HomeMy WebLinkAbout2014-00143 - plumbing CITY OF ORONO ll I I III I II ! ll Ill 11111 11
* 2014 - 00143 *
2750 KELLEY PARKWAY DATE ISSUED: 02/20/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 875 WAYZATA BLVD W
PIN : 35-118-23-44-0011
LEGAL DESC : UNPLATTED 35 118 23
: LOT MB BLOCK MB
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: LAUNDRY TRAY
VALUATION OF PLUMBING 800
APPLICANT PLUMBING FIXTURE FEE 50.00
ASSOCIATED MECHANICAL CONTRACTORS, STATE SURCHARGE PLBG(VALUATION) 0.40
1257 MARSCHALL ROAD MAIL-IN FEE 2.00
SHAKOPEE, MN 55379 TOTAL 52.40
952-445-5119 Payment(s)
Minnesota State License#: mech-059419-PM,plbg-PC643141 CREDIT CARD 5255 52.40
OWNER
KA Reality
4210 W. SHAKOPEE RD
BLOOMINGTON,MN 55437-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
(-2/U Lae"
Applicant Permitee Signat at Issu By Signature Date
95223331?7. 08:34:30 a.m. 02-19-2014 2/4
R rips.ONLY
City of Orono22,�,!ti-126 I
��D� p.0.Box 66 Date Receive lqPermit# /
O 2750 Kelley Parkway C A w, /�-7
Crystal Bay,MN 55323 Approved By: Amount$: a '
(952)249-4600-Main
s (952)249.4616-Fax
yFI, C' CITY OF ORONO—PLUMBING PERMIT
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(All Commercial Permits Must be Approved by the State Prior to City Approval)
lrttp://www.dli,mn,eov/CCLD/PDF/pe plumbplanrevapp.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 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.
(24-48 hour notice required)
TYPE OF PERMIT
(Check All That Apply)
❑Residential 0 Commercial(Approval Required)
❑New 0 Additional ?'Repairs Pt/te O'E L_ 0 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: g Z S L)A Y/N- A t�U
Owner: L.t Y`t. C X Mailing Address: '.P 2.)D Ix.1 pt"<tiviakverAka
City: g1 DE31'1 Zip: "S-`1,S
Home Phone: 952. ~9411t—IA 16 C Alternate Phone:
Contractor Information:
Contractor: AO0CG 4'tD 11 c. A Jze &Contact Person: 11
Address: /2-g State Bond#: pc 1043 14
City: 54,4440 Aft Zip: Expiration Date: ‘D.- 31—
Phone: 9E Z.` 4'. "S!bZ) Alternate Phone: ei5�' �j'j 3 13
❑ Insurance—Current: `1%Y\ 16(i A 2
I
r
952233313: 08:35:17 a.m. 02-19-2014 3/4
FIXTURE BSMT Is' 2" OTHER FIXTURE BSMT 1FL OTHER
TYPE FL FL TYPE 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
„. TRAV000240,.
❑ 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
9522333137 08:36:04 a.m. 02-19-2014 4/4
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contractprice with a(Minimum Fee of$50.00
Q
AO x.0125$ No
(contract price) (minimum$50.00)
2. STATE SURCHARGE *g
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ SZ
■ * 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 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.
;k1Applicant'sDate: 1Jj ;j( TSignature: �-------���" � 1 ((„ 111
3
I' ii-„...en........„----•- � DATE ,` TIME t-CITY OF OR OIN zT
INSPECTION N•TI - SCHEDULED •-/.+'--1 if rf..,_340
PERMIT N• - 4.) / COMPLETED
ADDRESS e 75 c I ' /,i/ / . ( Ud
OWNER .1. PHONE NOP) a_ 3_D 59
CONTRACTOR / 11/tXe
DESCRIPTION PI6 �r�
LU 0 FOOTING ❑ PLUMBIN NAL 0 EXCAV/GRADING/FILLING
cr 0 POURED WALL ❑ MECHANI L RI 0 LAKESHORE/WETLANDS
h ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
2
0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
0 FINAL ❑ SEWER HOOK-UP 0 COMPLAINT
v 0 DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP
IQ ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL
v 0 PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES/ NO
(0) COMMENTS:
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0 111544 lloCQ
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IQ ❑WORK SATISFACTORY:PROCEED COMPLETE
W CC
❑CORRECT WORK&PROCEED ❑ IS E CERTIFICATE OF OCCUPANCY
CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlC• •ctor on site: I 0 4J
Inspector. 0 i
White Copyllnspector's File Canary Copy/Site Notice
e& DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOOlta �'/,SCHEDULED�
D2-c / I q q:
PERMIT NO. nCOMPLETED
ADDRESS 875 Wail-el-a_ CD
46I U�
OWNER TELEPHONE NO.
CONTRACTOR 0
DESCRIPTION 4)/1641t
IQ 0 FOOTING 0 PLUMBING FINAL� � ❑ EXCAV/GRADING/FILLING
0 POURED WALL 0 MECHANICAL RI ❑ LAKESHORENVETLANDS
y
0 FRAMING 0 MECHANICAL FINAL 0 TREE REMOVAL
0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
Q ❑ RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
is 0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT
v ❑ DE O-SITE 0 SEPTIC MAINT ❑ FOLLOW-UP
0 MO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL
ER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
cc
C �
jY64"
O
cc
cc
w
CC
WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
0 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952 ' ' -4600
Owner/Contractor on site:
Inspector_ White Copy/Inspector's File 41,4eVAF
y/Site Notice