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Home My WebLink About2013-00070 - plumbing _ ,� CITY OF ORONO * 2 0 1 3 — 0 0 0 7 0 * 2750 KELLEY PARKWAY DATE ISSUED: OU28/2013 ORONO, MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 2178 SHADYWOOD RD PIN : 17-117-23-42-0009 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 017 BLOCK 001 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: PLUMBING FIXTURES: (1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER,AND(1)MISC FIXTURE VALUATION OF PLUMBING 1700 APPLICANT SOUTHTOWN PLUMBING INC. PLUMBING FIXTURE FEE 50.00 6636 PENN STATE SURCHARGE PLBG(VALUATION) 0.85 RICHFIELD,MN 55423 MAIL-IN FEE 2.00 (612)866-3057 TOTAL 52.85 OWNER ANDERSON,MR.&MRS.CURTIS 2178 SHADYWOOD RD WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. ^ �� i3 LS�Y?/t�C- / /oZ�'/ /3 � Applic t Permitee Signat Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . ti OR C USE ONLY ,¢Q�� City of Orono � � � P.O.Bo�66 Date Receiv . �ermit# ao�3 � o�� 27>0 Kelle� Parkway �+ }:"'':� �'r Crystal[3ay,MN 55323 Approved By: Amount$: �� .y �^�;�: . R,: :�t� - ,.�,: c; (9S2)249-4600—Main ��'xaaicaPb'' (9�2)249-4616—P1x :::..- CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt 3://tivati��,d(i.mn.«trv/t:C�I..I)/Pt)��I c ��I�r��ab y(��rai•ev,t��.3{�t' GENERAL INFORMATION EIVED 1. You may apply for plumbing permits by mail or in person at the Ciry offices. Applications will reviewed and a pennit will be issued within two working days. �N �8 2013 2. Permit cards will,be sent by return mail after a review is completed. PERMITS ARE NOT�'TM OF ORON� VALID UNTIL YOU RECEIVE A PERMIT. R'ORK �1liST N01'BEGIN UNTIL TH PF,RMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to properry o�vners residing in the dwelling. 4. When any ne�v construction or remodelir.g is involved, a separate buildin�permit must be obtained. 5. All worh 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 ❑ Replace ❑ ln Accessory Structure? *You will need urior approval and may need CC:P. (Per Orono City Code,Chapter 78,Article IV) Job Site /Owner Information: Site Address: � l �� J�i�,,��»� KJ Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Infonnation: Contractor: ��Jl�rv� ��,��h� Contact Person: �,P�--.�� , 7� . � Address �� '�n,✓Z�-�� State Bond #: �'_ (�� ;��,� City: �c,h � % Zip:,S 5 y,.�� Expiration Date: � ��3�—� ,� Phone: �[ od--�(v(o'��_� Alternate Phone: ❑ Insurance—Current: �/��(—/��—�r—�3 1 � PLUMBING FIXTURES BEING INSTALLED FI?CTURE 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 ,i Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous , PERMIT FEE CALCt1LATION(S) BASED OFF -2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three of the following requirements: ]. 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 homeo�vner or licensed plumbing contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-ln Fee([f Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 S PERMIT FEE CALCULATION S -JOBS OVER$500,00 If above does not appl�; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) � � �� x.0125 $ .��'�� (contract price) (minimum S>0.00) 2 STATE SURCHARGE ��- � 1 �(J� x .0005 $ � 5 (con[ract 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 fumished by the owner, tenant or any other party, the reasonable marhet 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. PLUMBING.PERMIT;:AP�I�TGATION AGREE1vIENT>.:: The undersigned hereby applies to the City for issuance of a Plumbing Pennit, 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: Date: ",�.� Reset Form �� 3 �/�" � </� E TIME ✓ CITY DfORONO CALIED IN � � � INSPECTION NO I SCHEDULED �%�_�� o-'.�' PERMITNO. ��—�� COMPLETED ADDRESS �� L�1�1�(�-��-- �� OWNER TELEP O E NO.��- 3�8��7`f'% CONTRACTOR I.(��- � DESCRIPTION � - � ❑ FOOTING ❑ PLUMBING F L ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ 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. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTI FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOFi TO MEEf YOU:�YES_NO � COMMENTS: � W C � J O a � O � W � Q � Z W � W � j d W� �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnedContractor on site: Inspector. _!.a� White Copy/lnspector's File Canary Copy/Site Notice