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� CITY OF ORONO * z 0 1 7 - 0 1 3 6 6 *
2750 KELLEY PARKWAY DATE ISSUED: 10/20/2017
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 570 SANDHILL DR
PIN : 33-118-23-24-0016
LEGAL DESC : ORONO PRESERVE
: LOT 9 BLOCK 1
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (4)WATER CLOSETS(6)LAVATORIES(3)BATHTUB(1)SHOWER(1)KITCHEN SINK(1)DISPOSAL(1)DISHWASHER(2)
SILLCOCKS(1)FLOOR DRAINS(1)LAUNDRY TRAY(1)WASHER(1)WATER HEATER
VALUATION OF PLUMBING 17484
APPLICANT PLUMBING FIXTURE FEE 218.55
STATE SURCHARGE PLBG(VALUATION) 8.74
SABRE PLUMBING&HEATING MAIL-IN FEE 2.00
15535 MEDINA ROAD
PLYMOUT'H,MN 55447- TOTAL 229.29
(763)473-2267 Payment(s)
Minnesota State License#:mech-MB3392,p1bg-PC645349 CREDIT CARD 7681 229.29
OWNER
OPS Orono LLC
15250 WAYZATA BLUD#101
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
pertnits. 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 consttuction authorized is not
commenced within 180 days of the date of issuance,or if conswction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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�Applicant Permitee Signature Date Issued By Signature Date
�4/19/2017 TxU 15: 29 sAx 763 a73 8565 Sabre xe�ting & Air Cond f�042/407
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�u.(,��.� (952)249•4Gqp- M�w� -- --•-• --•-_
�i.y�.� (952)2A9-461 b-T�nx
CX'T'Y OF QR4N0 — PLUMBING 1'k��M�'!`
(All Commercial Permits Must be Approved by the Sfate 1'rior to City Appsoval)
ht :/w �.dCi,mn. c►��/ �:f'LU/PDI�/�e lwnb�laurer•o .idf
GLNERAL 1NFORMAT3,ON _..._..�„�„ �,�,�,��
�, You ma,y aUply fur plumbi��g pamits by n�il or in perso►�at the City offices. Applications will be
reviewed at�,d a.peamit will be issued within twp workin�days.
2. permit cards will be sent by return mail a£ter a review is completed. PE�tMY.TS A1tL N'OT
' VALID UNTII.YOLJ R�C'BTVE A Y'ERMIT. WORK N�UST�iOT BEG11�T U1V'1`Yx,lY�]s`
pERN�T CA�p_IS POSTFD QN TIiL JOB SIT�.
3. �lumbing pennits may be issued ONLY to lieensed plumbing co;nSractors at�d to properry owners
residing in�he dwelling. .
4. vVhen an,y oew construction or remodeling is involvad,a separate building permit n�ust be
obtained
5. �►1[work must be done in accordance with State Code roquirements. �
' 6. All work must be inspected and air tested before it is covered, C�a11(952)249-4600.
� (24-48 hou�•notice��equired)
T�C�'E OF PERMIT
Check All That A 1 �
[�Residential ❑Commercial(Approval Required) �
[�Naw ❑Additional ❑Repa.irs �Replacc�
❑ In Accessory 5truct�ue7
*Yqu will ueod uri�r snnroval and may need(•�.(Pe�Orano C:ity Codq Chapter 78,Article I�
Job Sif,e/Uwncm Info�ma�on:
Site Add�ress: V
� Owner: Mailing Address:
City: Zip: �
Home Phone: Alternate Phonc: �
Contractor�Tnforma�ion�
Contractor: r ' 9� Contact Person.: J�/t�l �_
Address: 15535 ��„�d State Doz�d#: � �CV�53�9 �
City: .I Zip:�r��'� Expiration Date: � �Z
PI�oz�e: "�a����1�•2Z1.� .A.�tP.Tnd[8 P110i1C: Iv�•Z�3 •�7�'� .
� � �taSUTFi11C8—Clt17L1]l': � �
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:0/19/2417 THU 15: 29 FF►x 763 a73 8565 Sabre Hedting 6 Air Cond �403/007
r+1X7'CJRI± BSM'T ! 2 OTl�R 17I�GTUR13 RSMT 1 2 ()TfiFil.t
'r"Y�E FL �L TYPF r1, n1,
Water Cioset � � �loor Drains �W�~ �
�'
I.avntory 1 � 5ewer Ejector
1
Bathtub � Lau�id�y Tray I
Shower ` Washer
Kitchen Sipk 1 Water Heater � �.. .. "�.�
1)iSpo5a1 ' WAier$OftenBr+ �
Dishwasher ' � Wet Bar
Sillcock� � 1Viisccllaneous
❑ Yeg,this section applies
The replacemcnt of anly one Residentiai�xtura or apnliAnc.�tha#mcets all xhree of the foilowing
requirements:
