HomeMy WebLinkAbout2016-01357 - plumbing � CITY OF ORONO * 2 0 1 6 - 0 1 3 5 7 *
� 2750 KELLEY PARKWAY DATE ISSUED: 10/24/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2166 SHADYWOOD RD
PIIv : 17-117-23-42-0011
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT 000 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
COIVSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: PLUMBING FIXTURES: (1)WATER CLOSET,(1)LAVATORY,(1)SHOWER,(2)KITCHEN S[NK,(2)D[SPOSAL,(2)
DISHWASHER,(1)WET BAR
VALUATION OF PLUMBING 8455
APPLICANT PLUMB[NG FIXTURE FEE 105.69
STATE SURCHARGE PLBG(VALUATION) 4.23
STEWART PLUMBING, INC. MAIL-IN FEE 2.00
13025 GEORGE WEBER DR
SUITE#1 TOTAL 111.92
ROGERS,MN 55374 Payment(s)
(763)428-1833 CREDIT CARD 3122 111.92
Minnesota State License#:plbg-PC000474,mech-MB003262
OWNER
LACROIX, STEPHEN&SUSAN
2166 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 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 l80 days of the date of issuance,or if eonstruction 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 cau�e. •
�'�D ��! �z� /� � �/�
Applicant Permitee Signature Date Issued B ignature Date
Stewart Plumbing, Inc. 7634281733 p.2
�
��4QN City of OrOno FOR CITY U�E ONLY
� O P.O. Box 66 Date Received: �8� `7� ��
j (l 275D ICelley Parkway
'`�\` ,.� Crystal Bay, MN 55323 Permlt# o� -D/ S�
\�"1 c`� (952)249-4600-AAain
`�KESH�% (952)249-4616-Fax APProved 6y: l /
; Amount$:
CfTY OF ORONO— PLUMBING PERMIT
(Ail Commercial Permits Must be Approved by the State Prior to City Approval)
http:Nwww.dli.mn.qovlCCLD1PDFlpe plumbplanrevapp pdf
GENERAL INFORMATION �
1. You may apply for plumbing permits by mait or in person at the City offices. AppJications will be
revietived and a pem�it will be issued within two working days.
2. Permit cards will be ssnt by retum mail after a review is cornpleted. PERkU1TS ARE iVOT VALID
UNTIL YOU RECEIVE A PERMIT, WORK MUST NOT BEGIN UNTIL THE PERMIT CARD iS
POSTED QN THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed ptumbing contractors and to property owners
residing in the dwelling.
4. When any new oonstruction or remarieling is involved,a separate building permFt must be obtained.
5. A!I worlc must be dane in accordance with State Code requirements_
6. All work must be inspected and air tested before i#is covered. Call (952)249-�4600.
(2448 hour notice required)
TYPE OF PERMIT(Check All That A�piy)
�Residential ❑ Commerciaf (Approval Required) [Backf�otv Device:[]AV$ ❑PVBJ
❑ New �Additional ❑ Repairs �Replace
!
❑ En Accessory Structure?
''You will need prior approva! and may need CUi�. (Per Orono City Code, Chapter 78, Ar#icle !V)
Job Site / dwner lntormation:
Site Address: ��.�� �'\�� �, l,�S �
Owner:�'���ti�1��u�,a�'l �G���� t x Mailing Address: �j���f ����a(l�,(,��CC��' l�G� •
City: �,�CL'���C� Zip: �'7>j�'I J
Home Phone: Alternate Phone:
Contractor lnformation:
Contractor: � �1,LrC��r�- ' � �,,'� Contact Person: ����►�E✓1
Address: ���.,���?���2� l'��." �' D�'. �.�;��f.�tate Bond#: PC OO��j�I.
