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Home My WebLink About2012-00129 - plumbing � CITY OF ORONO PERMIT NO.: 20��00129 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 02/14/2012 952 249-4600 FAX: 952 249-4616 ADDRESS : 2900 DEER RUN TR PIN : 04-117-23-24-0013 LEGA•L DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 008 BLOCK 004 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: PLUMBING FIXTURES: (2)WATER CLOSET,(3)LAVATORIES,(1)BATHTUB,(1)SHOWER,(2)SILLCOCKS,(1)FLOOR DRAIN,(1)SEWER EJECTOR, (1)LALINDRY TRAY,(1)WASHER AND(1)MISCELLANEOUS VALUATION OF PLUMBING 6850 APPLICANT PLUMBING FIXTURE FEE 85.63 MANATEE PLUMBING STATE SURCHARGE PLBG(VALUATION) 3.43 11525 199TH CIRCLE SILVER LAKE,MN 55381- TOTAL 89.06 (612)756-1172 Minnesota State License#:005923PM OWNER KACZKE,ROBERT&JILL 2900 DEER RLJN TR LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This pertnit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be oked at any time for due use. al l � l/ G�� O�l � l � Applicant P itee Signature � Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � + � " . � ; �R�'3II�?��5�°�NL'� �; ` � City of Orono ` � �g' �''� P.o.soX 66 z�a�� '�� ,��#��. ;�, `C90�" 2750 Kelley Parkway � � � p � � Crystal Bay,MN 55323 �1�rc�vetl�� ,�Amount�$. � ; (952)249-4600—Main � ` ��,. � (952)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://www.dli.mn. ov/CCLD/PDF/ e lumb lanreva . df >��f�R�,�'�IOi�I �� .� � � � � ,: � , � � . , � � a � , .; 1. You may apply for plumbing 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 retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pemuts may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 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 State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) `i'��'E Q�PER�TT . J�: �5' "�4i y 5,,. c { � ..> ��C�� ',`�1i3't� c � �'�, �Residential ❑Commercial(Approval Required) ❑New �dditional ❑Repairs ❑Replace ❑ In Accessory Structure? *You will need nrior aauroval and may need CUP. (Per Orono City Code,Chapter 78,Article N) '�o�i.��e/Owner�Eo�m�i�an �; �.°"�� ; Site Address: ��a�"� (J�� r rret� 1 Owner: Mailing Address: City: �r e�� Zip: Home Phone: Alternate Phone: ��ontr��tar��r��on:; Contractor: CYk'tir��taeQ ��vvr��,i v�� Contact Person: �0�j ��p P Address: `15�S I `�°I�� C i Y�1-P State Bond#: �C �o'-t`��{ � (p City: ��Y �� 1Lc Zip�3�, Expiration Date: � a ��J 1� � 3 Phone: (Q �`, -�5 6r (�`7`�. Alternate Phone: ❑ Insurance—Current: 1 , � , � FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet � � Floor Drains � Lavatory � � Sewer Ejector I Bathtub � Laundry Tray � Shower I Washer � Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks � Miscellaneous I ❑ Yes,this secrion applies The replacement of only one Residenrial 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 or replaced by the homeowner or licensed plumbing contractor. Skip next section,if this applies; Cost of Pemut $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Negt Page) 2 , � If above does not apply;follow guidelines below: l. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) �.D� �� x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * 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 furnished by the owner, tenant or any other pariy, the reasonable market value of such items must be added to the esrimated 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 undersigned hereby applies to the City for issuance of a Plumbing 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 conect. Applicant's Signature: Date: � — l y � � �_ 3 ��/D �`�'�" � TE TIME " CITY OF ORONO CALLED IN ��' INSPECTION OTICE SCHEDULED y � PERMIT NO.�o�a oo�z9 COMPLETED ADDRESS � ��"r� . OWNER T EPHONE NOYJ�� '7��""`�Z�"�- CONTRACTO / �_ � � � DESCRIPTION � ❑ FOOTING � PLUMBING N L ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANI I ❑ LAKESHORENVETLANDS 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C J �� O � O � W � Q � 2 W � W � � � �QAK SATtSFACTORY:PROCEED ❑PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CAI.L FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT O CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN INSPECTOR WFIL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTIOIJ REQUIRED.CALLTO ARRANGE ACCESS. Ca�l tor the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on sit • Inspector. �-f �,..�,�j � White CopyllnspectoPs File Canary CopylSite Notice � `lDATF� TIME - / CITY OF ORONO CALLED IN � �� INSPECTION NOT CE��ZG'�SCHEDULED �Z :o0 PERMIT NO d�I�^ /COMPLETED ADDRESS Z.gGI� I� / /' OWNER TELE pNE NO.�f Z 7S� ��Z CONTRACTOR��1 �[ �'�� • � DESCRIPTION ��tGt.G P/u n�h� n � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/G ING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ � DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W a � ' � °s��o�� c � o cS � ,.o � c� c -� c� '' =�, � c,s�-t�" H �� t-,c,i" � ° vtf- Q r � -- �"G� �..r��.�� W � Q � 2 W � W � � � ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLEfE W(�"B�QRRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�VERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner►Contractor on site: Inspector. _ White Copyllnspector's File Canary Copy/Site Notice �