HomeMy WebLinkAbout2015-01319 - plumbing CITY OF ORONO � 1 5 - 0 1 3 1 9 *
« 2750 KELLEY PARKWAY DATE ISSUED: 10/12/2015
ORONO,MN 55356-
# 952 249-4600 FAX: 952 249-4616
ADDRESS : 1990 SHADYWOOD RD
pIN : 17-117-23-24-0027
LEGAL DESC : SHADY-WOOD
: LOT 040 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: 3 WATER CLOSETS,5 LAVATORY,3 BATHTUBS, 1 SHOWER, 1 KITCHEN SINK, 1 DISHWASHER,2 SILCOCKS, 1 FLOOR
DRAIN,
1 LAUNDRY TRAY, 1 WASHER, 1 WATER HEATER, 1 WATER SOFTNER
VALUATION OF PLUMBING 14000
APPLICANT PLUMBING FIXTURE FEE 175.00
STATE SURCHARGE PLBG(VALUATION) 7.00
SAM HENDRICKSON PLBG&HEATING INC MAIL-IN FEE 2.00
29901 725TH AVE
DASSEL,MN 55325- TOTAL 184.00
Minnesota State License#:plbg-PC646230,mech-MB005006 Payment(s)
CREDIT CARD 7507 184.00
OWNER
VONFELDT&ELAINE WYATT,JEFF
1990 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 separate
permiu. 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
l�
� d � �o ��`�(� ) o � tZ �iS
Applicant Permitee Signatu Date Issued By Sign re Date
.�
7 � (� Cit of Orono � 'FQR G7xY�SE O�V'f,Y �(�
F"„'"� P O Box 66 Dat�.Itec�ived:� Penmit� ���� 1�
� 2'750 Kelley Park�vay � �
Crystal Bay,MN 5>,3?3 ,�pArovzd Bp�; ANn.ai�ntS;
(952)249-4600-Main �
� (952)?ao.a6ie-r•sx
L�� CITY OF ORONO-PLUIVIBYN'C�PERMIT
�C�'t�SHO�� (All Commercial Permits Must be Approved by the 6tate prior to City Appro'val)
htt ;//�uvww.dli.mn. ov/C.CLD/ / e iumb CAttrer•�z� . df
G�N�RA�,.INFQR�ATTbN ....
,
:.
I. You may apply for plumbing permits by mail or in person at the City offices. Applicadons will be
reviewed and a permit will be issued within two working days.
2. Permit cards vvi11 be sen[by return mail after a review is completed. P�RMY'C'S ARE NOT
VALID C1NT�,YOU REGE�VE A AERMIT_ WORK MUST NOT B�G1N UNTIL TNE
PERMIT CARD IS POSTED ON THE yOB STTE.
3. Plumbing permits may be issued 01�lLY to licens�d plumbing contr8ctors and to property owners
residing in the dwelling.
4. When any new cons[ruction or remodeling is involved,a separate building permit must be
obtsined.
5. All work must be done in accordance with St&te Code requirements.
6. All work must be inspected and air tested before it is covered. Call(452)249-4600.
(24-48 hour notice requited)
- �`Y�!E(��P��!�I`T
C�iec�c t�Zl.'�'�ta� � . �. .
�Ctesidendal ❑Commercial(Approval Required) '
❑New �Additiqaal ❑R,epairs ❑iteplace
❑ In Accessory StruCture?
*You will need nrior sonroval and may need C 1P.(Fer Orono City Code,Ch�pter 78,Article IV)
3ob S�it�/f�'�e,r Infoit�at�4n. , ` ... �:
,
site Address: � � ��� ��r�
Owner: �[.�� MailingAddress�>99�-����/��'� ��
City: (,•G/�y��`� Zip: ��
Home Phone: Alternate Phone:
Co�aCCac#a��oi�ti�n: .. . �
Contractor. ���i+�'1 ntact Pe�;df�'�"'�...lU��? �/C-�-��
Address���� /� �„���"� State Bond#: �� ��`�
C�ty; ���� Zi��,�Expiration Date: �� 3� ��
Phone: �� ✓ /�� A.lternate Phone: J����� /�
� Insurance-Current:
1
g,b:a6pd 9ti9b6t�ZZS6Z��l ZbZtiSZZOZ� H'8d uos��?.apuaH wes:wo.�� ZS�Zti SZOZ-80-1�0
�
�Sl�vr,�-L�J' ..>�:;nii�<-�I�Y,r.�::::l.,."}�.�1.. � - 1.� �'i:".." _ _ _ .%4,',;. '`-_�,_�,�),�
....... . .......y. y� ,��. '�," :>i:f,:'w�,,.t-_�:...., ,::r.:'."
:;�. ....,...�,�. ,�,M„ r�:,._"£. 'a. 'ti _'"(u.;..�....:..:;,,a ..,.. ' .�.�
; ,..;,;... .,R���rr,
.r.tl'N1.J,..i_J;!f.1C. '�,'N'�cL�� �^4 'J\N. :C RJi�.:,•:VII�R�'J::V'5,�,�W�,f�'r.yri`�
. � ,. ;,,
. ..
