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Home My WebLink About2013-00207 - plumbing . � CITY OF ORONO * z 0 1 3 - 0 0 2 0 7 * 2750 KELLEY PARKWAY DATE ISSUED: 04/O1/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2765 SHADYWOOD RD PIN : 21-117-23-24-0060 LEGAL DESC : REG. LAND SURVEY NO.0415 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NOTE: WATER HEATER AND REPLACE LAUNDRY TUB. VALUATION OF PLUMBING 1500 APPLICANT PLUMBING FIXTURE FEE 50.00 PETERS PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.75 20455 MAOR ROAD EXCELSIOR,MN 55331- TOTAL 50.75 (612)803-5066 Minnesota State License#: PM093027 OWNER RANDGAARD,THOMAS 1730 KENWOOD PKWY MINNEAPOLIS,MN 55405- 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 on(y the work described and does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming 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 ue s . ..- � �� ip / i3 Ap ant itee Signature Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. t FOR CITY USE ONLY a,¢p�O. CityofOrono P.O.Box 66 Date Received: Pemrit# .;, 2750 Kelley Parkway a !` !' �' Crystal Bay,MN 55323 AP�oved By: Amount S: �`r '}.��,,.c, (952)249-4600—Main ��'y (952)249-4616—Faac CITY OF ORONO-PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) tat! ;:'��e�e�.c1��.anrs.��>e�r��L�)!P�F!,c luant�.l.ana•e3a �,ncif GENERAL INFORMATION 1. You may apply for plumbing pemtits by mail or in person at the City offices. Applications will be reviewed and a pemut will be issued within two working days. 2. Permit cards will be sent by retwn mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD LS POSTED ON THE dOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contraaWrs and to property ownexs residing in the dwelling. 4. When any new consdudion or remodeling is involved,a separate building pernrit must be obtained. S. 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. (2448 hour notice reqaired) TYPE OF PERMIT Check Al1 That A 1 ' ❑Residemial ❑Commercial(Approval Required) ❑New ❑Additionai ❑Repairs ❑Replace ❑ In Accessory Structure? *You w�il nee�odor aooroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site l Owner Information: ` Site Address: 2 76'6 — 5�,��wod'0 � � Owner:r�o�MA �A�1 a r?�2 � Mailing Address: City: Zip: Home Phone: Z• J� �7JI� Alternate Phone: Contractor Information: Contractor: ��%�'�5 �u/w,d�MG Contact Person: �/id !'�1�,� Address: a�� / State Bond#: /�G GlSbg3 City: c�S�6c.4/d/L Zip:6�3f1 Expiration Date: �Z� 3� " Zd�3 Phone: G�Z'��11' �� Alternate Phone: �� s�s�� ❑ Insurance—Current: �� 1 PLUMBING FIXT'URES BEiNG INSTALLED FIXTURE BSMT 1 2 OTI�R FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Q /` Shower Washer Kitchen Sink Water Heater j r v�spo� w�sot�� Dishwasher Wet Bar Sillcocks Miscellaneous FERAiIIT FEE GALCULATI4N(S) BASET�(?�F-2Q02 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixtare or appliance that meets all three of t.�e following requirements: 1. Does not require modificadon to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine the cost of the fiact�re 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 Totai Permft Fee $ (Permit Fees Continued On Neat Page) 2 PER:MIT FEE CALCULATION S --J4BS+�VER$540.OQ If above does not apply;follow guidelines below: l. CQNTRACT PRICE •is 1.25%of contract price with a(Minimnm Fee of 550.00) �Sad x.0125$ (conuact Price) (mieimrm�o.00) 2. STATE SURCHARGE x.0005 S (comract Price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) S 2.OQ 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ • * CONTRACI' PRICE or JOB COST means the actual or estimated dollaz amount charged for the pemiitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged to�e customer for the work done. If any material,equipment,labor or installations aze fiunished by the owner,tenant or any other party,tlie reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the evem 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. PLUMBIN�`ir PERMTT APPLICA�t}1'�A+CCI�FEA�#ENT 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 thai all statements made on this application are complete, true and correct. Q/_ Zoi3 Applicant's Signature: Date: Reset Form 3 � / DAT TIME CITY OF ORONO CALLED IN �� 3 INSPECTION NOTI E SCHEDULED S-�/ 3 d. ' d PERMIT NO.oZbJ � '�aD7 co LETED ADDRESS �� OWNER LEPH NO. / CONTRACTOR � �: DESCRIPTION � a � ❑ FOOTING ❑ PLUMBIN INAL ❑ EXCAV/GRADING ILLING Q ❑ POURED WALL ❑ MECHA I AL RI ❑ LAKESHORE/WETLANDS 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 ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERlCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � d W� ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 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) 249-46�� Owner/Contractor on site: Inspector. .� White Copylinspector's File Canary CopylSite Notice