HomeMy WebLinkAbout2013-00499 - plumbing • CITY OF ORONO
� � 2750 KELLEY PARKWAY * 2 0 1 3 - P1 0 4 9 9 *
DATE ISSUED: 06/13/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 4300 SIXTH AVE N
PIN : 31-118-23-12-0022
LEGAL DESC : SHARON HILLS
: LOT 000 BLOCK 001
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: BSMT:2 WC, 2 LAV, 1 TUB, 1 SHOWER, 1 WATER HEATER, 1 WET BAR
1 ST:2 WC,3 LAV, 1 TUB, 1 SHOWER, 1 KITCHEN SINK, 1 LAUNDRY TRAY
VALUATION OF PLUMBING 12000
APPLICANT PLUMBING FIXTURE FEE 150.00
NORTH ANOKA PLUMBING STATE SURCHARGE PLBG(VALUATION) 6.00
22590 RUM RIVER BLVD.N.W.
MN 55070- MAIL-IN FEE 2.00
(763)753-3373 TOTAL 158.00
OWNER
GEHRMAN,ROBERT&MARILYN
4300 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 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for d;e caus�'
��'�--C �� / / �t-r�►�� / /
Applicant Permitee Signature Date Issue y i nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
�
,,,,�_ . FOR CITY LtSE O1VZY
� Cin•of Orono
'r! �ON � P.O.Box 66 DateRecm�ed Pcmit=
� t 1?50 ItidleF�Perkway
�� 4ystal Bay,�3I`55323 ApprovedBy: AmounC 5:
� t (95:)249-4600—Vlaia
l ( 4 ; ' (952):�9-4616—Fax
, � CITY OF ORO�O-PLL�IBIti G PERI4IIT
\\'���ti�'�`i`�/ (All Commercial Permits Must be Appro�•ed b�•the StatePrior to City Approval)
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GEl�'ERAL II�'FOR.��TIO1�T
1. 1'ou may apply for plumbing peruiits by rnail or in person at the City offices. Applications v�ill be
revie�ti�ed and a perrnit�t�ill be issued within two working days.
2. Permit cards�ti�ill be sent by return mail after a re�•ieci•is completed. PER1�iII'S:�RE NOT
�'ALID U�ITIL YOU RECEI�'E A PERI�4IT. V4'ORK'�1LTST NOT BEGIN L'tiTIL THE
PER'�IIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing�ermits may be issued ONLY to licensed plumbing contractors and to property ov�ners
residing in the dwelling.
4. When any new consrruction or remodeling is invol�•ed,a separate building permit must be
obtained.
5. All work must be dane m accordance�ith State Code requirements.
6. All urork must be inspected and air tes2ed before it is covered. Call(952)249-4600.
(24-�18 hour nodce required)
TYPE OF PERMIT �
---___----- (Check All That APPIY) �
�Residential ❑Commercial(Approval Required)
�Ne�r ❑Additional ❑Repairs ❑Replace
❑ In Accessor�Structure?
*You will need nrior aoaro�-a1 and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job S ite/Owner Information: --�
Site Address: �" 3 b U �� d�--� i�
Owner: Mailing tlddress:
Ciry: Zip:
Home Phone: Alternate Phone:
Contractor Informarion:
�
Contractor: N o r-� �-►-..e lc�. � �'"'"'�orrt�ct Per os n: �Lo�re.�►.��A•..,s�
2 Z�l o IZL�w. R.�e.., Q (v-�N w
Address: ate Bond#: � C L`-{2-� g �
S-�� o
City: S'� • ���c-,s Zip: Expiration Date: l�-/3 l / l 3
Phone: � (, 3 - �)J� - 3 3 � 3 Alternate Phone: (o I 2- � ! °1 -�7 0 3 �
❑ Insurance-Current:
1
i
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 2' � OTHER FIXTURE BSMT 1 2' OTHER
TYPE FL FL � TYPE FL FL
____.___---_ ------- ..______ _..___._ . ___--_ __.
V�'ater Closet � � Floor Drains
Lavatory � Sewer Ejector
Bathtub I 1 Laundry•Tray l
Shower I W'asher
Kitcheu Sink ' �Vater Heater
I3isposal �L%ater Softener
Dishwasher VJet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ I'es,this section applies
The replacement of on 1�•one Residential fixture or appliance that meets all three of the following
requirements:
