant Permitee Signature Dale Issued By S' iature ?AAP Date <br />