HomeMy WebLinkAbout2004-P07849 - plumbing PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07849
Crystal Bay, Minnesota 55323 Permit Type: FiX�ures
(952) 249-4600 Date Issued: g�2o�2004
SITE ADDRESS: 2482 Sandstone La
L.ong L.ake,MN 55356
PID: 33-118-23-11-0025
DESCRIPTION:
Proposed Use: xesidential
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures
DE7AILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 90.00 Valuation: $ 7,200.00
State Surcharge Fee: $ 3.60
TOTAL FEE: $ 93.60
APPLICANT: Thoen Plumbing Service, Inc. OWNER: Dahlstrom Development LLC
2605 Campus Drive 7745 Polaris Lane
Plymouth,MN 55441 Maple Grove,MN 553ll
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI-IE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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ARPT.ICANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1
08/18/2004 09:19 FA% 763 591 6071 IVERSON ��8y 9 l�004
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CTTY OF ORONO APPLICATION FOR PLUI�ING PERMIT
Box 66 (2750 Kelley Parkway)
Crystai Bay, MN 55323
rENERAi.II�iFORMATION
1. � You may apply for plumbing permits by mail or in persoa at the City offices. �
Z. 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 PERMIIT CARD IS POSTED ON
�'�E JO� SITE.
3. Plumbiag permits may be issued ONLY to licensed plumbing contractors and to property owners residing
ia the dwelling.
4. When aay new coastructioa or remodeling is iavolved, a separate building permit must be obtair�ed. .
S. All work must be done in accordance with the State Code requirements.
!6. AII work must be inspected and air tested before it is covered. Call (952) 249�600. 24-hour notice
required.
Instructions Complete all items on this applicarion. Compute the permit fee. Sign and date the
�ertification. 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: �.. c Zip: �
Owner's Name: o � ����.�cc Nar►�e�, Telephone Number: .
Mailing Address: City: Zip:
Cou�ractor's Name: 't'1�cEr� Pl v�-.l���� � �,� Telephone Number: �i SZ-��y S'3�
Mailing Address: ?-io[� C��v: �2 City:_p�,y,,x,� Zip: S'9./�{/
PLiTMBING FIXTURE SCHEDUI,E
. FIXTURE B5MT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTH�R
TYPE FL FL TYPE FL FL�
Water Closet � Floor Drains �
Lavato � � Sewer E'ector
Bathtub � � Laun Tra
Shower Washer �
Kitchen Sink ! Watec Heater �
D' sal � water Softener
Dishwasher Wet Bar I •
Sillcucks Misc liat
08/18/2004 09:19 FAR 763 591 6071 IVERSON [�005
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��IT FEE CALCULATInN(c� ��Z �,� ��-�o+�. ���
2002 State Statute Q Yes, This Section Applies
The replacement of a Residential �Yn��e�R li n that meets all three of the following •
requirements:
1) Does not require modification to electrical or gas servi�e.
2) Has a total cost of$500.00 or less; �cludinQ the cost of the fixture or applia.nce:
and
3) Is improved, installed or replaced by the homeowner or licenced contractor.
Skip next section; Cost of Permit $ _ 15.00
State Surcharge � .50
Mail In Fee S _ 1.50
If above does not apply, follow guidelines below:
1. Contract Price* is .0125 % of job with a D��um Fee of(�3� 001 ,
_ ��� � � .x .0125 S
(contract price) (minimum$35.00)
2. �te Surcharge. ** Add the State Building Code Division a �iinimum Fee of$ .50)
720 0 � x .0005 S
(coatract price) (minimum$ .50)
3. Posta�e and Handline (Only mail-ici applications) S 1.50
4. TOTAL PERNIIT FEE (Add lines 1-3 above) S
* CONTRACT PRICE or JOB COST means the actuat or estimated dollar atnou�t charged for the permitted
' work including materiats,labor,pmfic,and other fixed costs. It is the amouat to be charged to the customer
for the work doae. If any material, equip�nent, labor.or installation are furnis�ed by the owner, tenant or
any other parry the reasanable market value of such items must be added to t�r estimated cost or contract
price for permit fee purposes. In the event that there is a dispute on the amouni of the job cost,ihe Ciry may
request the submission of a signed copy of the actual conuact.
** The STATE SURCHARGE is.000S of the contract price under$1,000�000 or 5.50 -wluchever is greater.
For valuations over$1.000,000 ea[1 the Depaztment of InspecNon Services for rl�e price. .
. 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 re�ulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
.
Applicant's Signatur Date: �'C8�
�/� � DATE TIME ✓
CITY OF ORONO CALLED IN 2���
INSPECTION NO ICE SCHEDULED '" �-�`� �!�
PERMIT NO. O COMPLETED
ADDRESS � �4 � �{�
OWNER CONTR. �c?/7 /��CJ
TELEPHONE NO. Q-�a `7 y7� �SJ�1
� DESCRIPTION ��L�� ���"
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 D 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 9 PLUMBING 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PL FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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0 ❑ CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL 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
OwnerlContra site:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice
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CITY OF ORONO � CqLLED IN ��-'' l�' �'��
INSPECTION �r +�DULED I � `.�'
PERMIT NO. ��� 1 COMPLETED � �km
ADDRESS Z�'O��J� �9`-'�c�J�i�-c � G/�'�
OWNER CONTR. ���'� �"� ���-��
TELEPHONE NO. �i:(3- . ��� '� 3 Z-`�`C
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� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 1 XCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
=c�NC� 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑ CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALlTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on sit :
Inspector��.�iT/ll��
White Copyllnspector's File Canary CopylSite Notice
�'1i� (,�.,1�1 ��'�e.�
�! DATE TIME
CITY OF ORONO CALLED IN �'� ��U�
INSPECTION N ICE . .� SCHEDULED f -�� %/:�'C�A�rI/I
PERMIT NO. � � COMPLETED
ADDRESS � C� � ' ' �' `
OWNER CONTR. I�10 C4�7 G'�.
TELEPHONE NO.���� o � - ��`�N
� DESCRIPTION t'� ���� SX3�-�-T—
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lV 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
h
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLU 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J PLUMB FINA 36 FOUNDATION/REMOVAL
� OW CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTIOtJ REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on sit -
Inspector. l/ � � ��,
White Copyllnspector's File Canary CopylSite Notice