HomeMy WebLinkAbout2016-00331 - plumbing EIRMIREMEM
CITY OF ORONO * 2 0 1 6 - 0 0 3 3 1
2750 KELLEY PARKWAY DATE ISSUED: 04/05/2016
ORONO,MN 55356-
(952)249-4600 FAX: 952)249-4616
ADDRESS 755 TONKAWA RD
PIN 05-117-23-33-0003
LEGAL DESC AUDITOR'S SUBD.NO.217
LOT 001 BLOCK 000
PERMIT TYPE PLUMBING
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE FIXTURES-MULTIPLE
NOTE: 2 WATER CLOSETS,2 LAVATORY,2 SHOWERS, I KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER, 1 WATER HEATER,2 PREP
SINK OR WASHER BOX
VALUATION OF PLUMBING 10654
APPLICANT PLUMBING FIXTURE FEE 133.18
GENZ-RYAN PLUMBING&HEAT STATE SURCHARGE PLBG(VALUATION) 5.33
2200 HIGHWAY 13 TOTAL 138.51
BURNSVILLE,MN 55337 Payment(s)
(952)767-1838 CHECK 153620 138.51
Minnesota State License#:mech-MB003541
OWNER
SARAH BUSTON,JULIE BROWN
755 TONKAWA RD
LONG LAKE,MN 55356-
AGREEMENT AND SWORN 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 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 the State Building Code.This permit may be
revoked at any time for due cause.
AO
A p rcant Perrnitee tgnature Date Issued B ignature Da
Apr, 5. 2016 9: 08AM Genz — Ryan No. 0446 P. 1
O City of Orono FOR CITY USE ONLY
P.O. Box 66 Date Received:
2750 Kelley Parkway Permit# ZU 1 L, —
Crystal Bay, MN 55323 Z
(952)249-4600—Maln Approved By:
kesHo4 (952)249-4616—Fax 5
Amount$:
CITY OF ORONO- PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http:/Iwww.dii.mn.gov/CCLD/PDF/pe plum bolalirevapp.pdf
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 be 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 SITF,
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) [Backflow)Device:❑AVB ❑PVB]
F 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 lnfarmation: �,f
Site Address: _75� :c Ca
Owner&�" - 6LAb _1 _Mailing Address:
city. Du)rv-) Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor:
Clea-z t`���I� Contact Person:Address:aao H/1/� II ''w'' ,o 1 ff 11 w
State Bond
City: 6u([\�AIQ Zip:_95,54 r Expiration Date:
Phone: 95 `-�Ul—) �,3
3 Alternate Phone:
Insurance- Current:
Page 9
Apr. 5. 2016 9: 08AM Genz — Ryan No, 0446 P. 2
M
)? UM�ING<FIXTURES:131�1G'IN;STALLED
FIXTURE BSMT IST 2ND OTHER FIXTURE BSMT 18T 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Misce=s
w �x
± PERM11FEE:CAL'C-Ul
1. CONTRACT PRICE " ib
s1.25%hofcontract price with a(Minimum Fee of$50.00)
(1 (PSL X.0125 $ 33' 1) U
(contract price) (minimum$50.00)
2- STATIE SURCHARGE
x,0005 $ +
tcontract price)
3. POSTAGE&HANDLING (Only on Mail-in Applications) $ fib»
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 patty, 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.
PLUMB�(�IG'f F MFT;APPLICATION A'CtkEEMENT:.',
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 m de on this a licatio m late, true and correct.
Applicant's Signature, ` Date,
Building Official/Inspector: Date;
Page 2
CITY OF ORONO CALLED IN ( pCU j(v TI
INSPECTION NO I E CHEDULED
PERMIT NO. �� MPLETED
ADDRESS J f�
OWNER ELEPHONE NO. f03 7
CONTRACTOR
DESCRIPTION 1c, Ile
W ❑ FOOTING ❑ DEM INAL ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑WFOUNDATION/ OVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO V /���
C) COMMENTS: G�
Cc
W
a
J
O
� f
QC
O
W
Cc
Q
W
W
Cc
J
O
W ❑ RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
QCW
ECT WORK&PROCEED L1 ISSUE CERTIFICATE OF OCCUPANCY
CORRECT WORK CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 urs in advan 249-4600
Owner/Contractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice