HomeMy WebLinkAbout2010-00769 - plumbing ` ' CITY OF ORONO PERMIT NO.: 2010-00769
2750 KELLEY PARKWAY
ORONO, MN 55356- DA7'E �ssUED: 09/02/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3423 SHORELINE DR
PI1� : 20-117-23-12-0034
LE..._L DESC : REG. LAND SURVEY NO. 1422
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : COMMERCIAL- BUSINESS
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: THIS PERMIT IS FOR 3435 SHORELINE DRIVE-BOWLING ALLEY
(1)3-COMPARTMENT SINK
(1)PREP SINK
(1)HAND SINK
(3)FLOOR DRAINS
VALUATION OF PLUMBING 3600
APPLICANT PLUMBING FIXTURE FEE 50.00
PERFECT PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.00
16609 ILL(NOIS AVE
LAKEVILLE, MN 55044- TOTAL 55.00
(612)867-1192
OWNER
TAMMER, BARRY
144 NORMAN RIDGE DR
BLOOMINGTON,MN 55431-
AGREEMENT AND SWORN STATEMENT
Thc work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requeste onformance ' the State Building Code.This permit may be
rev ed• an t�me f cause.
�
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Applicant Permitee Signature Date ]ssued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� �� ' FOR CITY USE ONLY
,¢p� City of Orono 1 p
O O P•O.Box 66 �1i `\ Date Received ��G� permit# ����W� ' �� �
"� 2750 Kelley Parkway ,,
r �1�;
� � � �-. � Crysta]Bay,MN 55323 rJ-� Approved By: �_ Amount$:�
�o�G` (952)249-4600 � �
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CITY OF ORONO-PLUMBING PERMIT C�`_� ���p
(All Commercial permits must be approved by the Building Official or Inspector)
,GENERAL INFORMATION '
1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Pernut 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 pernuts 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 pernut 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 APP1Y)
❑Residential �Commercial(Approvai Required)
❑ New ❑Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior aparoval and may need CUP. (Per Orono City Code, Chapter 78,Article IV)
Job Site/ Owner Information: ; � � ;
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Site Address: �y 3 , .s ��-��� �-' "�� � ��Z-- •
Owner: J�:�22�/ (��tiz� MailingAddress: ��� �+'�'Lwti�M %2� ��y-c. �"�
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City: I�►�� ,.�, �....� -�-L,� zip: S��S y 3..7
Home Phone: Alternate Phone: �.rZ �Z-' � � � � b Z Z 3
Contractor Information:
Contractor: �)��� L�� ��wr.��- Contact Person: �+G�C- 1��K+ �.J�n-�
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Address: I Ic b C�� �C C, .,�;;.� �.�-t,� State Bond #: I��- �p(p j `�`{- 7S
City: �-A-���� ��, Zip:S.SC%��Expiration Date: j � �� ti
Phone: Cc��Z�L'�7 �� � z- Alternate Phone:
� Insurance-Current: �/c�
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FIXTURE 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 Water Softener
Dishwasher Wet Baz
Sillcocks Miscellaneous
` � � C °m'(J'a�.Tn'U-c'`' ��^��
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❑ Yes,this section applies
The replacement of a Residenrial fixture or apnliance 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;excludinS the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Pemut $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
,� �
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 125%of contract price with a(Minimum Fee of$50.00)
O�
���� � x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00)
x.0005 $
(contract price) (minimum$ 5.00)
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 estima.ted 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 aze fiunished by
the owner, tenant or any other parly, the reasonable market value of such items must be added to the
esrimated 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 STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
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 that all statements made on this application are complete, true and
correct.
Applicant's Signatur . �� Z� — �d
ate:
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CITY OF ORONO � CALLED w �� ��C�J
INSPECTION NOTICE SCHEDULED Q '
PERMIT NO.ao/4-0�7(�9 COMPLETED 7'�� ' O
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ADDRESS .� � �� �G�/%i'-L`' / � f�1�' �-�fZ
OWNER TELEPHONE NO.��� �('� � �����
CONTRACTOR � � ��''t 7'� �rn
�; DESCRIPTION �
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l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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
J ❑ PLUMBING RI ❑ SEPT�IC/�INAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU:�YES_NO
� COMMENTS:
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GW �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnedContractor on s' e:
Inspector. � L ,
White Copyll�spector's File Canary CopylSite Notice
✓
E TIME
CITY OF ORONO CALLED iN �
INSPECTION NOTICE SCHEDULED - � '
PERMIT NO�O/D� D476Q COMPLEfED
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Q ❑ POURED WALL ❑ 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
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J � PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
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❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952) 249-4600
Owner/ConVactor on site:
Inspector.
White Copylinspector's File Canary CopylSite Notice
DATE TIME ✓
CITY OF ORONO CALLED IN ��-2�
INSPECTION NOTICE Q� SCHEDULED /0-27-/O �
PERMI jV� a0/D—�d�� / COMPLETED
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WlLL REfURN
❑STOP OADER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALlTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector. '"� /1^S
White Copyllnspector's File Canary Copy/Site Notice