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Home My WebLink About2016-01471 - plumbing CITY OF ORONO * z 0 1 6 - 0 1 4 � 1 * � '"`' 2750 KELLEY PARKWAY DATE ISSUED: 1U23/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2500 SHADYWOOD RD PIN : 20-117-23-11-0034 LEGAL DESC : REG. LAND SURVEY NO. 1630 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : FIXTURE NOTE: ADDING A KITCHEN SINK VALUATION OF PLUMBING 750 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 038 STEVE HAUCK PLUMBING LLC TOTAL 50.38 16413 JASPER STREET N W RAMSEY, MN 55303- Payment(s) (612)619-5749 CREDIT CARD 0347 5038 Minnesota State License#: plbg-PM059349 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS, MN 55343- AGREEME1vT 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 afrer 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 revoke at any time for due cause. �� l ;� � �. J`��'�-- �ti,,� �� l� �3 � � � � �� .,�..��u 1 � �z "�� l w Applicant Permitee Signature Date Issued By Signatu � Date �p� City of Orono FOR CITY U$ p CL� � P.O. Box 66 Date Received: � � 2750 Kelley Parkway Crystal Bay, MN 55323 Permit# � �` � , �F c> (952)249-4600—Main A p p r o v e d B y: `'KesHo`�� (952)249-4616—Fax Amount$: CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) http://www.dli.mn.qov/CCLD/PDF/pe plumbplanrevapp.pdf 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 finro 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 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 Apply) ❑ Residential [� Commercial (Approval Required) [Backflow Device: ❑AVB ❑ PVB] ❑ New ❑ Additional ❑ Repairs ❑ Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV) Job Site / Owner Information: Site Address: �� U ��C.�� (r�' �-�� G/ Owner. L� ' ��U2,�� o/c�- "�� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Inf,ormation: � rt Contractor: ��- G,�ti�';C,� �1��. Contact Person: � �� Address: ,� ll �� 's��- �� • '��I,� � State Bond #: :. City: �1^'�� '�� Zip: �5 �J �3 Expiration Date: Phone: 6 � � � � � � ' �� `� Alternate Phone: ❑ Insurance — Current: Page 1 ��.� �; - ��: -}� ,�U �1��`� � Rt1:f�E� 1�(� t�ST�►L,��fl�;�� " �� . � � � � �. , , � � .... . _� r >. r �v . , �,� . i FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1ST ZND OTHER TypE Floor Floor TYPE Floor Floor Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink � Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous _ . . ��. ., . _. . .�< m �� A � ,. ;� � 1. CONTRACT PRICE " is 1.25% of contract price with a (Minimum Fee of$50.00) �� ,) x .0125 $ (contract price) (minimum $50.00) 2. STATE SURCHARGE x .0005 $ (contract price) 3. POSTAGE � HANDLING (Only on Mail-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. �� x s V,�Rt- G �u .�1� ;,�F'�11�l1�`��',�'�',��n►'�1.��.:�,, �i� ��1�1�� {: � �� 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 certifies that all statements made on this application are complete, true and correct. Applicant's Signature: `-'t� l �., N ��'' _Date: l� Z-3 � � Building Official/ Inspector: Date: Page 2 � 9'�q' � II�I ��,�.,.. �G�. N�!�};,��" '� `��' * ~ 7 � K+�'�� $..v.. .� �,_....--�''-�"`�,...-'` �t«e' F� w ti ��,,,„.�--_�"" ti . .._ . .. ... ��is"��:i�i'jfi� Yj. G� �� Z � O `� ' , . 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