1. Does not require modification to electrical or sas service.
.'.. Has a total cost of S500.00 or less; escludinst the cost of the fi�cture or appliance: and
3. Is impro�ed,installed or replaced by the homeo��ner o.licensed plumbing contractar.
Skip next section,if this applies; Cost of Petmit � 15.00
State Surchar¢e S 5.00
Mail-In Fee(If Applicable) S 2.00
Total Permit F ee S
(Permit Fees Continned On Nezt Page)
2
J
PERMIT FEE CALCULATION S —JOBS �VER$500.00
If above does not apply;follow>guidelines belo�-:
1. CONTRACT PRICE * is 1.25%of contract price�*ith a(MinIm um Fee of S50.00)
«—. � � � x .0125S � �C7
(co tract price) (mmimum SSU.00)
2. STATE SUItCHARGE /
x.0005 S Lo
(cont�act price)
3. POSTAGE&HANDLING(Only on I41ai1-In Applications) S_ 2.00
4. ?OTAL PERMIT FEE (Add Lines 1-3 Above) S � 5 �
■ * COtiTP.ACT PRICL or JOB COST means the actual or estimated dollar amount charaed for the
permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged
to the customer for the��ork done. If any material, equipment, labor or installations are furnished by
the o�ner,tenant or any other party,the reasonable market�alue of such items must be added to the
estimated cost or contract price for permit fee purposes. In the e�ent 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.
PLL'��IBIl�G PER'�iIT APPLICATIOl�AGRF.E1-IEIvTT
The undersigned hereby applies to the City for issuance of a Plumbin� Permit. agrees to do all
�vork in strict accordance ���ith the ordinances of the Ciry and the re�ulations of the State of
l��innesota, and certifies that all statements made on this application are complete, true and
co�rect.
.� licant's si nature: � Date: � ' � � —1 3
�! � /�
3
� DATE TIME ✓
CITY OF ORONO�— CALLED IN
INSPECTION NOTICE SCHEDULED 7-2�� d'3v
PERMIT NO. d CJ COMPLETED
ADDRESS ��
OWNER TELEPH � O. , � ��
CONTRACTOR
� DESCRIPTION —�y�Yv
� ❑ FOOTING ❑ PLUMBING FIN ❑ EXCAV/GRADING/FIILING
Q ❑ POURED WALL ❑ MECHANICAL R ❑ LAKESHORENVETLANDS
y 0 FRAMING ❑ MECHANICAL FINAL
Q ❑ 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
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �'11fQ�K SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECAVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. OPHOTOTAKEN
INSPECTOR WIIL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. �G
White Copyllnspector's File Canary CopylSite Notice
�� DAT TIME V
CITY OF ORONO �iN �2" ��
INSPECTION NQ�ICE_ _ / SCHEDULED �2-Z / /a'v0
PERMIT NO� 3� COMPLETED
ADDRESS ��''��� � �
OWNER TELEPHONE NO. ��3 7 S'3 33 73
CONTRACTOR N. �� �J���ti9
� DESCRIPTION � � �G
� ❑ FOOTING PLUMBING FINA ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ ECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAMING ❑ MECHAN�CAL FINAL
Q O TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� . EFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Ca11 for the next inspecti 4 hours in advance. (g52 49-46��
OwnedContractor on site: �
Inspector.
White CopyMspector's File _ Canary CopylSite Notice
J� � DATE TIME J
( CITY OF ORONO CALLED IN 6 �-3
INSPECTION N TI, SCHEDULED t��J.3—���`-J�'�}
PERMIT NO. � COMPLETED "
ADDRESS ��D(� `�TT!'l !-zs��'K�� ,
OWNER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION ���3 � �S �
� ❑ FOOTING P�UMBING FINA� ❑ EXCAV/GRADING/FILLIN�
Q ❑ POURED WALL • ❑ MECHANICAL R //,�� ❑ LAKESHORE/WETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL ��
❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SIAB � WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 ho in advance. 249-46��
OwnerlContractor on site:
Inspector.
v
White Copyllnspector's File Canary CopylSfte Notice