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Home My WebLink About2012-00017 - plumbing CITY OF ORONO PERMIT NO.: 20��000�� . 2750 KELLEY PARKWAY . ORONO,MN 55356- DATE ISSUED: OU06/2012 952 249-4600 FAX: 952 249-4616 ADDRESS : 2420 SHADYWOOD RD PIN : 20-117-23-11-0002 LEGAL DESC : iJNPLATTED 20 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: REPAIR WATER CLOSET ADA BACK GRAB BAR. INSTALL GRID STRAINER ON LAV SINK. INSTALL ADA LAV WRAP ON WATER AND WORK DRAIN LINE. REPAIR AND REPLACE P-TRAP CONNECTION AT WALL. APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 DOLDER PLUMBING&HEATING STATE SURCHARGE PLBG(<$500) 5.00 7760 COLTNTY RD 26 TOTAL 20.00 MAPLE PLAIN,MN 55359- (763)479-1942 Minnesota State License#:061486-PM OWNER Voyaguer Service Centers COiJNTY RDS 15& 19 NAVARRE,MN 55392- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shail be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested' onformance ith the State Building Code.This permit may be revoke t ' e e cause. � 6 �� /� /� Ap licant Permi ee Signatur Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE. . � C USE ONLY �p� City of Orono O+ Q P.O.Box 66 Date Receiv ermit# �� 7 2750 Kelley Pazkway �� Crystal Bay,MN 55323 Approved By. Amount$: �d (952)249-4600—Main � (952)249-4616—Faac CITY OF ORONO -PLUMBING PERMIT (All Commercial Permits Must be Ap�roved by the State Prior to City Approval) htt ://www.dli.mn. ov/CCLD/PDF/ e lumb lanreva . df 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 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 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 A 1 ❑Residential �Commercial(Approval Required) ❑New ❑Additional [�Repairs ❑Replace ❑ In Accessory Structure? *You will need arior anaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: � /�cE'• � Owner: r• � Mailing Address: � �•�d �/'' . City: ��rd�t/' �/t� Zip: JS33� Home Phone: �S�' �7l��z Alternate Phone: Contractor Information: � d'/� 6r�� JI Contractor: �N� •' � ontact Person: Address: 7�`� �i #� State Bond#: ' /��y�SZ$ City: �� lcr�e. Zip:�/U Expiration Date: �"3�"z6/3 Phone: ��"y�l'��y2 Alternate Phone: ❑ Insurance—Current: ' � 1 FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTI-�R TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks . Miscellaneous _ G :r ��C �D/¢• /3a� i/a�-- =ny'�i��/'iGC�J'�i;�-�-. r ,� �� v7-� GA✓ si%.� ,Si,s'/��G( /��il'6�r� cvr.�/��s+ G„o�,,�-��.-x�:,-, �'szC. !' - l'G�a;r�rc��ccc,. � �1� con1�Z�,C� G�(. ❑ Yes,this section applies The replacement of only one Residential fixture ar anpliance 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;excludine the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 E If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) 300. �� X.0�25$ (contract price) (minimum 550.00) 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 dollaz 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. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do a11 work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made n is application are complete, true and correct. Applicant's Signature: � Date: /`� zol Z— . ,��Yk�' !9� ;�, �Ij l��#i'i��"i�� iV_.� i 3 �� /_D/�T TIME � CITY OF ORONO CALLED IN � INSPECTION OTIC�OD�, SCHEDULED -� � PERMIT NO. COMPLETED ADDRESS a 7"�� S ��'i � �r OWNER LEPHONE NO. ��g��s CONTRACTOR DO ��t_ a DESCRIPTION a'�'L �`^""`'` � ❑ FOOTING ❑ PLUMBING FIN ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL O 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 _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W a o t' � �} Q 6 �. � C`� Vr c2�2G� a � ° ��r'v�-� .� c. �C�i��t t� C��"G�J CJ� �s�'� W Q � :`nt� �=� x�.c� � � � '/ �"�,� .� ��-�S .�'�t S-�.n ite W � � � � ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 �CORRECT WORK,CALL FOR REfNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WiLL RETURN O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REGIUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerfConVactor on sit • - Inspector. �— White Copyllnspector's File Canary CopylSite Notice