HomeMy WebLinkAbout2017-00693 - plumbing � ' CITY OF ORONO * Z 0 1 7 - 0 PJ 6 9 3 *
2750 KELLEY PARKWAY DATE ISSUED: 06/28/2017
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2060 SIXTH AVE N
PIN : 27-118-23-31-0002
LEGAL DESC : UNPLATTED 27 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: INSTALL NEW RPZ TO REPLACE 9D DEVICE ON BOILER MAKEUP WATER FEED
VALUATION OF PLUMBING 1311
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.66
HARRIS COMPANIES MAIL-IN FEE 2.00
909 MONTREAL CIRCLE
ST PAUL, MN 55102- TOTAL 52.66
Minnesota State License#: plbg-PC642810 Payment(s)
CHECK 589604 52.66
OWNER
Trinity Lutheran Church
2060 SIXTH AVE N
LONG LAKE,MN 55356-
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 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 ifconstruction authorized is not
commenced within l80 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.
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Applicant Permitee Signature Date Issued By ' ature Date
Jun, 27. 2017 ?2: 55PM No, 0434 P, 3_
C'�1�a�rr�l r 1FJ.1'J 9522494616 CT7Y 0� ORON❑ r+�ut 02/03
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2750 Kelley Parkway �
�� �, Cryst�l Bay, MN 55323 perrnit� �`
<<{A �c; (952)249-46�0—Main �U� �3 �017 Appro�ed By:
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�L� !,S �� �B�Q W'e.✓' Amount$: � ,
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� -�j � c'j (p0� CITY OF ORONO- PI�UlUIBIN� PERMIT
(AI ommercial Permits Must be AppFo�ed by the State Prlar ro City Approval)
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GENERAL INFCIRMATION
�. You mey app(y fvl�plumbing permlts by m�ll vr In person at the City o#fices, AppliC�tions will be
re�iew�d and a permit will be issued within iwo warking days.
�_ P�rmlt cards wll� be sent by return mail aft�r a revlew Is completed. F'�RMITS Af�E NpT VALID
U�JTIL YOU R�CEIVE A P�RMIT. W ll T TIL THE PE MIT CAR.D IS
POSTED QN THE JaB SITE.
3, P(umbin8 pe�mits may be issued ONLY to I�censed plumbing contraotors and to property owners
fe6lciing in the dwelling.
4. When any new construction or remodeling is imotved, a separate building permit must be abtained.
5_ All work must be dane in accorclance with Sta4e Code requirements.
6. Jall work must be inspected end �1r test�d b�fora it is covered. Call (952) 246�a600,
(24-48 hour notice required)
TYPE OF PERMIT(Check All ThatApply)
0 Reslderrtlal . ❑x Commerciai (Approval Required) [$ack'flow DevSce: ❑AVS ❑PVB]
❑ New � Additional � [� Repalrs ❑x Replaca
❑ In Acc��ory Structure?
*You will need rior a roval and may need CUP. (Per�rono City Code, Chapter 76, Article IV)
Job Site/Owner Information;
Site Address; 2060 6TH AVE N, LONG LAKE MN 56356
4wner, TRINITY LUTN�RAN CHURCHMaiIing Address= 2a�� ��H AVE N
City: ��NG LAKE ,��p; 55356
Home Phone: �12-599-6043 Alfiernats Phone;
LContractor Information;
Contractor; HARR�S CQMPANIES Cpntact Pers4n; �MBER M,QDS�N
Address; 909 MONTREAL CIRCLE State Bond #_ 929539558 - - � C�NTRACTOR
�it : ST_ PAUL L.IC# PCG4281 Q
Y Zip: 55102 �xp�ratlon Date: 12/31/17
Phone: 651-602�6539 , ., _, , Alternate Phone:
❑ Insur�nce�Curren#�
P9go i
Jun, 27. 2417 12; 55PM No, 0434 P. 4_
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FIX1"UR� sSMT 1ST 2�' OTHER �'IXTUftE 9SMT 1 T � ��ER
TYPE FioOr Floar TYPE Floo� Floor
Water Clo�et Floor Dralns
�a��ry 9ewer�vctor
Bathtub Leunciry Tray
Shower Washer
Kltehen Slnk Water Heater
Dlsposal Water Softener
pishwasher Wet Bar
Sillcocks MlaceRaneous l►1 � �a � ��k'
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..'. ., L'+'tiJ- j'e,! •i;J}��n din'�B7a,;�u�I�!' \,��'�.l�LX•
�`k; �•••�+' y � l,�N 3 �74� yl � ,;;;jr_�;;,' �„I;�:.,G.`,J�'1�;�'Y'••:,; L r!'i'.,.
�t"�!�'f :r '�I, N74,� i^�r 4.I��,IG., _b.��f: i. ,i �',1��..'i,,.,�it:. _r.,.n•',., "!R'�;,..r•,.:;p�..� .i!;•�{•�•:•: ,
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1. CaN7RACT PRICe "' Is 1.25% of contr�ct price with a(Minimum Fee of$50.�0)
$1311_00 x.012a $ $50.00
(cpntract price) (minlmum $50.00)
2. STATE SURCHARG�
�1311.Da x .0005 $ $0.66
(contract price)
3. P45TAGE � HANt]L.ING (�nly on Mall-In Appllcations) $ Z
�4. TdTAL PERM11' FEE (Add Lines 1-3 Above) � $'Z•�6
�` CONTRACT PRICE or J4B COST means the actual or estimated dollar amount charged for the
parmitC�d work Inciudlhg mate�rlals, labor, pro�t, and other fixed aosts, It 1� the amou�t to be charged to
the customer for the work done. lf any material, equipment, labor ar installations are fumished by the
ownar, 4enar�C or any ather pariy, the rea�onab[e market valua vf such items must be added to the
e�tlmated cost ar con'tt'�ct pr(ce for permit fee purposes. In the event that there Is a dlepute on the
amount of the job cast, the City may request the submission of a signed copy of the �ctual contl'act_
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The underslgned hereby applies ta the City for issuance af a Plumbing Permi#, agrees to do all work in
strict sccordance with the ordinances of the C1ty antl the regufaxions oP the state of Mlnnesota, end
certifies that al1�t�Cements made on thls �ppllcatton are camplete,true and correct,
Applicant's Sign� r Date: �
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�ulld�ng Offic�aU lnspecxor: Date: �
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DATE TIME \ /
CITY OF ORONO cnLLED IN �/.'�/��
INSPECTION N E /�J SCHEDULED ��•dD
PERMfT NO. � '�" CO PLETED
ADo��ss o�0�0 �! �
OWNER TELEPHONE NO. ���2-���
CONTRACTOR � � �``
� DESCRIPTION �� �J'���'�`��-
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OMRIERICOKTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLETE
� O OORRECT YMORK 6 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
0 ❑CORRECT VNORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORECdVERIN(i PERMANENT
❑COFiRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPEC170N REdU1RED.CALL TO ARRANGE ACCESS.
CeM for tl�e next inspection 24 hours in advance. (952) 249-4600
on site:
I�spector.
yYhib CopyAnspsctor's FlM C�nary CopylSfb Nolla