HomeMy WebLinkAbout2015-00278 - plumbing CITY OF ORONO * 2015 - 00278 *
2750 KELLEY PARKWAY DATE ISSUED: 03/09/2015
` ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS 970 TONKAWA RD
PIN 08-117-23-12-0002
LEGAL DESC AUDITOR'S SUBD.NO.217
LOT 000 BLOCK 000
PERMIT TYPE PLUMBING(>$500)
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE FIXTURES
NOTE: (2)WATER CLOSETS
(2)LAVATORIES
(1)BATHTUB
(1)SHOWER
(2)KITCHEN SINKS
(1)DISPOSAL
(1)DISHWASHER
VALUATION OF PLUMBING 21300
APPLICANT PLUMBING FIXTURE FEE 266.25
STATE SURCHARGE PLBG(VALUATION) 10.65
GENZ-RYAN PLUMBING&HEAT
2200 HIGHWAY 13 MAIL-IN FEE 2.00
BURNSVILLE,MN 55337 TOTAL 278.90
(952)767-1000 Payment(s)
CHECK 146317 278.90
OWNER
BAKER,GARY
970 TONKAWA RD
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Iss d By Signature Date
X 1 s -0595-
City of Orono
R FOR CITY USE ONLY
�O•VO
P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:
(952)249-4600—Main
y (952)249-4616—Fax
CITY OF ORONO—PLUMBING PERMIT
kf5H0�� (All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.gov/CCLD/PDF/pe PlumbPlanrevapp. df
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications wi11AR 0 5 2015
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 NOTPTM OF ORON�
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL TH �+
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.
(2448 hour notice required)
TYPE OF PERMIT
Check All That Apply)
Residential ❑Commercial(Approval Required)
❑ New ❑Additional �Q 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: C l� 304 o"� u'
Ownerluyo( �UJ G��1 L Mailing Address:
City: W' ( � Zip:
Home Phone: Alternate Phone:
Contractor Information:
Np'tContractor: 0,-N Contact Person: rp
Address: �� State Bond#: i`p ��
City: l' Zip:,41SZ Expiration Date:
Phone: -1��" I�V� Vh� Alternate Phone:
❑ Insurance—Current:
I
S �
LUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT IST 2 ND OTHER FIXTURE BSMT IST 2ND 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(
F-2002 STATE.
❑ 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 section,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
PERMIT FEE CALCULATION(S)—JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$/50.00)
x.0125$
(co tract price) (minimum$50.00)
2. STATE SURCHARGE
C,21 0 U 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
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.
PLUMBING . I; APP - CATION AGREEMEN
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.
Applicant's Signature: Date:
3
CITY OF ORONO CALLED IN 1
INSPECTIO TICE SCHEDULED
PERMIT N 'Do2 OV COMPLETED
ADDRESS �a-�O
OWNER TELEPHONE NO �' ��� LTe7
CONTRACTOR
DESCRIPTION
W ❑ FOOTING ❑ D1540-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL kp4,LUMBING RI ❑ EXCAV/GRADING/FILLING
❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
Z OWNERlCONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
0
i 10 - J4 !/G' 5c - 7o f!sZP
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Q �- G6VV
W
W
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� fiiCS�TISFACTORY:PROCEED O PROJECT COMPLETE
W D CORRECT WORK&PROCEED D ISSUE CERTIFICATE OF OCCUPANCY
O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
D CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
El
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
CalFpct.eF11W9'
on 24 hours in advance. (952) 249-4600
Ow ctor osite-
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