„
. � .�. . �i;' , . .
�.
�
...:.... . �:•c,:..��.:.:,..,.���-.�,;�.,,�,:.u.,........,_.._......._.._... .. : �. : � . .:.........r.�..�. �
.�.....:.......r;.i .. �. . .:.. ........:.......
FIXTURE BSMT f 2 OTNER FIXTURE $SMr t' 2 OTHER
TYPE P�. FL TYP$ FL FL
Water Closet � � �loor Drains I
�.avatory � � Sewer EjeCtOr
Bathtub � � T.,aundry Tray f
I
$hower � Washer �
Kitchen Sink J Water Heater !
1 (
Disposal Water Softener �
Dishwasher r Wet Bar
�
Sillcocks � Miscellaneous
_ _ _ _ ;�,.. i::F.�__ .,::.
�.�::r•�
,.,:d•_ - — i!;�.�.. ..M.:i':.
- ��N'� i;;r'1. �,,':
,r.:a.� ....u.:.•.�a . . . . .. .n
�_�!�:;:'l:....._.,��..^_1.^;.i�..�.:�•'«a:>�,:�i::i�..v.
• - . ��. '.'� . •�. .
...
.-. . ���,..
�'f.:r.w_y.�- ....� ....Y�..n„,.....J'l� ...1._.3x,C,.: : c:._. �'::e' .:t'� _ — = - ;.:x�,.'',i,�f• ::•:.�c-
•. �.:,. ,.
, •
,. .....,..
� .�5�._.,,. . ., • 4;�� ` :;�;;
�:, ,:.....;.�......,;..�.._::-::,:.,_,..__:..,.�-::�--� , i._ , .�. . ;;1� ;:r ;;r:::
-- •i.if•r���,�. ,�� . �,.. t'i,�ii:>::,:;;; .,r;=�:s��'
....,�,•:.. _ . .,...,. � . - .—_,,.�.:-... _._.�..;;.•.;-.. - -
- - � r:.��,�•, .,. ••�a.. �i;,c ��•-•r::x:k.� _•� - -`::w:� i::�'_5_f:'. -:c��,:,.
^-�.;�:i�A;.�`�. ,�c�� ..,r, - — r ::.a�� `�A.__ �,,r.:c;i::a:c:-.,.:..
... ..,�„�. s.: ";;" �
� • —r
.. � ._..,....w. -. �... .
..;��l.�;n,.c..:. ,c�.......:::...:.3:.-r z;.:•_u..,.,.;�,�,...s„ ..., . ,.. ., ;"^.1::�:cc;i:�ici:"i•:c;c4,i,::;::::acr,:t�..,.,:.'r�liy:
',�i;�,.��t�.:ii�:., _;•-a:a�'.dcea��;�:!:.�': I ,.��. 1^,- ,�i� - `:ier;, 1,,,. we�;r,>�-:;::3z"�'
:,,�f�o_�! r '
�^-�:::: -. �;;., 4�;N —' '�,t,.�..eG.E� �. �;�r„ii^.i�_,.-:,..,.;_,_�
.
c . . .'.
�,
. ., , , ' .
�.:
!•
� . :. �..
.y , :
„�r�
• .:..:.
.... .. . . .. ....:
.� .
-��.�_ — -- -
� Yes,this section applies
The replacernent of onty one itesidential fixtu e or a liance ihat meets all three of the following
requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cosc of$500.00 or less;excludin the cost of the fixture or appliance:and
3. Is improved,instaqed or replaced by the homeowtler or licensed plumbing contractor.
Skip next section,if this applies; Cost ofPermit $ 15.00
State Surcharge $1-QO
Mail-Tn�ee(If Applicable) $ 2.00
Total Permit�ee �
(Permit F'ees Continued On Next Page)
2
9,S:a6pd 9Z9b6bZ2S6���1 LbZ�SLZOZ� H'8d uos���.apuaH wpg:wo.�� ZS�ZT SIaZ-80-1�0
. '
,,,:.,�;,_�,::......t......,.�;..�:::....... ........:- - - - - -- - -
, .. .. ... ..,. ......
,. .. . .. .,_._.............. ....
,_�:::a=,:�:,';,s,ra,_o�..�.�.. • ... ;.., . . �� '`�FT.-::i�:..
---'.'„PH:�:e:;: :::�^.:==- .,i�. .k' - '�r'�'{�3ijF;�:in:f�o:�::,i�f�
:.._..,. �... ... ��_ . , �?� ��.�#� �?:;��. �.�:�� ' .;:r:::
..,,.
,;:.:.: .,,.. .. . . .�. .,�.,: :, _
. .�.:; .,
. :
, ,..: ,.
,.,...,,...,,, �,�,.,_.._.� . . .. .. .,. :. •� �� � ' .,�:�: .�.�, :..�.,.
