HomeMy WebLinkAbout2015-00079 - water softner - CITY OF ORONO * Z 0 1 5 - PJ PJ 0 7 9 *
2750 KELLEY PARKWAY DATE ISSUED: OU22/2015
• ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2170 SHEVLIN DR
PIN : 03-117-23-34-0018
LEGAL DESC : WEBBER HILLS
: LOT 001 BLOCK 003
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
COIVSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG(<$500) 5.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345- TOTAL 22.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 22.00
OWNER
KNUTSEN, PHILLIP&TERAH
2170 SHEVLIN DR
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 sepazate
permits. AIl 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. ��
�C1� � � C;t�t C � ��- L�. ��ti"'1C.r��1 � / 1-G/ � �
Applicant Permitee Signature Date Issued By Signature Date
01/22/2015 1�:30 FAg 9529aa5049 CULLIGAN MNTKA 1�002
, FOR CI7Y�7SE ONLY
p�` City of Orono
04 -�`O P,D.6ox 66 Date Received; Pomtit#
2750 Kellcy Parkway
� t � � CrystaJ Bay,MN 55323 Approvcd By, Amoun[S:
, . ' �' � (952)249-4600
.,�
CITY UF OYtON'O—PLLTIV��NG PERNII'T
(all Comrt�rcial permi[s mus�be approved by�he Buildmg pffcial or Inspector)
GENERAL INFQRIV�ATION
1. Yov may app2y for plumbing permits b�mail or in person at the Crty offices. AppliCations will be
reviewed and a permit will be issued within two workmg days.
2. Permii catds rviIl be serrt by reiurn nn,ail aRer a review is completed. PERMITS?►RE NOT
VAJ.CD�JNTTL YOU RECEIVE A PERMIT. VNORK NNST NOT BEGIN UNTTX,�'�
P�RMX'�'CARD IS POSTED ON�'�E,�OB SITE.
3. Plumbing perrnits may be issucd�NLY to licensed plumbing Contittactors and to property ovmers
residing in the dwellin�.
4. When any new construction or remodeiing is involvcd,a separ�e building pennit must be
obtained_
S. All work must be done in accordance with Statt Codc requirements.
6. All work must be inspectcd and air tested before it is cov�ed. Call(952)249-4600.
(Z�8 honr notice requircd) "
'X'YPB OF PERMIT �
Check.4,11 That A 1 � �
�Residential ❑Commercial(Approval Required)
�New ❑Additional ❑Rcpairs ❑Replace
❑ In Acocssory Structure? �
'�'You�yill.need nrior avoroval and may need C'�UP.(Per Orono City Code,Chapter 78,Article N)� .
Job Site/Owner Information:
Site Address: a�l �� 5 e V �i n �'`
Ovmer: ��� �r�v� 5 Mailing Address:
c�ri: z�p:
Home Phone: 6� o� -$$�' _ S S 9S Alternate�hone:
, Contractor�Tnformation:
GUL�9�9�V!AT vQ�'t� Contact Person: 1�U�
�V �
60�Q C��.�IGAN 1�IA�
�I�T�NK��MN 55345 , State Bond#:
(992) 933-7'200
City: Zip: �xpiration Date:
Phone: Alternate Phone: �1'S -"�31 �
❑ In5urance—Cur�rent:
l
01/22/2015 1�:a1 FAX 95293�5049 CULLIGAN MNTKA [�OOa
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FI7C'fURE BSMT 1 2 Q7'��R FIXTURE BSMT ] 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet FIOor Drains
Lavatory 5ewcr Ejector
Bathtub Leundry Tray
5hower Washer
Kitchen Sink Water Heater
Disposal Water 5oftenery"
f
Dishwasher Wet Ber
Sillcocks Miscellancous
���iy�:,'^,�{�;il'i���.��).;�,y', �",•:jr. „�i'„��.r.�`:+.�ygi�.if�,p,vfi,r� yY,-. ,P �.i'„� i "',' ,.,;r^'�+�7-!�� ��� �y.'P:.'�-y';��`{�;',1"ar�...,���,,,���i.�".�'�r:,r,.�,l.(, �•lilr 3o'r;
�:�7 i���l�?ji dry t� Y`a�,1 �n 1t r, i l �J.Y���,L"�E',"�,i��r�t�tl"'L{�lY��il�� 'frli I �p 1 t� 'F^ � j'"
�� r)� �u1M � .��', il II � I� �� u .� �. V . � � ,_.. r �' � i .11 �nr � r(��r,�;"ry1��."h��l
���i �! � t S il r 1�1',�h•i�:z, 4�
,�;�;��, ,, ,,��;.��. ,. , � ,, .s� �. ,�A�SEI���F�F:=1�i.Q0��'�'T�'�'�;��T�.'1'LTE�, � �.�'� -.��:i,�:��n�,�;�:.��_.
