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HomeMy WebLinkAbout2015-00471 - water heater CITY OF ORONO * 2 1 5 - 0 0 4 7 1 DA 2750 KELLEY PARKWAY DATE ISSUED: 04/23/2015 ORONO, MN 55356- (952) 249-4600 FAX: 952 249-4616 ADDRESS 200 TRUFFULA TR PIN 33-118-23-44-0039 LEGAL DESC MEADOW WOOD POND LOT 005 BLOCK 001 PERMIT TYPE PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER NOTE: REPLACE WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 APPLIANCE CONNECTIONS,INC. STATE SURCHARGE PLBG(<$500) 5.00 12850 CHESTNUT BLVD MAIL-IN FEE 2.00 SHAKOPEE,MN 55379- TOTAL 22.00 (952)445-4803 Payment(s) Minnesota State License#:mech-MB004165 CHECK 6436 22.00 OWNER ADAMS,DONALD&SHEILA 200 TRUFFULA TR 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. 11061 Applicant Permitee Signature Date Issued By Signature Date R i FO CTTY USE ONLY 1004' City of Orono _ , !�/ P.O.Box 66 Date Received: � Permit# 7 i 0 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: 9— Amount '• o` (952)249-4600–Main o (952)249-4616–Fax CITY OF ORONO —PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) �t€ :::'R<<.�w.ilii.ltl�,.+�ss�:� � l.l')1f131•!;� si!tsit;lsP31;1t:;r�a � y. alit 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 SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property wners 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(„(..:�,I'.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: 7 ()[Y"Ol Q, '7-r- Di-oxl o 5 5 5(6) Owner:-h oq Ado YK-s Mailing Address: 7 tAJL City: JrI C3 zip: Home Phone:95a.4o4-a 68-o' Alternate Phone: Contractor Information: Contractor: 1 KQ�17 Contact Person: �JQ64(e 1� �a � cash Of $1� Q Address: State Bond#: 570 City: c.. 0 Zipa53-7g Expiration Date: Phone: 60 -5 Alternate Phone: ❑ Insurance—Current: 1 � I PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1ST 2 ND OTHER FIXTURE BSMT 1 ST 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 CALC JLATION(S) BASED OFF.-2002 STATE.STATUE 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 $ 422 06 r, (Permit Fees Continued On Next Page) i r 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) (minunum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00) x.0005 $ (contract price)' (minimum$ 5�9) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ y ■ * 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. ■ ** The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. 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. C Applicant's Signature: L Date: fS N .. t ., 3 GG /' TIME V CITY OF ORONO CALLED IN j �/ INSPECTION NOTICE SCHEDULED 5 l5 3'•30 PERMIT NO.aU 1S.0047� COMPLETED ADDRESS OWNER � T LEPHONE NO. Sa' CONTRACTOR A ft-AL— �b vr1� DESCRIPTION WCFA_Q-K' "QC' "VfLrQD�_ l~y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ 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 XJ WATER HOOK-UP ❑ FOLLOW-UP TZ ❑ AS BUILT-SURVEY / ❑�SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc Cz W 2 Q z W Z ccr r.t• •�(RO j WEl WORK SATISFACTORY:PROCEED A401EUCOMPLETE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN INSPECTOR WILL RETURN El ❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. 'all for the next inspection 24 h rsin advance. (952) 249-4600 60�3wnerltractoronsite: White Copy/Inspector's File Canary Copy/Site Notice