Tf above does not apply;follow guidelines below:
1, COIVTYLA p1t10E * is 1.25%of conCr&ct price with a(Minimum�'ee of$50.00)
����/� �� x.0125$ �/�7���
(tOnlratt pCiCe) (mioimum S5fl.40)
2. STAT�SURCHARGE ��y�
(�� � �� x.0005 $ ��
(contrBCt pr{CC)
3. pOSTAGL&1-CANDLING(Only on Msit-Tn Applicaiions) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ���f" —
■ * CONTRAGT PR.ICE or JOB COST means the actual or tstim&ted dollar arnount chargtd for the
permitted work inoluding materials,labor,profit,snd otfter fixed costs. Ct is the 3mount to be charged
to the customer for the work done, ff any rnaterial,equipment,labor or instsllations are furn•ished by
the owner,tenant or any other party,the reasonabfe market value of such items must be added to the
estimated eost or contract price for permit fee purposes. In the eWent that there is a dispute on the
amount of the job eosC,the CiCy may request the submission of a signed eopy of the actual contraet.
.:_.�... _.r.:.�:::,.:<::-.._ ...T,�. .._ -- 'fb . - ' =..;„d�1' -
_ .eSS_."V�:":�i�`;a.'S_�(�'= y` e�i :q? v :::�y:L:
���H a�,:R,t,G�,u -_ .{`; 1�' ..�' _ - ,iV..�,.ii:"'!1:'�_Y
The undersigned hereby applies to the Ciry for issuance 4f a plumbing Permit, agrees to do all
work in strict accordanee with the ordinances of ihe C►ty and the regulations of the State of
Minnesota, and certifies that all st3tements made on this application are complete, true and
correct_
� ` �
� � Date: / �� ��
Appl�cant s Si�xtu c:
3
g,g:a6pd 9T9b6bZZS6T��l ZbZZSZZaZ� H'8d uos���.�puaH weS:wo.�� �S�ZT StiOz-80-1�0
� -�' �-�-�-
�
CITY OF ORONO CALLED IN ��l�L.� TIM
INSPECTION TI� �� SCHEDULED ��'�Z�� ___� •Z�_
PERMIT NO� L MPLETED
ADDRESS � � �
OWNER TEL N NO.��- - ��•Z
CONTRACTOR G�� �i
� DESCRIPTION �
4� ❑ FOOTING ❑ DE -FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ING RI ❑ EXCAV/GRADING/FILLING
"j ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERlCONTNACTOR TO MEET YOU:_YES_NO
� COMMENTS: ���_�d '
� _��fOI�60�i NI�ti7i ,t��it� �r � �.�i"ihs `K
� �.L- —
�
� ,�� a,f �,� ,� ,c o<.�„�< -
W
� �
Q �—
a � � sb d'L
W
�
W
�
�
J
d
� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W �QAR�CT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Call forthe next inspection 2a hours in advance. (952) 249-4600
OwnerlContractor on site:
InSpeCtor.� /^'►--- `4� ��Y/srts � _`
r= Not
Whits Coprllnapectors Ffle
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE, �1G� SCHEDULED -c�������
PERMiT NO. 7_��(���� COMPLETED
ADDRESS ����� -z-����-/Cl���'% ��
OWNER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION � ' / �� ����
lN ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ 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 OWNERICONTRACTOR TO MEET YpU:_YES_NO
v�i COMMENTS:
W
�
�
�
J
O
�
�
O
k
W
�
Q
�
2
W
�
W
�
j
d
W� ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALLINSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance.�(J5 �49-46�0
OwnerlContractor on site: '
Inspector. �
`��
White Copyllnspector's File Canary CopylSite Notice
C� �
DATE TIME
CITY OF ORONO cnLLED IN
INSPECTION NOTI E SCHEDULED ���
PERMIT NO. � � COMPLETEo_
ADDRESS S "
OWNER TELEPHONE NO. �`��'o���/.��
,
CONTRACTOR
� DESCRIPTION �/ U��%� �
41 ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF �.F�EUMBING FINAL ❑ 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
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ S PTIC INSTALL
2 OWNERICONTRACTOR TO MEET Y�OU:�YES_NO
c� COMMENTS: ~-
� �D/10 - �5 �/ol�.��
j _/ �I'D V�e z Y� �o.► /!a�`It/� SDie�iG/- �.�. �
O
�. urper l evt,� - betA — �
�O F�`N. �, /►1 / •Ns �/ t- / Gr✓tf
� — [�
Q ���✓i0• b���r .Sd�+� /M.f�4�si R.1 4.i O¢Q
�
2
�
W
�
J
O
� ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPLEfE
W ❑CORRECT WORK 8 PF�CEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECTUNSAFECONDITIONWffHIN HOURS. p pHOTOTAKEN
INSPECTOR W{LL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
pJpISPECTION REQUIRED.CALL TO ARRANGE ACCESS.
��
Cau forthe next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site: s��!d'� ,
Inspector. /_l 1 r"" �'
VYhite CapyAnspector's File Canary CopylSke Notice