HomeMy WebLinkAbout2016-01518 - plumbing CITY OF ORONO * 2 0 1 6 - 0 1 5 1 8 *
2750 KELLEY PARKWAY �ATE [SSUED: 12/OS/2016
�- ORONO, MN 55356-
f (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3010 SOMERSET LA
PIN : 04-117-23-22-0029
LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN
: LOT 001 BLOCK 003
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (2)WATER CLOSETS,(3)LAVATOIRES,(1)BATHTUB,(1)SHOWER
MATER BATH REMODEL-ROUGH-IN AND FINISH
REPLACE TOILET AND LAV IN 1/2 BATH
VALUATION OF PLUMBING 3200
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.60
LEGEND SERVICES,INC
201 N MEDINA ST TOTAL 51.60
P O BOX 382 Payment(s)
LORETTO, MN 55357- CREDIT CARD 5960 51.60
(763)479-5002
Minnesota State License#: mech-MB005090
OWNER
BUTLER, PATRICK&JILL
3010 SOMERSET LA
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shali 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 after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with Ihe State Building Code.This permit may be
revoked at�ny time for�cause. ��i
���? ���� �, ,) `/�-��t;t.C`--� j � G=-- �D
�� ; ` � � � � l
Applicant Permitee Signature Date Issued y Signat re Date
Dec 05 16 12:45p Legend Services Inc 763-479-6003 p.2
�/�Q�. City of Ofono FOR CiTY USE ONLY
r �� P.o� �nx 66 Date Recenred: —� �
'.y�11 '�� 2750 Kelley Parkway
;� Crystal Bay,MN 55323 Permit# f -dlJ��
��� t� (952)249-4600—Main A ro�ed B : �1( �
k�r�*��,�' (952)249-4616—Fax PP Y .�
Amount$: � �' �
CITY OF ORONO — PLUMBING PERMIT
(A!I Commercial Permits Must be Approved by the State Prior to City Approval)
t�ttp:llwww_dli.mn.qov/CCLDlPDFIpe plumbplanrevapp.pdf
GENERAL INF��MATI�N
1. You may apply for plumbing permits by mail or in person at fhe Ciry o#fices. Applications wila be
reviewed and a perm�t will be issued within two working days.
2. Permit cards will be sent by retum mail atter a reyiew is completec3. PERMITS ARE NOT VALID
UNTIL YOU RECE�VE A PERMIT. WORK MUST NOT BEGIN UI�ITlL THE PERMIT CARD IS
POSTED ON THE JOB SfT�.
3. Plumbing perrnits rnay be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. 1Nhen any new construction or remodeling is involved, a separate building permit mus#be obtained.
5. All woric must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call{952) 249-4800.
(24-48 hour notice required)
�_ TYPE OF PERMlT(Check All That Apply)
�esidential ❑ Commercial (A�proval Required} [Backflow Device:❑ AVB ❑PVB]
❑ New ❑Additional ❑ Repairs [Replaoe
❑ �n Accessory Structure?
"You wili need prior aqproval and may need CUP. (Per Orono City Code, Chapter 78, Ar�icle I�
Job Site /Owner Information:
Site Address; 3�'�� Se��-�-�-j L n�
Owner: ���-f�`� Mailing Address: �%� �� -� b�'�
City: Zip:
Home Phone: Alternate P�one:
Contractor Information:
Contractor: _���j�:l� ����<<rs, ..:tr-� Contaot Person: ___C��l��-
Address: �1 ,1��°x 3�1�2 St�ate 8ond#: ('L 6 Y�j5r1/
City: Lc�� � Zip; SS3S 7 E�iration Date: � 3�-f7
Phone: 7�3 -�/7`-�Pd� Alternate Phone:
[�`Insurance—Current: ���'c 4��v-nf-�-S
Page i
Dec 05 16 12:45p Legend Services Inc 763-479-6003 p.3
PLUMBING FIKTURES BElNG INSTALLED
�
FIXTURE BS14AT �sr ZND OTNER FIXTURE BSMT 1ST 211D OTFfER
TYPE Floor Floor TYPE Floor Floor
Water Cioset � 1 Floor Drains
Lavatory � ,;� Sewer Ejector
Bathtub � Laundry Tray
Shawer � Washe r
Kifchen Sink Water Heater
Disposal Water Svftener
Dishwasher Wet Bar
Silloocks Miscellaneous
�!�' �-$K�t V.'+ft• �Q✓i't4'� - n-L t�ie;:sh — �f'=�F�cx (Z�le.<?i c �t�(,r ,;v �.2 � C��
PERMIT FEE CALCULATION
'I. CONTRACT PRlCE '" is 1.25% of contract price with a(Minimum Fee of$50.00�
� 3�0�> X .0�25 $ ��%
(contract price) (minimum$50.00)
2. STATE SURCHARGE
�� 3�uC� �°
x.0005 $ 0:
(contract price)
3. POSTAG�8 HANDLING (Only on MaiE-In Applications) $���
4. TOTAL PERMIT FEE �Add Lines 1-3 Above) $ �lx ��
* CONTRACT PRICE or J�B COST means the actual or estimated doilar amount charged for the
permitted work including materials, labor, profit, and other fxed costs_ It is the amo�nt to be charged to
the customer for the work done. {f any material, equipment, labo� or Enstallat9ons are fumished by the
owner, tenant or any other party, #he reasonable market value of such items rnust be added to the
estimated cost or contrac! price far permit fee purposes. In the event that there is a dispute on the
amount of fhe job cost, the City may request the submission of a signed copy of the acival contract.