�:��:
Yes,this section applies
e rcplacement of a Residcntial fixture or 9 liance that meets al1�ree of the following r�quirements:
I. Does not require modification to eleCtriCal or gas s�rvice.
2. �as a tota]cost of$500.00 or 1ess;excluditae the Cost of the�xture or 8ppliance:ar�d
3. Is improved,installed or replaeed by the homeowner or licensod contractor.
Skip next section,if this applies; Cost of Permit $ I5.00
State Surcharge $ 5_ 0
Mail-In Fee(ItApplicable) $ 2.00
Total Permit Fee �
(permit�'ees Continued Qn Next PAge)
2
01/22/2015 13:31 FA% 9529a�5049 CLiLLIGAN MNTKA 1�004
.
�1���5{�1'e,�'�t`�?�14�'6��4 ,�I' y � ��, �; , tli.�I�Mq�G ,�rti.,qy?r
•ir� r i P� i i f�w, �
' a� � � ,��: `'.�.�,�,�.., 1�7' k#'��''Q.T�!•'����(�iQ:�, „�a;'�.h'?F��'r1�;";.a,;.
If above does not apply;follow guidelines beIow:
]. CONT�tACT pRICE *is 1.25°�of contract price�with a(Minimum Fee of 350,00)
x.0125$
(conuac�price) (minimum 550.00)
2. S1'A'Y'�SU�CHARGE �'Add the State�Idg Code Div.5urcharge(Minimum Fee of 55.00)
x.0005 �
(COntmctprioe) (minimum$ S.QD)
3. P057'AGE&HANDLING(Only on Mail-ln Applications) $ Z,00
4. TOTAL PERMIT��,(Add�,ines 1-3 Above) S c��,0�
■ s CpNfRACT pFt10E or 30B COST means the actual or tstimated dollar arnount charged for the
permitted work including matcrials,labor,profit,and other fiaced costs. 1t is the amount to be r.harged
to the oustomcr for the work done. If any material,equipment, labor or installations are fumished by
the owner,tenant or arry other parry,the re�sonable market value of such itcrns must be added to the
estimatGd cost or eontract price for perni,it fee purposes. In the event that there is a dispute on the
�no�mt of the job cost, the City may request the submission of a signed copy of the aetu&1 corrtract.
■ *{The STA7'E SUIZCHARGE is.0005 ofthe contraet priec under$1,000,000 or$5.00—whichever is
grcatcr_ For valuations over�I,000,000 ca11 the�uilding Depertment at(952)249-4600 for the priee.
ur�5�sc� 'i. f'N�=T � ° � 1�� ?r�a}� ,� �.' "" uI� � i�° �,ir �rt��, t�,e
�Fy�;� ,x' .� +IP.�wA,l� .�!,.�` '�� � lJ�" .�' �f�� ,.;t�,�`M�I�l2���;6�7'i��,�''�=u;�?;(�'
The undexsigned hereby applics to the City for issuance of a Plumbing Permit, agrees ta do all
work in sMct accordance with the ordinances of the City and the regvIations of the State of
Minnesota, and eertifies that all statements madc on this application are eomp]ete, true and
C017CGt.
Applicant's Signature: bate: � -ao�� �
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„�iA��R2+�.�titi,v,d;!��,�'�'rr�
3
r� � DATE TIME �
`J ` CITY OF ORONO CALLE IN
INSPECTION N TICE SCHEDULED Z�f_'_`�`/ ��
PERMIT NO. � 7�/ COMPLEfED
ADDRESS �I�� �i'�-Q ��I ll� � �
OWNER TELEPH NE NO.����3J� ��_Y1
CONTRACTOR
� ��� � _
� DESCRIPTION
ll� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
k1 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ PTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:�YES_NO
� COMME .
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W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Call for the next inspection 24 hou advance 5 � �9-46��
OwnerfContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice