HomeMy WebLinkAbout2015 - 01594 - plumbing CITY OF ORONO 1111 11 1111 111 1 II I II
* 20 1 5 - 0 1 5 94 *
2750 KELLEY PARKWAY DATE ISSUED: 12/28/2015
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2606 WEST LAFAYETTE RD
PIN : 21-117-23-21-0001
LEGAL DESC : REG. LAND SURVEY NO.0131
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (10 WATER CLOSET,(2)LAVATORIES AND(1)SHOWER
VALUATION OF PLUMBING 2995
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.50
B&D PLUMBING&HEATING INC.
4145 MACKENZIE CT NE TOTAL 51.50
ST MICHAEL,MN 55376- Payment(s)
(763)497-2290 CHECK 552074 51.50
OWNER
EKHOLM,PAUL&L
2606 WEST LAFAYETTE RD
EXCELSIOR,MN 55331
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 y time for due c use. r
a. �G�- /2 �—� 4 8"/
Applicant Permitee Signature Date Issued Signature Date
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o CityofOrono ! $ 5L/I'.O.rbx66Date Rmencd ' l arm r rt. D� 77r""d (41---04b
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* c o� CITY OF ORONO PLUMBING PERM1/4 IT'
N ESHCO't' (All Commercial Permits Must be Approved by the State Prior to City Approval)
Into illiv,n.dli.mn.eov/ :CI a)/PDFine plumhpianrcvapp.pdf
GENERAL INFORMATION
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0 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
in
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
NI. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
tO 4. When any new construction or remodeling is involved,a separate building permit must be
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obtained.
N 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)
0 New 0 Additional 0 Repairs ®Replace
❑ In Accessory Structure?
"You will need prior approval and may nod CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site 1 Ovvner Information:
2 C�cj(Q wz,t L ( .+
Site Address: �tY<' II -- e
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Owner:LAu.-.c C K!wlr� Mailing Address: -S-.f?-Y-
City k c_ls/> v: Zip: $f, 3 7/
Home Phone: Alternate Phone:
Contractor Information:
'
Contact Person: C---ree 1....).,1 1c1,,,£.='
B&D Plumbing,Heating&A/C r::
4145 MacKenzie Court NE State Bond n:
Si Michael,MN 55376
m Expiration Date:
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V -7Cc 4/ 1 --267-`42 i i s;
Phone: 3 ' Alternate Phone: 6,i Z- 5 2 (2- 7'75{, C'
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FIXTUREBSMT IS7 2`D OTHER 1 FO(TURE BSMT lsr 2" OTHER
TYPE l FL FL TYPE FL FL
Water Closet Floor Drains
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.. Lavatory Sewer Ejector
Bathtub Laundry Tray
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o Shower Washer
Kitchen Sink Water Heater
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Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
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❑ 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 015500.00 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 S 1.00
Mail-In Foe Of Applicable) 5 2.00
Total Permit Fee S
to
(Permit Fres Continued On Next Page)
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2
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o_ ATIOX-$10013.)0V043.04,00J;',VYkPg7„,a
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to If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of S50.00)
x.0125$
(nnnxct prig) (minimum$50.00)
0
0 2. STATE SURCHARGE
x.0005 $
(ccwtnut pnou)
3. POSTAGE&HANDLL*IG(Only on Mail-In Applications) $ 2.00
co 4. TOTAL PERMIT FEE(Add Lincs 1-3 Above)
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• *CONTRACT PRICE ur 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 G i llate:to
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From:7634974263 12/28/2015 11 : 10 #180 P.004/004
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DATE TIME
CITY OF ORONO CALLED IN / - 5
INSPECTION NOTICE CHEDULED - //:,7O
PERMIT NO. s -r 9 OMPLETEDo /�
ADDRESS c���O .�5� L�A y t(AL �Ge-
OWNER T•,LEPHON• O.
CONTRACTOR • 01 / *I
3.-. DESCRIPTION �,.�✓h — /
W ❑ FOOTING ■Ar O-FINAL 0 SEPTIC FINAL4.
❑
Q POURED WALL t PLUMBING RI 0 EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF 0 ` UMBING FINAL 0 TREE REMOVAL
❑ 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 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
IC Z OWNER/CONTRACTOR TO MEET YOU:_Y _ 0
WCOMMENTS: 6 ,_1 o. 17
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W i' l•RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W /U CORRECT WORK&PROCEED CIISSUE CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952 ' 600
Owner/Contractor on site:
Inspector. r
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME 'j�
CITY OF ORONO CALLED IN =/ zl E�
INSPECTION NOTICE SCHEDULED _ J j /9114PERMIT NO. 2-C i�-01 cD`j 9- COMPLETED
ADDRESS 2 ( C (r, c-U , - — in
OWNER TELEPHO ENO. 447-- `3z Z . -0 33
CONTRACTOR /6 // "Ph c/-7-
32 DESCRIPTION p/ L-L-/717v. a /A � /
W 0 FOOTING 0 D MO-FINAL 0 SEPTIC FINAL / 1Th
tis
0 POURED WALL 0 LUMBING RI 0 EXCAV/GRADING/FILLING
h ❑ FOUNDATION WATERPROOF UMBING FINAL
0 TREE REMOVAL
Z ❑ RADON SLAB MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
1, ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ �EP//��IC INSTALL
2 OWNER/CONTRACTOR TO IIEET YOU: LYES_NO
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c.) COMMENTS: /�
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(41:-/AtOit t0
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Lu ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY
CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING
PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 h urs in advance. 9 249-4600
OwnerlContractor on site: /--'1
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice