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Home My WebLink About2011-01550 - water heater CITY OF ORONO PERMIT NO.: 2011-01550 � ' 2750 KELLEY PARKWAY - ORONO,MN 55356- DATE ISSUED: 1?✓14/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1670 SHADYWOOD RD PIN : 17-117-23-21-0015 LEGAL DESC : SHADY-WOOD : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(<$500) 5.00 3670 DODD ROAD-SUITE 100 EAGAN,MN 55123- MAIL-IN FEE 2.00 O TOTAL 22.00 Minnesota State License#: 61770PM OWNER KIELLEY,DONALD&ARLENE 1670 SHADYWOOD RD WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Buildi�g Code.This permit may be revoked at any time for due cause �.,� / / / L�/� ,,� � Applicant Permitee Signature Date � / Issued By Signat Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ` ♦ Q City Of OCOnO FOR CIT'Y USE ONLY '¢' � P.O.Box 66 � � Date Received: Permit# � 2750 Kelley Parkway � ".} "' �: Crystal Bay,MN 55323 A roved B t < PP Y Amount$: ��k��p��,�;, (952)249-4600—Main _ (9��)249-4616—Fax CITY OF ORONO —PLUM�ING PERMI'T (All Commercial Permits Must be Approved by the State Prior to City Approval) r�',_."�CEIVED '�t£�:11��w.tlEi.r�n.Ro��/CCL�lP��/ e lun�l� ian�•ev� . . c�f GENERAL INFORMATION - - `' , '� � 20�� 1. You may apply for plumbing permits by mail or in person at the City offices. Applications willj�G reviewed and a permit will be issued within two working days. C,IT�Y Jr �RONO 2. Permit cards will be sent by return mail after a review is completed. PERMTTS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERIVIIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pemiits 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 1 `�Residential ❑Commercial(Approval Required) ❑ New ❑Additional ❑Repairs �eplace ❑ In Accessory Structure? *You will need prior annroval and may need CLP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: w � , Owner: I ) Mailing Address: S�LYY�� c�ty: Z;p; `'j�j3� � Home Phone: Z '� Alternate Phone: Contractor Information: Contractor: Contact Person: � � 5 amp on iur�l�fng Address: # 6177Q-pM State Bond#: 3670 Dod City: Fanan nen��i��_ Expiration Date: Phone: Alternate Phone: ❑ Insurance—Current: I I �� 3� �° ' , . PLIJM�3Il�1�.�T�'�;7R;�S'B��N�''r�2TI�'�'$A�:.L�� : -_ .: FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater � Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous � PE�N1�T��CA�.C��TIQ1�7�S�� n� �� "�.� �, BASED-O�'F`=20�2`ST,�,.TE.��i'T`C��. ��.�.�: �:��`... �.F< ° `�. "<. � Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three of the following requirements: l. 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. Sl:ip 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 � � PERMIT F�E+CAT�C�I,A'TION S "-W=��S��V��t$500:t�0 : :;" If above does not apply;follow guidelines below: l. CONTRACT PR10E '�is ].25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCRARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of�5.00) x.0005 $ (contract price) (minimum S 5.00) 3. POSTAGE&�-IANDLING(Only on Maii-In Applications) $ 2.00 4. TOTAIL P�RMIT PEE(Add Lines 1-3 Above) $ ' * 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 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 sig�ed copy of the actual contract. • **The STATE SURCHARGE is.0005 ofthe contract price under$1,000,000 or$5.00—whichever is g�reater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. .` - ; PLUIV�B�i�PER1��`AP'PLTC�.Ti�1��:A:GK��11�1�I�;` ' . � s_: � ,. � � . „ � � �., . 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 ce�tifies that all statements made on this application are complete, true and correct. Applicant's Signature: — Date: �Z� _I � � � —r--�— � Res�t Form 3 l..-�� DATE TIME CITY OF ORONO � CALLED 1N ' � � INSPECTION NOTICE SCHEDULED l 9-' �5 �f 3 a PERMIT NO. ��D/�Sb COMPLETED ADDRESS ��O �b o��a-.�Si v�`� �� OWNER �� TEL PHONE NO. �/S'L"-t�7f`7ob� CONTRACTOR � >; DESCRIPTION ��-�%� � � ❑ FOOTING �LUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z 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 �G RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � WNE ONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W 4 � J O �. � O � W � Q � 2 W � W � � � � ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR u CITATION ISSUED G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952� 249-46�� Owner/Contractor on site: Inspector. P/ b �� White Copyllnspector's File Canary CopylSite Notice