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Home My WebLink About2012 - 00494 (voided) CITY OF ORONO 11111111E0 I III 1 1 IIIc lH II�1H I HH II�1 2750 KELLEY PARKWAY DATE ISSUED: 06/05/2012 ORONO, MN 55356- • (952)249-4600 FAX: (952)249-4616 ADDRESS : 2615 WEST LAFAYETTE RD PIN : 21-117-23-24-0049 LEGAL DESC : SHORE HILLS : LOT 018 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: 1 LAV, 1 SHOWER VALUATION OF PLUMBING 1800 I APPLICANT PLUMBING FI ' , ' FEE 50.00 RIVERSIDE MECHANICAL 12460 ZINRAN AVENUE STATE SURC. 'GE PLBG(VALUATION) 0.90 SAVAGE, MN 55378- Minnesota IL-INF 2.00 State License : PC644 9 TOTAL 52.90 O NER GAGNE,JIM&TORRE 2615 WEST LAFAYETTE ' 16_____ \tr EXCELSIOR„MN 55331 - )\ r, i -''.'‘k AGREEM ' AND SWOR STATE NT ...9..._, ‘6 „ � The work for which this pe issued shall b, performed acc o �, . 11S1 the approved plans and specificati. applicable, . approvals,and the 'State Building Code. This permit is r the wo described and does0p')t \ l not grant permission for additional or relat- ork . h requires separate permits. All provisions of laws and ordinance ern :this type of work \ shall be compied with whether or not specified her- permit will expire and become null and void if construction author 's not \lb commenced within 180 days of the date of issuance,or if construction is Ci' \, \� suspended for a period of 180 days at any time after work has commenced. �1 ,/ The applicant is responsible for assuring all required inspections are y requested in conformance with the State Building Code.This permit may be revoked at any time for due causes / I '4 A�� . / / Applicant Permitee Signature Date Issued By�gnature � � Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB A E. FOR CITY USE ONLY ;SOA. City of Orono P.O.Box 66 Date Received: Permit# O 2750 Kelley Parkway ( r71¢tL. Crystal Bay,MN 5532.3 Approved By: Amount$: }. " (952)249-4600—Main asu� (952)249-4616—Fax CITY OF ORONO —PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htti://www.dli.mn.'ov/CCLD/PDF/ e lumb lanreva . 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) X]Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs I/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: a t )S' 1.13 ��'• o-�e.W. P4\ Owner: lac AL Mailing Address: City: Ot rw Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: R:uers\L Pc,L. Contact Person: Address: I1kleo Z)nr-r.,. t\v- State Bond #: 06061 A\ City: Zip: AAA Expiration Date: 1J-31' 3O Id. Phone: qSc}-*14-111o00 Alternate Phone: 6(4- `i l c- � ❑ Insurance—Current: Ye% 1 9 .r teF xi',FN,a.Gny,ay,u4++W4 . rw5.d4(w.a +�e».n 'a+n� .z....+..Mvsr .mbasd. -.Liv'�,wexu�d�frAWWi.Nc - �•..: FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory 1 Sewer Ejector Bathtub Laundry Tray Shower , Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous tales G gym. �a .1; :ASED OF ►GO a }A :. A'BUE r ' ❑ 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 • If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)` t$06 x.0125$ 50 (contract price) (minimum 550.00) 2. STATE SURCHARGE _AO0 x.0005 $ ' 90 (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ...ca.9 0 • * 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. . ; . .. PLUMB I c sa' 41 T APPLICATION AGR ,:,.41M1 ,..< t 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:- ___..-- Date: -Li— l ( - 1,'1�i �at' ' �i q 3