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Home My WebLink About2010-00024 - plumbing a • CITY OF ORONO PERMIT NO.: 2010-00024 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: OU20/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 395 SUSSEX LA PIN : 04-117-23-24-0007 LEGAL DESC : FOX BEND : LOT 006 BLOCK 001 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES - MULTIPLE NOTG: PLUMBING FIXTURES (1)WATER CLOSET,(2)LAVA"CORIES,(1)E3ATHTUB,(1)SHOWER AND(1)STEAM GENERATOR VALUATION OF PLUMBING 5000 APPLICANT PLUMBING FIXTURE FEE 62.50 PAVEK PLUMBING STATE SURCHARGE PLBG (VALUATION) 2.50 4550 COUNTY RD 10 N WATERTOWN, MN 55388 TOTAL 65.00 �) Minnesota State License#: 60617-PM OWNER CAMPBELL,JON& SUSAN 395 SUSSEX LA LONG LAKE, MN 55356 AGREEMENT AND SWORIY STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State E3uilding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shali be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. 'I'he applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked a time for due cause. � �� G��'�- /l 2�� 2�/C-� Applicant Permitee �gnature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � ' FO CIT USE ONLY � � , �,�` City of Orono � r7 D� 4 `Y P.O.Box 66 Date Received: �� "Permit# �a` 4� ��, � 2750 Keliey Parkway ¢ �'��. � Crystal Bay,MN 55323 Approved By: Amount$: �L� ��$�o (952)249-4600 CITY OF ORONO—PLUMBING PERMIT (All Cominercial pennits must be approved by the Buildin�Official or Inspector) GENERAL INFORMATION 1. You may apply far plumbing permits by mail or in person at the City offices. Applications will be reviewed and a pernut will be issued within two working days. 2. Perniit 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 remodeling is involved, a separate building permit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) TYPE OF PERMIT (Check All That Apply) �Residential ❑ Commercial(Approval Required) ❑ New ❑Additional `� tepairs �Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Articie IV) Job Site/ Owner Information: Site Address: �� US��X �- � Owner:��c't't �'„l'iL/a-�(� Mailing Address: City: �f`�O�J d Zip: Home Phone: Alternate Phone: Contractor Information: �� Contractor: �V�� P�4iN6;��G Contact Person: �U� � Address: �S�Q �� cQ/� State Bond#: �o��v�! -��3 City: ��QT6(,�,/t Zip�.S��xpiration Date: �� — 3� ' (� Phone:��2 / g!- ��3� Alternate Phone: �s�'� ��.38�� ❑ Insurance—Current: 1 * � � � PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1' 2' OTHER FIXTURE BSMT 1 2' OTHER TYPE FL FL TYPE FL FL Water Closet � Floor Drains Lavatory � Sewer Ejector Bathtub � Laundry Tray Shower I Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous � ��,,� G��EQ��2 PERMIT FEE CALCULATION(S) �� BASED OFF - 2002 STATE STATUE ; ❑ Yes, this section applies The replacement of a Residential fixture or ap liance that meets all three of the following requirements: 1. Does not require modificarion to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine 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) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 ` ; � • I '..I '� _;...� p..' . : �. PERMIT FEE CA�CVLATION�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$50.00) x.0125 $ (contract price) (minimum$50.00) 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) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * 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 puiposes. 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$1,000,000 ar$.50—whichever is greater. For valuations over$1,000,000 call the Building Deparm7ent 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 wark 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. Applicant's Signature: �—�;��C'�-� Date: 1 �d �� 3 � � DATE TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE CHEDULED � PERMIT NO. �d�O�GYi�OO�'f COMPLETED ADDRESS � 7 5 �/1 �5�� OWNER T LEPHONE NO.��d�-7�gf CONTRACTOR G � DESCRIPTION � � ❑ FOOTING �PLUMBING FINAL EXCAV/GRADING/FILLING Q ❑ POURED WALL MECHANICALRI ❑ 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 ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNER/CONTRACTOR TO MEEf YOU:_YES_NO c�., COMMENTS: � W C o � `� .+ C� � � � -` �3 �bc�„n_ 0 � °� � • C� � 1.� 2 �'�'�, � '��, �-s �� v� ��2� Q Z � : �in� nl � v ' (� � r v e1 -( � ��C`��Grl/�^ �L1n �r �c � o r � UQ1- � rQ� � � ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail forthe next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: r �, Inspector. t�i �` � � � White Copyllnspector's File Canary CopylSite Notice