(� ��
CitY; 1��C��YS Zip; .�J�j���/ Expiration Date: J� ��
�,, �
Phane: � ��7`���'�- t�t����7 Alternate Phone:
� Insurance— Current: 5��.t,t,��G�
Page 9
Stewart Plumbing, Inc. 7634281733 p.3
, �
PLUiVIBiNG FIXTURES BEING INSTAl.IED
FIXTURE BSMT 1sr 2ND OTHER FIXTURE SSMT 1sr 2ND OTHER
TYPE Ftoor FEaor IYPE F�oor Floor
Water Closet �� Floor Drains
Lavatory � � Sewer Ejector
Bathtub �aundry Tray
Shower t Washer
ICrtchen Sink � Water Heater
Dispasal ,� Water Softener
Dishwasher Wet Bar t
Silicocks Miscefianeous
PERMIT FEE CALCULATION
1, CONTRACT PRICE • is 1.25%of corotract price with a (Minimum Fee of$50.00)
�-'� ����� � �i x .0125 $ � � �jr ��
(contract price) (minimum$50.00)
�. STATE SURCHARGE
�T��:J� �C�x .0005 $ '7� �_�'
(contract price)
3. POSTAGE 8 HANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 1_ 9
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pe�rnitted work including materials, labor,.profit, and other fuced costs. It is the amount to be charged ta
the customer for the work done. if any material, equipment, labor or installations are furnished by the
owner, tenant or any other party, the reasvnable market value oF s�ch items rnust 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 actuai contract
PLUM8ING PERMIT APPLICATION AGREEMENT
The unders9gned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
strict accordance with the ardinances of the City and the regulations af the State of Minnesota, and
certifies that all statements made on this application are complete,true and correct.
t _ �q� /
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Applicant's Signatiure: �'r,t 1,��' ��U.l,ll.Y�' ( Date: _ ��� �
6uilding Official!Inspector: Date:
Psge z
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CITY OF ORONO cnLLED IN I�-��
INSPECTION N � /�j���ULED �O�3�l� �
PERM�T NO. � MPLETED
ADDRE43 � �
pMINER NE NO. �-1�33
CONTRACTO �
� DESCRIPTION �
1y ❑ FOOTIN(i ❑ D - INAL O SEPTIC FINAL
Q ❑ POURED WALL UMB G RI � EXCAVKiRADIN(iIFILLIN(i
Q ❑ FOUNDATION WATERPROOF ❑ LU ING FINAL � TREE REMOVAL
Z � RADON SLAB ❑ HANICAL RI ❑ SITE INSPECTION
Q 0 FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� � INSULATION ❑ WOOD BURNER/FIREPLACE ❑COMPLAINT
Q 0 FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL
_
v ❑ DEMO-SfTE ❑ SEPTIC INSTALL
� TO YEET YCIl:_Y86_NC
y COMMENT&
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W� ❑ SI►71SFA . ED ❑ ECT
W C�Ef��-CT MIOWC a PROCEED �18SUE CEATIFK)ATE OF OOCUPMNCY
O ❑OORRECT WOW(.CALL WR REINSPECTION THrIPORARY
V BEFORE CCVEAINO PERMANB�IT
❑OOqRECT UN,4AFE CONDITION WITHIN HOURS. p p�pTO TAKEN
INSPEC'TOR WILL RETt1RN
O STOP ORDER PO�TED.GLLL INSPECTOR ❑qTATION ISSUED
❑IN8PECT10N REQUIRED.C/1LL TO ARRAN(iE ACCES3.
c��n��r�e�t��no���,�a„os. (952) 249-4600
on sit�
h,spector: � ••yJ�-
WhN�OoV11���� C�mry Cop�IM No1k�
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�._ �� �::C...,� DATE TIME
CITY OF ORONO CALLED IN _�„
INSPECTION NOTIC / .�, . �•..�HEDULED __�'�'�_�
PERMIT NO. � � J� /l%c�MPLETED
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ADDRESS '�-� �'"�.- � �� ]�E����, �CY� _ _
OWNER TELEPHONE NO. 7�3 Lf�:���`J73
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CONTRACTOR � �..-� � � � ����t�
,� ' � t ���� � /!�1C� �
� DESCRIPTION �—L.� ,D'
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�Q ❑ FOUNDATION WATERPROOF �LUMBING 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
_
J ❑ DEMO-SITE ❑•SEP'TIC INSTALL
2 01MNERICOt�ITRACTOR TO MEET YOU��YES_NO
� COMMENTS: �- -
� ^�Icµ � �lSr �c�/�-f 1i k�l.r ��,c�r
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W O WORK SATISFACTORY:PROCEED ❑PROJECT COMPLEfE
� ❑CORRECT WORK 3 PROCEED ❑15SUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
�CORRECTUNSAFECONOITION WITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
�SPECTION REWIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner►Contra r on site:
Inspector: � �
WhiM CopyAnspector's File C�nary CopylSite Notics