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Home My WebLink About2010-00539 - plumbing �� CITY OF ORONO PERMIT NO.: 2010-00539 `� 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: 06/29/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2172 SHADYWOOD RD PIN : 17-117-23-42-0010 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 000 BLOCK 001 PERMIT TYPE : PLUMBING (>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: 4 WATER CLOSET,6 LAVATORY,3 BATHTUB, 1 SHOWER,2 KITCHEN SINK,2 DISPOSAL, 1 DISHWASHER,2 SILICOCKS, 1 FLOOR DRAIN, 1 LAUNDRY TUB, 1 WATER HEATER,2 WET BARS VALUATION OF PLUMBING 12000 APPLICANT PLUMBING FIXTURE FEE 150.00 AREA WIDE PLUMBING STATE SURCHARGE PLBG (VALUATION) 6.00 9989 190TH ST. SILVER LAKE,MN 55381- TOTAL 156.00 (952)292-5297 Minnesota State License#: 61937- PM OWNER DORE, STEVEN 8351 WEST 109TH STREET BLOOMINGTON,MN 55438- AGREEMENT AND SWORN STATEMENT The work for which this pemiit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are � reques[ed in conformance with e State Building Code.This permit may be f revoked at a2x due ause. c� �`�� G � z� � �� l��-� �`�'t�t� (� —Z�l 0 � � Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � ,.. � FOR C[TY USE ONLY / ,�p�\ City of Orono P.O.Box 66 Date Received: Permit# �",, � ' 2750 Kelley Parkway a �r a Crystal Bay,MN 55323 A roved B Amount$: �� yo'� (952)249-4600 pp �� y��o$ CITY OF ORONO— PLUMBING PERMIT (All Commercial permits must be approved by the Building Official or Inspector) GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a pem�it 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 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 contractars and to property owners residing in the dwelling. 4. When any new consri-uction 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) �a�' ❑Additiona] ❑Repairs ❑ Replace ❑ In Accessory Structure? *You will need prior anuroval and may need CUP. (Per Orono Ciry Code, Chapter 78,Article IV) Job Site/Owner Information: .� I , /'� Site Address: x� � 7 -.� �>l 1��,a (,L/�;. � /C� Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: /� � Contractor: `�{L� �,'�-4%�- I-'f u�.�,� �� rContact Person: Address: ��i�� `l� � �f � State Bond #: `� � 31 - �� !� City: 5. ��r �c 1r:` Zip_S5 3�/ Expiration Date: �� z �:��l G Phone: �`�S�� a`�� ` `� 7 Alternate Phone: ❑ Insurance—Current: 1 �� \ PLUMBING FIXTIJRES BEING INSTALLED FIXTURE BSMT 1' 2` OTHER FIXTURE BSMT 1� 2� OTHER TYPE FL FL TYPE FL FL Water Closet � � Floor Drains � Lavatory I � Sewer Ejector Bathtub 3 Laundry Tray � Shower % Washer Kitchen Sink 2 Water Heater � Disposal � Water Softener Dishwasher r Wet Bar / i Sillcocks � Miscellaneous � PERMIT FEE CALCUL�ATION(S) �� -� BASED OFF - 2002 STATE STATUE � � ❑ Yes,this section applies The replacement of a 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; excludin�the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 � . I , PERMIT FEE CALCULATION(S -JOBS OVER$500.00 ' � ' If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) %�2�Go c- '�� X.oi2s $ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) x .0005 $ (contract price) (minimum� .50) 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 fizrnished 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. ■ ** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50—whichever is greater. For valuations over$1,000,000 call the Building Department at(952) 249-4600 for the price. � � � ��PLU�IBING PERMIT APPLICATION AGREEIVIENT <��: �� .�; 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. ' A licant's Si ature: �� • � �� ° pP � Date. 3 G- �' � ✓ <a.f� � rA�E !� TIME CITY OF ORONO CALLED IN � / INSPECTION NOTICE SCHEDULED � � PERMIT NO. a`d� �-�✓�3y COMPLETED ADDRESS o?� a� DO� � OWNER �LEP NO.�O��9� - � CONTRACTOR � �� DESCRIPTION "� � �`""`--�' � � ❑ FOOTING ❑ PLUMBING FI ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J�PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO c�n COMMENTS: � W a o v � �G-�o� � � � o C�. �. � 0 � W � Q � 2 W � W � � ��ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CA�L INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnedContractor on site: Inspector. I�/ White Copyllnspector's File Canary CopylSite Notice �~ � �`'�`�� DAT / TIME V �� / L CITY OF ORONO CALLED IN � � INSPECTION NOTICE ��HEDULED �..� PERMITNO. �ID- ��/cOMPLETED ADDRESS � 7 � OWNER � PHO NO. ^ �a`� �7 CONTRACTOR '� >; DESCRIPTION � � � ❑ FOOTING ❑ PL G FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ M ANICAL RI ❑ LAKESHORENVETLANDS y � FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP iDEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J �PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 WNER/CONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: � W a � J O a o � � � � W � Q � � �'�S t�'cJ� k Q � �'� L-�An�Ov'I— � � � �RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 pQ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V ��FORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. � � /�y � White Copyllnspector's File Canary CopylSite Notice DATE TIME � C OF ORONO CALLED IN f INSPECTION NOTICE SCHEDULED � � PERMIT NO.�/�-b0.� co ED ADDRESS 7 OWNER TELERHO NO. �y �r � CONTRACTOR a- 'L�J � DESCRIPTION � �� ❑ FOOTING �P ING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ 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. ❑ FOILOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a r\e ✓L�o�!'� ��C�l�� U lJ ��}�..J n $-f �4�'2'S , o ( � c�T' � ��5� ��SS P l a � ° T(� � ��'C2SS � � �5-� �+ �rS W � Q � � �-'-r�� c� z'� l /�.�c� �Jt.�� 5-� � ,' r--S � ��' j n/�A�c� dvvt--f-Cl� -��S��' O � a W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W ��CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� Owner/Contractor on site: Inspector. , White Copyllnspector's File Canary CopylSite Notice