�LUMBING PERMIT APPLICATfON AGREEMENT
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
strict accordanc� with the ordinances of the City and the regulations of the State of Minnesota, and
cert�es that a9!statements made on this application are complete, true and correct.
Applicant's Signature: r/��' /�cz��� , � -1�
✓
Da#e: ��-
Building �ficiall Inspector: Date:
Paye z
�� � ,_`��--.___'---_
--��_K.s DATE TIME
CITY OF ORONO cnLLED IN ��
INSPECTION NOTICE l� SCHEDULED 7 -/� //��=�Z�
PERMIT NO. �� �'� � �MPLETED
ADDRESS ,��D`� ��l��l S-�7� Ci�LI�
OWNER TE EPHONE N0.��3�7�5��
CONTRACTOR �'�y�
� DESCRIPTION ��5�.'vl `
ty ❑ FOOTING ❑ DEMO-FINAL SEPTIC FINAL
Q ❑ POURED WALL �PLUMBING RI ❑ EXCAV/GRADING/FILLING
�Q ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
? OWNERlCOKiRACTOR TO MEET Y�U:_YES_NO
� COMMENTS: U�.S �!R�i —
� IN�S�r /1 a�i� Ye �—
j D ��/- 1�� �xz�e��Lc �4 ���� �'
� e�x.r 6'��K y Ig-B S sGA- �U -
�
0
� _ ven�"�Hf n�C �'!� ✓vo� � -�-�<s �� —
iC�vi�i i.r��a i � S��e-s�io�e i�/J• �.�J h� •t
� �f��`� �o�.t�if,e r -F -f�✓�c vor'�-�
� -
� �K -� ror►��K��
�r%�fidlTISFACTORY:PROCEED ❑PROJECT COMPLETE
� ❑CORRECT YMORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
0 ❑CORRECTNfORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERINO PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HWRS. p pHpTOTAKEN
INSPECTOR WILL REfURN
�STOP OR�ER POSTED.CALL INSPECTOR ❑GTATION 15SUED
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advsr�ce. (952) 249-4600
OwnerlContractor on sfte:
Inspecta: �'''"
WINts CapyMnapecMrs FlN Canary CoprlSib NoRkx
� �--
� '�'`�y} DA � TIME
ITY OF ORONO CALLED IN _�
INSPECTION TI (�HEDULED �-' �C����� � � �n
PERMITNO. �15 �cOMP �
ADDRESS �` � ��'��
�NNER ELE ONE NO. 7y `� 2'
CONTRACTOR � �
t�`' DESCRIPTION �'�'�° - �
y ❑ FOOTING ❑ DEMO-FIN ❑ 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
_
� ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNER�CONTMCTOR TO MEET YOU:_YES_NO
�� COMMENTS:
� � /� .M � ,
o " � � '.� �� �` n-'�-'G 1 ' �"�'�
� `D��:; �J` '
p " �.+ '� ��' �� �,[. ,c
� �' ., s j
Q
�
W
�
W
�
�
W �IORK SATiSFACTORY:PROCEED ❑PROJECT COMPLEfE
W�a CORRECT WORK 3 PHOCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
O ❑f�RRECT NfORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORE COVERINO PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p p�{OTO TAKEN
INSPECTOR WILI RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on ite-
Inspector: i� :��L
VYhits CopyAnspector's File Canary CopylSits Notice
�' � DATE TIME
CiTY OF ORO O cnLLED IN a—�r'1�
INSPECTION NO ICE� r SCHEDULED �'�b —1 7 /b' �
PERMfT NO. � COMP TED
ADDRESS �d�� ���
OWNER TELE H NE NO� � ��
CONTRACTOR I��-L��C�
4�`' DESCRIPTION �
j ❑ FOOTING ❑ DEMO I AL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUM RI ❑ EXCAV/GRADING/FiLLING
�O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WAILS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OMINERICOKTRACTOR TO MEET Y�OU:_YES_NO
� COMMENTS:
� - ; � � -li
j -- d
O /L � �j
� � /�,
� � /Cl .C✓` .v� !/ "'C.�!7
W
� �:l ^ .iv`
Q
2 ... ��s � ;�-
� �
� �
_ �,.
�
� ❑WORK SATISFACTORY: ED �W ECT COMPLETE
� ❑CORRECT WORK 3 PROCEED ISSUE CERTIFlCATE OF OCCUPANCY
O ❑WFlRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE C01/ERINO PERMANENT
❑CORRECTUNSAFECONDITIONWRHIN HOURS. p pHpTOTAKEN
INSPECTOR NfILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REW IRED.CAIL TO ARRANGE ACCESS.
Cafl for the next inspection 24 hours in advanoe. (952) 249-46��
OvvnerlContractor on s :
Inspector. �� '
White CopYAnspector's File C�nary CopYlSib Notks