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Home My WebLink About2006-P09961 - vacuum breaker ' PERMIT C:ITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P09961 Crystal Bay, Minnesota 55323 Permit Type: Vacuum Breaker (952) 249-4600 Date Issued: 6/7/2006 SITE ADDRESS: 745 Spring Hill Rd Unit# Wayzata,MN 55391 P�� 36-118-23-21-0003 DESCRIPTION: Proposed Use: Residential Permit Class: Plumbing Permit Type: Vacuum Breaker Pemut Sub-type(s): Vacuum Breaker DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: RPZ for Lawn Sprinkler FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00 State Surcharge Fee: $ 0.50 Misc.Fee: $ 1.50 TOTAL FEE: $ 37.00 APPLICANT: Pro Plumbing OWNER: 7amie Wilson 9743 Humbolt Ave. S. 745 Spring Hill Rd Bloomington,MN 55431 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. . �(�.t� �M. ��/��'"�`� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 FOR C[TY USE ONLY �� City of Orono ,�O O`O�1 P.O.Box 66 �� '\ Date Received: Pemut# �1 ;,;, , 2750 Kelley Parkway ��+� :p'�'�• �.1� Crystal Bay,MN 55323 Approved By: Amount S: `��' '�'��r'r�o�/� (952)249-4600 ��swo�. CITY OF ORONO-PLUMBING PERMIT (All Commercial permits must be approved by the Building Official or Inspector) GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit will bc issued within two working days. 2. Permit 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 permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or reinodeling is invoived,a separate building permit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. All work must be inspccted and air tested before it is covered. Call(952)249-4600. (24-48 hour norice required) TYPE OF PERMIT (Check All That A 1 Q Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs ❑Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: / f� -s��'��'� �"�� r, ��/S� S�/`�L'i�-'� /�i/� �fa1> Owner:��/E ,��SOr� Mailing Address: City: ��'/(-�� Zip: SS--3r�� Home Phone: Alternate Phone: Contractor Information: Contractor: l�,�'G% ��/��:,C�� Contact Person: •�l//�� .l�l/�s��,�� / ��/� /� Address: �'J�/.��/.��1'r'�/�l��f:-k1- State Bond#: �/ � ��" City: ��j�l�/�� Zip:��.�� Expiration Date: � '3�� Phone: ��/��l�o Alternate Phone: ❑ Insurance-Current: /��L'��D .ric-'S, 1 �7�1�,��y � �'�� PLUMBING FIXT`URES BEING INSTALLED FIXTURE BSMT lsr 2ND pTHER FIXTURE BSMT 1ST 2�'rD OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathroom Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous �/G'S/"%1 t L. ,['"��,� ��' ``t�� j�,�='�w/�"�E'i�S . PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: I. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludin�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 Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 1.50 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 PERMIT FEE CALCULATION(S)—JOBS OVER$500.00 If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00) �j�.,�.0 x.o12s $ 3S;��' (con[ract price) (minimum$35.00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) x.0005 $ •� �� (contract price) (minimum$ .50) 3. POSTAGE&HANDLiNG(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines I-3 Above) $ � �' �r'C ■ * CONTRACT PRICE or JOB COST means the actual or estimated 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 are furnished by the owner,tenant or any other party,the reasonable market value of such items must be added to the estimated 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$1,000,000 or$.50—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. PLUMBING PERMIT APPLICATION AGREEMENT 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. �? � � ,�.D� Applicant's Signature: ` ' z�+�-- Date: Reset Form 3 w i�'` � . 4715.2260 . Annual Testi�g of R.P.Z. Yalves BACKFLOu PREYENTER TEST REPORT �. aooREss ��s�- S�',�inf�/�i��.PI�CI7Y �� ziPsrs"3�� ( QuNER � � _� , „ 7ELEPHONE N0. DATE�_ � - ./�/�1/co G/�'%Cf/LS'O' A�Gfi�' �i�Svic.J S-l� HAKF AND MOOEI OF DE%lCE��s � LSIZE / � SERIAL N0. �/s IOCATION OF DEYICE: �za�/�- d` �iJIJuS�' OG�!-S�PE' / � �l��S1- CHECK YAIYE /1 CHECK YALYE l2 PRES. OIf. PRES. DIF. S7RAINER aCROss 11 uNEx REttEF • CHECK OPENS TEST IEAKE� LEAICED S psi si NONE �C . BEFORE CIOSED ( CLOSEO (x� CLND ) REPAIR . OESCRI6E REPAIR F1NAL LEAKEO LEAxED �'�si _��si TEST CLOSED (t�. MATERIALS � USED . CERTIFICATIDN: ,. ,_ I hereby certify the fore9oing data to be correct and that the tesied device is �� functioning within the limits of the standards. � F I Rt-1 NAME /�� LL/i2l/i%�� ADORESS ��3 ��L,�l"�'v�� s`s��3� , � BY O/�i�-/ O%�4K'� TES7ER'S CER7IFICATIOt� N0. �7� l TEI. N0. -r'�S"�-�;fi�/�� OAT E REhSARKS ' �. t� (�� I I � � J� DATE E r C��UF ORONO CALLED IN -,�^�l0•�`F' INSPECTION N SCHEDULED � •oZ�•��X n� PERMIT NO. COMP TED ADDRESS � � OWNER CONTR. rO L.� TELEPHONE NO. U� ��- �� " O`i" l� �CJ�� DESCRIPTION W S � � l� 01 FOOTING 11 MECHANI AL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a J C .�-./� ��fi�� 0 � � � � �� , � S�C � e��./'� W � Q � � � r , � t=� es �� t �� W --� � � � 1� W� WORK SATISFACTORY:PROCEED G PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWiTHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN 0 STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on s'te: Inspector. �„� White Copyllnspector's File Canary CopylSite Notice