l. Doos not roquire modification to olaci,ticfl.l or gas se�vice,
Z. Has a total c�rt of$500.00 or les&;exclud9n►the cost oE t3�e f xture or appliancs:and
3. Ts improved,installect or replaced try the homeownor or licansed plumbing co�ntractor.
Skip nsxt section,if t6is applies; Cosc of�ermit $ 15.00
State Surcharge $ 5.00
N�ail-L�Fee(If Applicabte) �,�,2�0
Tou�l permit Fce S
(Pernnit Feca Corttuiucd Oa Nea�t�age}
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S�p/19/2017 TxU 15: 29 FAx 763 a73 8565 Sabre Heeting 6.Air Cond �00�/007
If'abo�ve does nocapply;follow�uidelines below;
1 CON�tACT PRIC� "i� 1.25%of caiiU'act price wit1�a(M'iui�num i+ee of S50.�0)
��:1�.. . .. x,Ul25S ��S�rJS _ .
(wnlriu:l piiu:) (minimunt$50 OU)
z. srAr�sr�ac�c�
� I`1�l k�• 35 x.000s $_.. , $��#�....�
(�o»trac�p�i,ce)
� 3. ,PUSTAG�&HANDLING(O�ily on Mail-In Applications) �2.00 ,
4. TOTAI,PF,RM�T���(A,dd�-ines l-3 Above) S �����-.
• * CON'�AC'�PRICE or JOB COST means the actval or estimated dollar amaunc char�ed for the
permitted work including materials,labor,profit,and other fixed cosls. It is the amount to be ck�arged
to the customer for the work done. Tf any mataial,eyuipment,labor or installa�ions are funiished by
the owner, temant or any o�th�party,the reasooable markcc value oF such items must be added to the
estimated cost a coatract price for permit fee pwpases. xn the en+er�that ihere is a dispute on the
smourn of thcs job cost, the City may request tho submission of a si�gned capy o£tltie actual contract,
'The undersigned l�ereby applies to the City for issu�nce o£a Plumbing Peimit, agrees to dp alX
work is� sh�ct accordFsnce witi� the ordin�ances o�'tho City and the regulations of, the State of
Miu�osota, and cert�es thai a11 stat�mernts mads oz� this applieation are comptete, true and
cotrect.
Appl.icant's Signatiu•e: d�(aMa�n,v lJ ,__ Aatc:__ �0-I 9•Zp I'y
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V DATE TIME V
� CITY OF ORONO CALLED IN
INBPECTION�lO E scHeouLED � �
PERMIT NO.�IJ� " �I COMP E
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O'WNER TELEPHONE NO. ' �
CONTRACTOR �
� DESCRIPTION �' �
1y ❑ FOOTIN(i ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL �PLUMBING RI � EXCAVK3RADIN(i/FILLINO
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB � MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPUICE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
� T�MEET YOU:_YES_NO
y COMMENT�
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� �Sp�RK SATISFACTORY:PROCEED O PROJECT COMPLETE
W ❑OOf�iECT WOfi1C 8 PROCEED ❑ISSUE CERTIFICATE OF OOCUPANCII
0 ❑C�iECT YMOFiK,C/1LL FOR HEINSPECTION TEMPORARY
V BEFORE CWERINO PERMANBdT
❑C�OF�iECT UNSAFE CONdT10N YYITHIN HOl1R3. ❑pHpTO TAKEN
INSPEC7OR 1MLL REI'URN
O STOP ORDER POSTED.CALL INSPECT�i ❑dTATION ISSUED
❑INSPEC110N REQUIRED.C/►LL TO ARRAN(�E ACCESS.
c.M�n����s�ctro��no�a,��,os. (952) 249-4600
o�site:
��;��il!n � _
Whib CuPY��1�FlN ��ry��
�� DATE TIME
CITY OF ORONO cnLLED IN
INSPECTION NOTICE SCHEDULED - D/7 � C�
PERMIT NO.o�(���f 3�o�O OMPLETE
ADDRESS �/O �S� �I' ��
OWNER TELEPHONE NO.��a� <�D'���
CONTRACTOR ��C1- /�._ ,RG�',LG2_..
� DESCRIPTION �/
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL $PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNERK:ONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� I'� � e �l�b�!i'�"+'O/1� I�cL` � !��2'��e �'v1�`
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W ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
� �CORRECT WORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT VYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECO�VERINCa PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP OR�ER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952) 249-4600
OwneNCorrtractor on site:
Inspector: T S���,L___2
White Copyllnspector's File C�nary CopylSite Notice