HomeMy WebLinkAbout2015-00335 - plumbing CITY OF ORONO 11111111111111111111111111111111111111111111111111
* 201S - 00335 *
2750 KELLEY PARKWAY DATE ISSUED: 03/31/2015
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(>$500)
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: 1 LAUNDRY TRAY,3 WASHERS
VALUATION OF PLUMBING 3800
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.90
ASSOCIATED MECHANICAL CONTRACTORS, TOTAL 51.90
1257 MARSCHALL ROAD Payment(s)
SHAKOPEE,MN 55379 CHECK 91331 51.90
952-445-5119
Minnesota State License#:mech-059419-PM,plbg-PC643141
OWNER
Kraus Anderson Realty
875 WAYZATA BLVD W
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issuey Signature Date
F .
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FOR CITY USE ONLY
A, City of Orono ,t
W
P.O.Box Date Received:3 II 5 Permit# 5-Ula 3
2750 Kelley ParkwayCrystal Bay,MN 55323 Approved By: + Amount$:
--CITY OF ORONO-PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
htt s://www.dliann.!ov/CCLD/PDF/I e •lumb i lanreva• i.i df
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 it Commercial(Approval Required)
❑New E 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 Information:
Site Address: 8) 5 'A-4-(--TA- 6L--q
Owner:1A-(L,S o T 0 go/vb Mailing Address: J+
City: b 4,0 tU 0 Zip: 553 cl, (
Home Phone: 015 Z-`173-44,5_5 Alternate Phone:
Contractor Information:
Contractor: /--3 c�DC 4_46vo nice;Contact Person: g- L)iiu III UC' _
Address: t 7S7 fAASC d 4-&RQ State Bond #: PC.. L;L f 3 NI
City: 5,4-41-op“ ` Zip d5,Expiration Date: ID - ?1- (5-
Phone:
jPhone: J 3Z--1'f5--5j 0 a Alternate Phone:
❑ Insurance—Current:
1
t
FIXTURE BSMT 1ST - 2AD OTHER FIXTURE BSMT 1sr 2r1D OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer 3
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(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 $
(Permit Fees Continued On Next Page)
2
ilL
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
�� 4,41be � x.0125 $
� p lifYU
`(contract price) minimum$50.00)
2. STATE SURCHARGE s�
3 Soc. x.0005 $ v
/ (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.
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:...,2---------- Date:512.31 15
3
DATE TIME
CITY OF ORONO CALLED IN .3-c3)
INSPECTION NOTIC —e653-3. SCHEDULED 31-15 /D:CO
PERMIT NO. C• • ET ED
ADDRESS
OWNER TEL PONE 0b5/ ?Z
CONTRACTOR C �/ • 4SDw.
DESCRIPTION
W ❑ FOOTING 0 DS FINAL 0 SEPTIC FINAL
❑ POURED WALL ING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI ❑ SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 PROGRESS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 HARD COVER REMOVAL
❑ DEMO-SITE 0 SEPTIC INSTALL 0 FOUNDATION/REMOVAL
c OWNER/CONTRACTOR TO MEET YOU:• YES NO
y COMMENTS: 1/6[4/
c L
Q. Lc�� / Gv a.� Zed &)C ' /' Qty
o dr/t - IOiJJ d P VG 6cst "
11)1/4cc
cc
W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
• ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CI 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 Copy/Inspector's File Canary Copy/Site Notice
/ v DATE TIME I/
Ci l CITY OF ORONO CALLED IN
INSPECTION N,9TICE SCHEDULED 7 - 4-n,
PERMIT NO. C 15 -e .(-- -)-7--)COMPLETED
ADDRESS B (.,k..:IA-1 7c t c 8k/di
OWNER TELEPHON
CONTRACTOR tt�� t , --' L - -
DESCRIPTION �,i,YLh i 7-J/lal
IQ ❑ FOOTING ❑ DEMO-FINAL 'J ❑ SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF El PLUMBING FINAL l=1 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
• ❑ INSULATION ❑ WOOD BURNER/FIREPLACE 0 COMPLAINT
*-4 ID FINAL 0 WATER HOOK-UP ElFOLLOW-UP
Z
❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 HARD COVER REMOVAL
v ❑ DEMO-SITE ❑\ PTIC INSTALL 0 FOUNDATION/REMOVAL
2 OWNER/CONTRACTOR TO MEET YOU: YES_NO
{.1• COMMENTS: '
W -
o `• / -See o f sE�� � 'cd. 4e.-.r 6e- /RSth�irQ
�O ,rersse d'e( cerra"N'rwale.e 2 Ai..:-a /ak.r�t - ofr.,
W
cc oe'6< w Pe k c+v . ACV e —
vcz
W /0 -e- ce-...l vC
ac
O 0 WORK SATISFACTORY:PROCEEDOJECT COMPLETE
CCW
0 CORRECT WORK&PROCEED 0 ISSU CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
0 CORRECT UNSAFE CONDITION WITHIN HOURS. 0 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. ./ ✓ �'b
White Copyllnspector's File Canary Copy/Site Notice