HomeMy WebLinkAbout2017 - 00405 - plumbing CITY OF ORONO l I I I I 3 I H 111111111111111111r
20 1 7 - 00405 *
2750 KELLEY PARKWAY * DATE ISSUED: 04/24/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1801 WEST FARM RD
PIN : 27-118-23-44-0019
LEGAL DESC : N/A
: LOT MB BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: IRON FILTER
VALUATION OF PLUMBING 1200
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.60
CITY VIEW PLUMBING&HEATING TOTAL 50.60
1880-B WAYZATA BLVD W
P.O. BOX 150 Payment(s)
LONG LAKE,MN 55356 CHECK 36961 50.60
(952)473-8793
Minnesota State License#:plbg-MB005208
OWNER
MULDOON,PAUL&SAMANTHA
1801 WEST FARM 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
revo d at any time for due cause.
Appli ant Permitee Signature ate Issued By ature [)ate
SpA City of Orono FOR CITY USE ONLY
0 P.O. Box 66 Date Received:
2750 Kelley Parkway
Crystal Bay, MN 55323 Permit#
m�`1 ��c` (952)249-4600-Main Approved By:
45140 (952)249-4616-Fax
Amount$:
CITY OF ORONO - PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.qov/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 ❑ Commercial (Approval Required) [Backflow Device: ❑ AVB ❑ PVB]
❑ New ❑ 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: 1�d 1 W 6� ��.�� 2
Owner:5� �il0�, Yr kAk106(1 Mailing Address I 5 , WeSt Foll'A
I, n City: 2-0(1-2-0(1- Lack/ Zip: &_5-J-*
Home Phone: 3P - 560 - q15..)- Alternate Phone:
Contractor Information: (Contractor: V( P/ L J` Contact Person: L5 eavi/ct id
LA)
Address: (g60` g w€S-- Cd(kY6A4k 4 State Bond #: FC 6 1 I /3
City: Lov 1-0, Zip:X51.2 Expiration Date:
Phone: 9.5.2-/ .3-- 5?-9 3 Alternate Phone:
Insurance - Current: 7e S
Page 1
a,.
PLUMBING,FIXTURES BEING INSTALLED
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocksce aneous I
J'ov I
PERMIT FEE CALCULATION
1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
(.) -
o lam/) x .0125 $
(contract price) (minimum $50.00)
2. STATE SURCHARGE
4 .1 / 0 x .0005
(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 becharged 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.
PLUMBING PERMIT APPLICATIONREEM)WNT '
The undersigned hereby applies to the City for issuance of ar 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 statemen de on this application are complete, true and correct.
(
Applicant's Signature: 407Date: 4(d-it
Building Official/ Inspector: Date:
Page 2
/ DATE TIME
1-/-
CITY OF ORONO CALLED IN l-2 ` 177
INSPECTION NOnTI _E SCHEDULED L/ Zia2-1—' .9.2::
PERMIT NO./7� 17 ' C��MP�LETTED
ADDRESS /yv L GL�'N'�-t _
/ _-c__,
OWNER , 1.tPHO NO�S ?'_��D" 0
CONTRACT e - l yIt P a-��V ,b —cf-vv
DESCRIPTION
W 0 FOOTING 0 DEMO L 0 SEPTIC FINAL
Q ❑POURED WALL JPLU .: RI 0 EXCAV/GRADING/FILLING
▪ ElFOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
C
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP ElFOLLOW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE ElSEPTIC INSTALL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
i
vi COMMENTS:
W
Q /r6rt 5-.. L6 ,As f4 1/ —
o — 4:1r y, if re,v"d�
o -r, ettic A 14564 11. /0er se,_,_s
W
O;
Q
W
Z
CC r
W 0 WORK SATISFACTORY.PROCEED air—PROJECT COMPLETE
R;
W 0 CORRECT WORK A PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COHERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR CI CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. (952) 249-4600
Owner'Contractor on site:
Inspector. / PIA
White Copy/Inspector's File Canary CopylStte Notice