HomeMy WebLinkAbout2013-00863 - plumbing � , � �
CITY OF ORONO * 2 0 1 3 - 0 0 B 6 3 *
. 2750 KELLEY PARKWAY DATE ISSUED: 08/26/2013
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 2140 SIXTH AVE N
PIN : 27-118-23-31-0026
LEGAL DESC : PHILLIPS WOODLAND TERRACE 3RD ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: WATER HEATER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00
12850 CHESTNUT BLVD
SHAKOPEE,MN 55379 MAIL-IN FEE 2.00
(952)445-4803 TOTAL 22.00
Minnesota State License#: 057209PM PAID WITH CC# 5244
OWNER
PHILLIPS, PAUL&MARY
PO BOX 755
LONG LAKE, MN 55356-0755
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within I SO days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due use.
�' �e210� � 8'�02.�0� �,3
App�cant ermi ture Date Issu By ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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08/26/2013 15:41 9524960064 APPLIANCE CONNECTION PAGE 61/03
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GENERAI-�ORMATI4N
1_ You ma5'$PP�S'�P�umbing pc�nu�s bY�1 or in persoQ at the Cicy offices. A,pplications will be
rc.wicwed amd a permut wil�be issuod widvn two woracing d�tYs-
2. Penmit cands will be scnt by reu►m ma�l a�er a rev�ew is completcd. PERMITS A�NOT
� VAX�ID rJN'T'I,I-YOi7 RECENE A P�RM1T. WO S NdT G
E CA�yq n'O1�I Y B S • rs and to 0 owR►ers
3. �lun�bing pesrn►its may be issuod ONLY to licer►sed Plumbing contracto Pr P�'
residiug in the dwe�ling. e buiiding peR'mit must be
4_ When,any new conshucaon or c�eanodeling is unvolved,�se�ara�
obtained•
5. All wrork rnust be dane in a�ccordance wi�th State Code requiremez�ts.
b. AIl wotk must be inspected and sir tiested be�'ore it 1s oovee�d. Cal�(952)249-4600•
(2q-48�our notia*equu'e�)
TY�E OF pERMY'�
Check A11 Tt�A 1
�Resid�ntial ❑Commercial(Approval Roquiaed)
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���„ ❑Additio�al ��
d �"°��ss°ry Sm"'�? P �ec Orono City Code,Chapter 78,Axticle N)
�'you w�,i need a or anoravai an,d may nced C�•(
IOb Sl�/OVV��`IY1fOIIIl�t1011: � :
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Site Address: • �
Owner:
- ^ Mailing Address: ��3`-� �1r�"��
` I ��i�� —
City: �� Zip:
�ionc►e Phone: �� S b)�o Alterr�ate'�hone:
ConUractor In�ormatio�:
ContactPecsoi�'�"�1't8t�c:2 Co�rlECti�t15 ICI�,
Contractvr. T285'�'���°�
�cope� M!�! �53�7�
Addxess: Stat,e Boud#: . . . ,
City: Zip: Expi�rativ�n Date:
�ihone: � K Alt�x'ttate Pfio�1e:
❑ Insurance—Current:
1
08/26/2013 15:41 9524960064 APPLIANCE CONNECTION PAGE 62/63
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FIXTCTR� �SMT � 2 OTI�R �'IXT(JR� BSMT 1 2 OTi-�R
TYPE 'F[., FL TYPB FX, �'X.
V17ater Closet �'loor Ih�ins
T,avarory Sewer Ejector
Bathtub Y.aundry 7ray
Shower Washer
XC,itchefq$xnlc VJater Heater .t
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�isposal Watcr Softcner
Aishwashe� Wet$at'
Sil�cocks Miscellaneous
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(� Yes,this section applies
'�Ete replactmcnt of only one Residential fixture or a�piiance that meets all three of the foilowing
�equi�e�e7pts:
1. Does not require modi�ication co etecuicaS or gas sexvice.
2. Has a total cosc of�5Q0.00 or less; cie„�c u_ding the cost of tb,e fii�ure or appliance:and
3. Is impro�vec�installed or rc�laced by the hoznemvxier or licensed plumbing eontractox.
Skip nexc secriou,if this applies; Cost of Permat $ I5.00
State Surchaxge $ 5.00
Mail-In Fee(If Applicab�e) $ 2.00
Tota1 Permit Fee $�
(pettnit�'ees ConNnued On Next Pa�e)
. �
. ,08/26/2013 15:41 9524960064 APPLIANCE CONNECTION PAGE 03/03
�f atwve does not�p1y;follow guidelines below�
1. CON�I' I�(' 'is 1.25°/u of contract pxicx with a(Mini�aum Fee of 55t1-00)
, x.0125 S
(aonora�x prico) • (mya�um SSo.00)
2. STA � RC E •�Add the State Bldg Code Div.Sur�hsrge(Miwhuu�m Fee of 55.00)
. x.0005 $ . .
, ���p;�)� (mfnimum s s.a0)
3. P05'�AGE&HANI7LING(Only o�t Mail-in t#pplicatia�ns) �, _ -�
� 4. TOTAY,PERMIT FEE(Add Lines 1-3 Above) S � �
+ = CON]CTtACi' PRICE or JOB C057'means the acRial or�dol�ar amount c�arged For the
per�niitted yvork includimg materials,labor,proft�and other fixod costs. It is t�e amouat to'b¢charged
to ttie custouxet for tb�e work doua. Yf airy maxriat,ecluiPment,labor or ins�l�stions are furnisb�ad by
nc�owner,tenant or any othar partv,tlie reasonable market vak�e of such items mast be addod to the
e.gtimated cost or wntract p�ice for'permit fee purposes. in the event that there i�a dispute on the
amo�mt of the job eost,the Ciry ia�aY'request the submission of a signed oapy of tho actual cont�ec.
■ **The STA'i'E S'(7RCHARt3B is.0005 ofthe c�►uact�ice u�er 51,000,000 or$5.00--whicf►ever is
gresta. For valuations ovar 51,000,000 oall the Build,iug beparm�ent at(952)249-4600 for u+e priee.
7]ae undersigr�ed hereby spplies to the City tb�'issu�nce oF a Plumbialg Permit,agrees to do all
work izi strict aocordance wiRh tha oxdinances of the City at►d the r�gulations of the State o�
Min,nesota, and ces ti�'ies that al1 statexnents tnade on t,his a�lication are complete, true and
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Applica�at's Sig►atiu'e: Dste• �� �
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TE TIME v
CITY OF ORONO CALIED IN ��
INSPECTION NOTICE SCHEDULED �� ""�:/� �
PERMIT NO�O I 3-DD g�3 COMPLETED
ADDRESS °��TD ���i A'U`e t�/•
OWNER �6 �� e LEPHONE NO.�
CONTRACTOR O/ ai7"�57�D l3(p
� DESCRIPTION �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG
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 ❑ COMPUUNT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v � PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL
Z 01NNERlCONTRACTOR TO MEET Y�OU:_YES_NO
c�.� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED �OJECT COMPLETE
W ❑CORRECT V1bRK 8 PROCEED ❑ UE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR WILL RETUHN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALI INSPECTOR
❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-460�
OwnerlContractor on site: �
Inspector: I
White Copyllnspector's Ffle Canary CopylSfte Notks