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HomeMy WebLinkAbout2012-00788 - plumbing 4 CITY OF ORONO _ f 2750 KELLEY PARKWAY * DANE ISSUED: 08113/20182 ORONO,MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS 3240 WATERTOWN RD PIN : 32-118-23-44-0017 LEGAL DESC SENN ORONO ADDITION LOT 001 BLOCK 001 PERMIT TYPE PLUMBING(<$500) PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE FIXTURE APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 1313 DANITA CR. MAIL-IN FEE 2.00 SHAKOPEE,MN 55379 (952)445-4803 MISC FEE 0.00 Minnesota State License#: 057209PM TOTAL 22.00 OWNER JURAN,DAVID&SHEILA 3240 WATERTOWN RD LONG LAKE,MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time �for due cause. Applicant Permitee Signature Date Issued By gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . FOR MY USE ONLY City of Orono 1/0 4�i P.O.Box 66 Date Received: Pemrit# ,'r 0 �'1 2750 Kelley Parkway S,fi4 Crystal Bay,MN 55323 Approved By: Amount$: \1 / (952)2494600—Main � (952)2494616—Fax CITY OF ORONO.-PLUMBING PERMIT (All Commercial Permits Must be Approved by the'State Prior to City Approval) Ittt2://ww%,N,.dli.mn.gov/CCLD/PDF/pe_pIumbi)lani-ev,ag12.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 PERMff CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may 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 E Additional -]Repairs Replace ❑ In Accessory Structure? *You will need prior avoroval and may need CUI',(Per Orono City Code,Chapter 78,Article M Job Site/Owner"Information: Site Address: 33u.o �1u krkwhl PA Owner:�JhL%I& u Y Q n Mailing Address: Ullylkd:a [>aj City: drUoo Zip: Home Phone: Q[a a�l�) �O Alternate Phone: COntractoI Informatiow. Contractor. Contact Person: VQrn,P Address; 1313 W InAa Car State;Bond#: City: Shy Zip-E5Wq Expiration Date: Phone: CbR,4L Alternate Phone: Insurance—Current: 1 FIXTURE BSMT lsT 2 OTHER FIXTURE BSMT IST 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 ' x ❑ 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 )?1✓TM 'i` E 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) (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) $ Q Q'0Q ■ * 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. a 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. D P Applicant's Signature: Date: "a JA 17 RRset F©rm 3 6V 4_1 gfAk TIME CITY OF ORONO CALLED IN INSPECTIONOTICE SCHEDULED %& PERMIT NO.aOlo?-DD 7&f COMPLETED ADDRESS -32-& U ' OWNER 0-116414 ���-� TELEPHONE NOI� r2 T73 9-_%/ CONTRACTOR LLQ' DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL Q El 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W a J O O W Q 2 W Z W O Uj ❑WORK SATISFACTORY:PROCEED D%,�ROJECT COMPLETE Cr W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 1:1 PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. White Copynnspector's File Canary Copy/Site Notice