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Home My WebLink About2002-P05418 - plumbing � TY OF ORONO PERMIT 27 0 Kelley Parkway - PO Box 66 Permit Number: Posals C tal Bay, Minnesota 55323 Permit Type: F�Xcures (95 ) 249-4600 Date Issued: �n�i2oo2 SIT ADDRESS: 3160 Sussex Rd Long Lake,MN 55356 P I D: 04-117-23-3 2-000 8 DES RIPTION: Propos d Use: Permit lass: Plumbing Permit ype: Fixtures Permit Sub-type(s): Multiple Fixtures DETAI S: Approv d per resolution#: Separat permits required: NOTIC S/REMARKS: FEE SU MARY: Permit Fee: $ 225.00 Vatuation: $ 18,000.00 State Surcharge Fee: $ 9.00 TOTAL FEE: $ 234.00 APPLIC NT: Pavek Plumbing OWNER: Thomas Forsythe 4550 County Rd 10 N 3160 Sussex Rd Watertown,MN 55388 Long Lake, MN 55356 THE DERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND A REES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNE OTA BUILDING CODE REQUIREMENTS. � CJ PLICANT PERMITEE SIGNATURE ISSUEDBYSIGNATURE Conies: 1- ile(SiQnitures Reauired), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 I CITY OF ORONO APPLICATION FOR PLUMBING PERMIT Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. 2. Permit cazds will be sent by retum 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 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 sepazate building permit must be obtained. 5. All work must be done in accordance with the State Code requirements. 6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice required. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call (952) 249-4600. Please check one: �New Addition Repair Replace Residential Commercial JOB SITE: 3�(�4 s'�5�� ,Qc� Zip: Owner's Name: -(?>�� r��/t Telephone Nwnber: Mailing Address• City: Zip: Contractor's Name: c.{iQ 1 �'yiK Telephone Number: 45 3—�15�=�/K3 Mailing Address: �,ls'S"� f� ��/C� City: t.�aTFrt'P� Zip; 5~S—��p� PLUMBING FIXTURE SCHEDULE FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL FL TYPE FL FL Water Closet � � Floor Drains Lavato �/ � Sewer E'ector Bathtub � Laun Tra � Shower � Washer Kitchen Sink � Water Heater � Dis osal � Water Softener Dishwasher � Wet Baz Sillcocks v Misc(list) PERMIT FEE CALCULATION(S) 2002 State Statute ❑ Yes, Tlus 5ection Applies The replacement of a Residential fixture or a�pliance 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 licenced contractor. Skip next section; Cost of Permit $ 15.00 State Surcharge $ .50 Mail In Fee $ 1.50 If above does not apply, follow guidelines below: 1. Contract Price* is .0125 % of job with a Minimum Fee of($35.001 �� x .0125 $ (co ract price) (minimum$35.00) 2. State Surcharge. ** Add the State Building Code Division a (Minimum Fee of$ .50) x .0005 $ . (contract price) (minimum$ .50) 3. Postage and Handling (Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the permitted work including materials,labor,profit,and other fiaed costs. It is the amount to be chazged to the customer for the work done. If any material, equipment, labor, or installation aze furnished by the owner,tenant or any other party the reasonable mazket 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 Department of Inspection Services for the price. The undersigned hereby applies to the City for issuance of a Plumbing Pemut, 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. �—cJ' `"�— / /� Applicant's Signature: Date: / �,+ViJ DATE TIME ITY OF ORONO � CALLED IN 1 SPECTIO�OTI E SCHEDULED � � ERMIT NO COMPLETED DDRESS ��0 d WNER CONTR. �C' � �j T LEPHONENO. �0(� -CI�"cG — C�„�� D SCRIPTION � � Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS INAL 14 SEWER HOOK-UP O6 PROGRESS � 07 EMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 EMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 LUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 LUMBING FINAL �� 36 FOUNDATION/REMOVAL � O ER/CONTRACTOR TO MEET YOU:?.,�YES_NO � C MMENT - ��` � W a � � J O >. C--- � O � W � Q � Z W � W � � d W� RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑C RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ RRECT WORK,CALL FOR REINSPECTION TEMPORARY � B FORECOVERING PERMANENT ❑C RRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑S P ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ IN PECTIONREQUIRED.CALLTOARRANGEACCESS. Cali for the next inspec ' n 24�i dvance. (952� 249-4600 Ow er/Contra or ite: . Insp ctor. � White Copyllnspector's File nary CopylSite Notice � � �% DATE TIME CI OF ORONO CALLED IN IN PECTION NOTICE SCHEDULED � �� _� P MIT N0. ��`�-11 Y! COMPLETED A RESS ��i l.o U �t��.y� t�c�� 0 NER CONTR. I��.�� l h . TE EPHONE N0. u' �� - ��G � �fL(r,�� DE CRIPTION � �-��, ,�Y��i ,j �j' /�C • � 01 F TING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 f MING 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS y 03 IN ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 W L BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FIN 14 SEWER HOOK-UP 06 PROGRESS � 07 DE O-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DE O-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PL BING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLU BING FINAL 36 FOUNDATIOWREMOVAL � OWNE CONTRACTOR TO MEET YOU:�YES_NO � � COM ENTS: � � � ��=� 1,��.� ' ' W C � v � e e.v C:�lK 0 a � 0 � W � Q � z W � W � � � WORK ATISFACTORY:PROCEED ❑ PROJECTCOMPLEiE W ❑CORRE T WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRE T WORK,CALI FOR REINSPECTION TEMPORARY V BEFOR COVERING PERMANENT ❑CORRE TUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INS ECTOR WILL RETURN �STOP O DER POSTED.CALL INSPECTOR ❑CITATION�SSUED ❑ INSPEC ON RE�UIRED.CALLTO ARRANGE ACCESS. 11 forthe next inspection 24 hours in advance. (g52) 249-46�� OwnerlC nUactor on� Inspecto White Copyllnspector's File Canary Copy/Site Notice