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Home My WebLink About2011-00904 - plumbing s ' ' CITY OF ORONO PERMIT IvO.: 2011-00904 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUEn: 08/22/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2540 SANDSTONE LA PIN : 33-118-23-11-0016 LEGAL DESC : STONEBAY : LOT 013 BLOCK 001 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RES(DENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: COMPLETING PLUMBING- SGTTING FIXTURES-ORIGINAL CON"CRACTOR DID NOT FINIS}i JOB (3)WATER CLOSETS,(4)LAVATORIES,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER,(1)LAUNDRY TRAY (1)WASHER AND(1)WATER HEATER VALUATION OF PLUMBING 3000 APPLICANT PLUMB[NG FIXTURE FEE 50.00 K& S PLUMBING LLC STATE SURCHARGE PLBG(VALUATION) 1.50 9572 KNOX AVE.N. TOTAL 51.50 BROOKLYN PARK, MN 55444- (763)425-8760 Minnesota State License#: 065380-PM OWNER O.T. Development,LLC 10300 IOTH AVE.N. PLYMOUTH, MN 55441- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspec[ions are requested i nformance with the State Building Code.This permit may be revoked a tim r u ause. � / � ��a � i -� B��aa�� Applicant Permitee Signature Date �� Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . � FOR TY SE ONLY � //,¢p��, City of Orono � aD//-�� / P.O.Box 66 Date Received Z Permit# '1��;,., �` 2750 Kelley Parkway �"/ .C" �� p�'� t�; Crystal Bay,MN 55323 Approved By: Amount$: �� J ��.i.'p�u�� (952)249-4600—Main ��'taso� 952 249-4616—Fax �� ( ) CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://ww�w.d(i.mn.Qo��/CCLD/PDF/ e lumb�lanreva . cif GENERAL iNFORMATION 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 RECENE A PERM[T. WORK MUST NOT BEGIN UNT[L THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits 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) TYPE OF PERMIT (Check All That A ly) �Residential ❑Commercial(Approval Required) �New ❑ Additional ❑ Repairs ❑ Replace ❑ [n Accessory Structure? *You will need arior approval and may need(_l P.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: O� �� 5�-+�C �• Owner: Mailing Address: City: ��.a>�j Zip: Home Phone: Alternate Phone: Contractor lnformation: t, � C �- Contractor: F�� l�►'�Qi� Contact Person: �.Y��/� Address: �►S`�o� ��dx �v�/�� State Bond#: City: ��'�-�f/ .tJ �� Zip:.t`s�/�{ Expiration Date: Phone: �6.�' �3�'�s��`� Alternate Phone: �6��{�.1��7(d ❑ Insurance—Current: 1 PLUMBING FIXTURES BE1NG INSTALLED FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT l T 2ND OT[-�R TYPE FL FL TYPE FL FL Water Closet ` � Floor Drains � Lavatory i � Sewer Ejector [ Bathtub � Laundry Tray � Shower � Washer f l Kitchen Sink � Water Heater ' Disposal Water Softener Dishwasher � Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential 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;excludinQ the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next section,ifthis 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 PERMIT FEE CALCULATION(S)-JOBS OVER$500.00 [f above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) � � .��i � x.0125 $ (contract price) (minimum$50.00) 2. STATESURCHARGE x .0005 $ (contract price) 3. POSTAGE& HANDLING(Only on Mai(-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 party, the reasonable market 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. PLUMBING PERMIT APPLICATION AGREEMENT 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: �� ( Reset Form 3 � �� 9ATE TIME I Y OF ORONO CALLED IN �/Z3 1( INSPECTION NOTICE SCHEDULED � —� PERMIT NO. �� —�� COMPLETED ADDRESS Z j�l C' S� ��S�� C.� OWNER TELEPHONE NO.��' �J a'� ��3T CONTRACTOR , �� ` >; DESCRIPTION ( / �-m b i Y1Cl �7 �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ 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 _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTiC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W a � � �� '' �� _ -� �✓C c�+�n� �._,� S (� ��d�-�� 0 � W � Q � z w � W � � GW r'�JB(QRK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEM PORARY V BEFORECOVERING PERMANENT ❑CdRRECTUNSAFECONDITIONWITHIN 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. (g52) 249-46�� OwnerlContractor on site: Inspector. �� White Copyllnspector's File Canary CopylSite Notice