HomeMy WebLinkAbout2010 - 00436 - plumbing ICITY OF ORONO PERMIT NO.: 2010-00436
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 06/08/2010
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2875 WEAR CIR
PIN : 33-118-23-34-0004
LEGAL DESC : UNPLATTED 33 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: FIXTURES INCLUDED:
(5)WATER CLOSETS,(6)LAVATORIES,(2)BATHTUBS,(2)SHOWERS,(2)KITCHEN SINKS,(1)DISHWASHER,(2)SILLCOCKS,
(1)FLOOR DRAIN,(2)LAUNDRY TRAYS,(2)WASHERS AND(1)WATER HEATER
VALUATION OF PLUMBING 16000
APPLICANT PLUMBING FIXTURE FEE 200.00
COX PLUMBING LLC STATE SURCHARGE PLBG(VALUATION) 8.00
17041 172ND AVE SE TOTAL 208.00
BIG LAKE,MN 55309-
(612)242-9247
OWNER
VAN PATTEN
2875 WEAR CIR
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any ti for due cause.
ve —._ ---7C._ / / auto_
or
Ap I t Permitee Signature Date Issu f By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
4
FOR CITY USE ONLY
O¢OAO City of Orono �y d ,n/1
P.O.Box 66 Date Received: / //0 Permit# 470"'��4w
2750 Kelley Parkway
t Crystal Bay,MN 55323 Approved By: Amount$:pip d
' 46". (952)249-4600
srso$
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
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 ❑ Commercial(Approval Required)
KNew ❑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: 5 tje f2
Owner: t/c(M) Mailing Address: /i✓A -7/;oe '��✓
City: ag/1--f\jd Zip: S3 COQ
Home Phone: Alternate Phone:
Contractor Information:
Contractor: C._-67X /7144tH .`�--j1CContact Person: ?Ai,/ e--er:v
Address: /7 c// /77)-✓/� State Bond#: l ? �
City: 8 t2al-k Zi�xpiration Date: ht-C.) 31 t l7
Phone: Alternate Phone: X.? v�o 3- 73i
d'-id- ? L/ 7
>, Insurance—Current:
1
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT Is1 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet f ) Floor Drains
Lavatory
/ 19 Sewer Ejector e-- 49—
Bathtub Laundry Tray
Shower
j Washer 6 l
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ Yes,this section applies
The replacement of a 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 contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
4'
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
/6O9O x.0125$
'contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
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 STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
:ra` FS - mor.;ki i llt
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:Pp ' � Date:
3
-
/ - ' ' /D TIME
CITY OF ORONO CALLED IN 111 Tl
INSPECTION NOXICESCHEDULED AP&�1 a 3:00
PERMIT NO. /O-00,,7' CO LETED It 1 I
ADDRESS T-
OWNER TELEPHONE NO��"-a'��g't 7
CONTRACTOR / b
V
DESCRIPTION GAO J '/ -
Lij ❑ FOOTING ❑; P ING FINAL ❑ EXCA diPADING/FILLING
Q ❑ POURED WALL ❑ ANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
• ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
• ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
APLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
WNERICONTRACTOR TO MEET YOU:_YES_NO
oy COMMENTS:
cc
cc
J
0
cc
0
U-
Q
W
W
cc
ofildCORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC
W ❑CORRECT WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY
tZ ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.3 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
Cl INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contract ron i
ri€4,
Inspector.
White opyllnspector's File Canary Copy/Site Notice
D TIME
CITY OF ORONO CALLED IN v
INSPECTION NOTICED:
SCHEDULED —/D ft
PERMIT NO.c1016 —00 COMPLETED
ADDRESS 07875 toe ctc Gv
OWNER �+ TELEPHONE NO. 612-ZzZ-9Z(11
CONTRACTOR S of C p / £ ,)I Pt a-o h
DESCRIPTION ' /2-,r
❑ FOOTING ❑ PLUMBING FINAL LI EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES NO
o COMMENTS:
CC
W
Q.
CC
CC
° r recrt u A 5 •r-sc<iss Q�
W
cc
W
W
cc
0
W ❑WORK SATISFACTORY:PROCEED 7 PROJECT COMPLETE
W
CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ 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 sit :
Inspector. FL
White Copyllnspector's File Canary Copy/Site Notice
CITY�� f� TIME
OF ONO DATE
CALLED IN / V
INSPECTION NQTICE `�D,/�s�HEDULED / " . • '3.• O
p
PERMIT NO. 7 '7`-Jani IPLEET�
ADDRESS /� 7S `/(/t� � L
OWNER Ca.
TELEPHONE NO Ar / a— 4'?CONTRACTO /
DESCRIPTION
L ❑ FOOTING PLUMBING FINAL ❑ EXCAV :-Am NG/FILLING
Q ❑ POURED WALL MECHANICAL RI . ❑ LAKE Ho E/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
• ❑ FINAL 0 SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL
• OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
cc
W
Q.
CC
O
CC
O
W
CC
Q
W
W
❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
CC
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
El CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP 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. U t(0 BS
White Copy/Inspector's File Canary Copy/Site Notice