HomeMy WebLinkAbout2015-00240 - plumbing . CITY OF ORONO * 2 0 1 5 - 0 0 2 4 0 *
�, 2750 KELLEY PARKWAY DATE ISSUED: 02/26/2015
ORONO,MN 55356-
� 952 249-4600 FAX: 952 249-4616
ADDRESS : 2498 SANDSTONE LA
PIN : 33-118-23-I1-0022
LEGAL DESC : STONEBAY
: LOT 019 BLOCK 001
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: 3 WATER CLOSET,4 LAVATORY, 1 BATHTUB,2 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASI�ER,2 SILCOCKS, 1
FLOOR DRAINS,
I LAUNDRY TRAY, 1 WASHER, 1 WATER HEATER, 1 WET BAR
VALUATION OF PLUMBING 12900
APPLICANT PLUMBING FIXTURE FEE 161.25
STATE SURCHARGE PLBG(VALUATION) 6.45
SCHULTIES PLUMBING MAIL-IN FEE 2.00
1521 94TH LANE NE
BLAINE,MN 55449 TOTAL 169.70
(651)786-4007 Payment(s)
Minnesota State License#:plbg-058799PM,mech-MB005379 CHECK 33207 169.70
OWNER
Wooddale Builders Inc
6117 BLUE CIRCLE DR
SUITE 101
MINNETONKA,MN 55343-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. /��
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Applicant Permitee Signature Da e Issued By Sign ure Date
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^ �A T� City of Orono
j�J�y P.O.Box 66 I�ate�ivezi: P`etmii�
2750 Kelley Parkway
Crystal Bay,MN 55323 Ap�Yed 8y: ' Art�utlt$:
(952)249-4600—Main
(952)249-4616—Fax
��',�� ti�`� CITY OF ORONO-PLUMBING PERMIT
'��$►��t` (All Commercial Permits Must be Approved by the State Prior to City Approval)
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GENERAL�UR�ATTG>3�T :
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 return 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 permits may be issued ONLY to licensed plumbing contractors and to properly owners
residing in the dwelling.
4. When any new construction or remodeling is involved,a sepazate 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)
T�P����PE��I't' .,'.
Che�`�.*; :'Th�^�k I .
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need orior aoaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job�ite 1(3wner Informa�i�an:
Site Address: �%�,,�l�r l/.�/ _�c.�' �i�,��D
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Owner: � , Mailing Address: G��7 i�� �/��,���
City: ���.r�����-.�, ��%� Zip: `�:��
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Home Phone: ��7����� Alternate Phone: �""'������
Cantractar Infc�ma�ian•
Contractor: � � � Contact Person: �
Address: State Bond#: �/
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City: ���� Zi��/ Expiration Date:
Phone: `��78�r- L�`L Alternate Phone: `7l�-/�-��
� Insurance-Current: / / a����,�
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet I � Floor Drains
Lavatory / � Sewer Ejector
1
Bathtub / Laundry Tray /
Shower / � Washer /
Kitchen Sink � Water Heater /
Disposal � Water Softener
Dishwasher Wet Baz
�
Sillcocks � Miscellaneous
❑ Yes,this section applies
The replacement of only one Residential fixture or apnliance 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;excludine 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 Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
Y
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
��C./� x.0125$ ��D�07�
(c•ontract price) (minimum SS0.00)
2. STATE SURCHARGE �,
��r��' X.000s $ �. ys
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��p 9. 7�
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the
permitted work including materials,labor,profit,and other fixed costs. It is the amount to be chazged
to the customer for the work done. If any material, equipment, labor or installations aze furnished by
the owner,tenant or any other party,the reasonable mazket value of such items must be added to the
estimated 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
correct.
Applicant's Signature: Date: O � ��
3
�� ATE TI �
CITY OF ORONO CALLED IN ��
INSPECTIO O I�.E SCHEDULED � �
PERMIT NO�U��2-��COMPLETED _
ADDRESS 2 u �� �"���
OWNER TELEPHONE NO. 3-Z���
CONTRACT�R
� DESCRIPTION ��'� � � �l�`�
lL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL �PLUMBING RI ❑ EXCAV/GRf�DING/FILLING
y ❑ FOUNDATION WATERPROOF PLUMBING FINAL ❑ TREE REMUVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINI"
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-Uf�
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVI=R REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATIC>N/REMOVAL
2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO
c�.� COMMENTS:
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W RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑C RECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE Oi°OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WlLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. g�}-2��g-46QQ
OwnerlContractor on site: �
inspector_ �
White Copyllnspector's Ffle Canary CopylSite Notiee
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CITY OF ORONO CALLED IN .2`l E.�� ��
INSPECTION NOTICE SCHEDULED �-��1 -/,h ���
PERMIT NO.�, 5 ' � C MPLET D
ADDRESS a ���r'-�-
OWNER , TELE I��IE NO. li��5l=� �
CONTRACTOR `e ��` �0
� DESCRIPTION � �� 'tiJ
4~j ❑ FOOTING ❑ DE -FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ P MBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF LUMBING FINAL
O ❑ TREE REMOVAL
Z ❑ RADON SLAB MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
� ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERlCONTRACTOR TO MEET Y'OU:_YES_NO
y COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE
� O CORRECT VYORK 8 PROCEED ❑ ISSUE CEHTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED_CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. 52� 249-4���
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice