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JUMMIENERM <br /> CITY OF ORONO * 2 0 1 6 - 0 1 4 9 2 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/29/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS 220 NORTHGATE RD <br /> PIN 36-118-23-41-0051 <br /> LEGAL DESC NORTHGATE TWO <br /> LOT 001 BLOCK 007 <br /> PERMIT TYPE MECHANICAL <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIREPLACE-GAS <br /> VALUATION $ 13,196.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> ADDITIONAL:3 GAS FIREPLACES(HHT) <br /> APPLICANT MECHANICAL 164.95 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 6.60 <br /> 2700 FAIRVIEW AVE MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 173.55 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 173.55 <br /> OWNER <br /> DAU,EDWARD&MICHELL <br /> 220 NORTHGATE RD <br /> WAYZATA,MN 55391- <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. yl , <br /> 2&/ <br /> Applicant Permitee Signature Date Issued By Signature Date <br />