The URL can be used to link to this page

Home My WebLink About2012-01209 - plumbing � � CITY OF ORONO * 2 0 1 2 - B 1 2 B 9 * 2750 KELLEY PARKWAY DA'rE �SSUED: 11/30/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2990 SUSSEX RD PIN : 04-117-23-31-0020 LEGAL DESC : FOX BEND : LOT 3 BLOCK 4 PERMIT TYPE : PLUMBING (> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES- MULT[PLE NOTG: PLUMBING FIXTURES: (I)WATER CLOSET,(1)LAVATORY,(1)SHOWER,(I)FLOOR DRAIN AND(l)WATER HEATER VALUATION OF PLUMBING 4000 APPLICANT PLUMB[NG FIXTURE FEE 50.00 H[LLCOR PLUMBING STATE SURCHARGE PLBG (VALUATION) 2.00 53 TERRACE RD NE TOTAL 52.00 ST MICHAEL, MN 55376- (763)688-0342 PAID WITH CC# 2293 Minnesota State License#: PC645327 OWNER KELLY,JUSTIN& SUSAN 2990 SUSSEX RD LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perfonned 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 separatc permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not spccitied 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 rmance wi[h the State Building Code.This permit may be revoked ime for due cause. �� 30 � - - . ' �� l/ �-�� Z ican ermitee Signature Date Issue ` y S�gnature Date SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE. .r � f � F� CIT USE ONLY U y �,�` City of Orono - �� —L� � ¢ `v P.O.Box 66 Date Receive�: � it# � ��; � 2750 Kelley Parkway �� 1��?�;^� � Crystal Bay,MN 55323 Approved By: Amount�:<� °Z� \�t� ^�+��,, �^o (952)249-4600—Main so"� (952)249-4616—Fax CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt�://www.dli.mn.�ov/CCI,D/PDF/ e � lumb �lanreva �. �dfi' GENERAL 1NFORMATION 1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pernuts 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 ❑ 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: I'p99� SJSS�� Owner: � Mailing Address: S� City: �/�r�0 Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: i` �t2 �i Contact Person: /"�'��I y Address: �3 �Q�C��'e �h� State Bond #: City: Zip:�'��p Expiration Date: Phone: ��0��p�o�ya Alternate Phone: ❑ Insurance—Current: 1 �- f 1 + PLUMBING FIXTURES BEING 1NSTALLED 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 Washer Kitchen Sink Water Heater � Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) � BASED OFF - 2002 STATE STATLTE i ❑ Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less; excluding the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed plumbing contractor. Skip next secrion, if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 � J `I � � -°° ' �� PERMIT FEE GALCULATI�N S '��=70BS 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$50.00) � yv�D`� X .oi2s$ (contract price) (minimum$50.00) 2. STATE SURCHARGE x .0005 $ (contract price) 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 pernutted work including materials, labar,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. �P � � � �, ��:�:.1�{;� ��NIIT APPLICATION A�: �� i� _� :,� µ�� :�� 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 state made on this application are complete, true and correct. ,s'� � Applicant's Signature: Date: / 3D 3 L�� C/� D TE TIME ✓ CITY OF ORONO CALLED IN � INSPECTION ICE SCHEDULED ' � � � ' PERMIT NO. �07�� COMPLETED � `� ADDRESS a g�� k=��G � r/ OWNER TELEPHONE N0.7� �� 3�`Z CONTRACTOR ��l � DESCRIPTION ��w . �E,� �� ❑ FOOTING ❑ PLUMBING FI ❑ EXCAV/GRADING/FILLING 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 ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: oc W C J O � � O � W cc Q � 2 W � W � � d � �NORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED 0 STOP ORDER POSTED.CALL INSPECTOR ❑ ItJSPECTION REQUIRED.CALLTOARRANGE ACCESS. Ca11 for the next spection 24 hours in advance. (952) 249-4600 Owner/Contractor Inspector. White Copyllnspector's File Canary CopylSite Notice DAT TIME � CITY OF ORONO CALLED IN 3 �� -3 INSPECTION��jO��TICE 7��,/ SCHEDULED -3 ��3c� PERMIT NO:�`"�`2- ��r``�� COMPLETED ADDRESS � �� S ��L /�� OWNER EPHONE NO. 7� � ��a�� CONTRACTOR �� >; DESCRIPTION �`� / � � ❑ FOOTING � PLUMBI FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPII>INT 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: � W a � J O � � O � W � Q � 2 w � W � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call forthe next inspecti 24 hours in advance. (J52� 24J-4600 OwnerlContractor on te: Inspector. White Copyllnspector's File Canary CopylSite Notice � DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED S-� . .'o b PERMIT NO. Z��Z.— �lZD9 COMPLETED ADDRESS z �9d °s�� ✓ OWNER TELEPHONE NO. ��-� ��P � � CONTRACTOR ��C-�L �.� T��/Z �� 73�j >; DESCRIPTION �-- —`` � � ❑ FOOTING ❑ PLUMBING FI ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL O ❑ 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � �t CT�,Q� � '� �`_ C� 0 � W � Q � z W � w � � a W� ❑WORK SATISFACTORY:PROCEED � ECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CA�I TO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. ,v.� L White Copyll�spector's File Canary CopylSite Notice