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Home My WebLink About2015-00811 - plumbing � � ,* CITY OF ORONO * z p� 1 5 - 0 0 8 1 1 * 2750 KELLEY PARKWAY DATE ISSUED: 06/23/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1910 SHORELINE DR PIN : 10-117-23-42-0017 LEGAL DESC : REG.LAND SURVEY NO.0096 : LOT 000 BLOCK 000 PERMIT TYPE : PLLTMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)BATHTUB,(1)SHOWER,(1)WET BAR VALUATION OF PLUMBING 4000 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 2.00 GENZ-RYAN PLUMBING&HEAT NIpIL-IN FEE 2.00 2200 HIGHWAY 13 BURNSVILLE,MN 55337 TOTAL 54.00 (952)767-1000 Payment(s) CHECK 148062 54.00 OWNER &HALIMEH MOUSAVINASAB,MAJID FEHRESTI 1910 SHORELINE DR WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � 1 U/ l ��l l� Applicant Perm�tee Signature Date Issue ignature Date Z�� .��z�- � � �� O� y �C�pq��i I�� FOR CITY USE ONLY Cit of Oron G�+► � O P.O.Box 66 Date Received: Permit# 2750 Kelley Parkwa �j vy Crystal Bay,MN 5�� i�� `�� Approved By: Amount$: �\��O'� (952)249-4600—Main v y y � (952)249-4616—Fax Fa�pN �' �` �UF-(3RSN0—PLUMBING PERMIT ��k�sNo�`` (All Commercial Permits Must be Approved by the State Prior to City Approval) � I�tt ://w�v�v.dli.mn. ov/CCLD/PDH/ 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 RECENE A PERMIT. WORK MLTST 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�uild�ng 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 prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: , � � � Site Address: ��I � ��\ � � �ti ,� � � � '��=� T Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Infarmation: ,.� . ,��, � _ �` 1 Contractor: �� I � l�' �� ', '�� Contact Person: � 1 �� u L'� �� , � `� � ; , , ;�,-- Address: � V '�'��,�'� '�;''� State Bond#: � �'� � '� �� '"?_�;�', City: �,� V' ' �� Zip:`�-� .,�) ( Expiration Date: f �.��"��;i 1 i ;^�i i ��, ��,�� `�; Alternate Phone: Phone: ; �, ; �„ ❑ Insurance—Current: 1 PLUMBING FIXTURES BEING INSTALLED F[XTURE BSMT 1 2' OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet a Floor Drains f Lavatory � Sewer Ejector Bathtub � Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar � Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential �xture or appliance that meets all three of the following requirements: 1. Does not require moditication 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 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 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) C� ,.,� r-:i� � � �,'�'La X .o t 2s $ J L� (contract price) '` (minimum$50.00) , � 2. STATE SURCHARGE /�� ' (� �~� "� V�l,1 � x.0005 $ �, V�� (contract price) '� 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 L� 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 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. PLUMBING PERMIT APPLICATION AGREEMENT 7�he 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. � � '�'i� �� Applicant's Signature:�- 'J i �, ��f ` � � ' ,y^ � �.�, Date: (' ��(`,! vI� � \ � 3 DATE TIME ✓ CITY OF ORONO cnLLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.�� COMPLETED � �� ADDRESS �CllO $�ltKd ,Q�; OWNER TELEPHONE NO. CONTRAC'TOR G e�z /e c,�,� /��• ��4 • l�l�. /_'�•taG � DESCRIPTION -T ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING "j ❑ FOUNDATION WATERPROOF �PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSUtATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP �OLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL Z OWNERlCONTRACTOR TO MEET Y�OU:_YES_NO � � COMMENTS: ��rw-,C �r«�.� �t•%� � C¢l� � 7�/' � �i�11� /�lS/e�s'�ia�-.� j � 't�•s ,oa..,M,r �•�rrz le p cJ/� .6��/. ° Gt��w�.�G �- �10lS' d076 v r��l 1 � o� 5r� ��.• W ' aC Q � W W OC J � ❑WORK SATiSFACTORY`.PROCEED �CT COMPLETE W ❑CORRECT VMORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY 0 ❑CORRECT WORK�LL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHpTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �pTATION ISSUED ❑INSPECTION REOUIRED.CALL TO AHRANGE ACCESS. CaY for the next inspection 24 hours in advance. (952) 249-4600 Ow�IContractor on site: ��«: �i� f� Whit�CopyAnspectors FIN C�nary CopyISIM Nodee