HomeMy WebLinkAbout2009 - 00234 - plumbing • CITY OF ORONO PERMIT NO.: 2009-00234
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 05/15/2009
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2740 WHITE OAK CIR
PIN : 04-117-23-42-0019
LEGAL DESC : REG.LAND SURVEY NO. 1447
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(> $500)
•
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: 1ST FLOOR:
1 WC
1 LAV
1 KITCHEN SINK
1 DISPOSAL
1 DISHWASHER
1 WET BAR
VALUATION OF PLUMBING 5230
APPLICANT PLUMBING FIXTURE FEE 65.38
WELTER&BAYLOCK INC. STATE SURCHARGE PLBG(VALUATION) 2.62
2014 4TH AVE. SW#3 -
NEW PRAGUE,MN 56071 TOTAL 68.00
(952)882-8681
Minnesota State License#: 003744PM
OWNER
BERRELL,ROBERT&KAREN
2740 WHITE OAK CIR
LONG LAKE,MN 55356
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in cont, , -with the State Building Code.This permit may be
rev. -a at.1 y /O ue cause.
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Appl cant ' • ee Signature Date Issued By Sign re y/ eate
SEP&I t.TF SERI - RE'Y:?IRE_ V.'1Ri . 7IS7FT977 B
FOR CITY USE ONLY
( O oO City of Orono
P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
'r• Crystal Bay,MN 55323 Approved By: _ Amount$:
yo (952)249-4600
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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)
❑New ❑Additional ❑Repairs eplace
❑ In Accessory Structure?
*You will need prior approval and may need .(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
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Site Address: c") 2 y0 L/ 14,--re �a- ✓C- e-
Owner: l\0 b Deice I I Mailing Address:
City: O(Ov\ D Zip: S5 3 S L
Home Phone: qac VOy"- ?(.9go Alternate Phone: /5a 4'73- 77
Contractor Informatiion:{.
Contractor: L)t'1' ( k )taj/X1(..1;16 Contact Person: Jl e LA?, Velzei
Address: 'l 15-4(),514) 11' 3 State Bond#: 700 g 33 74
City: Pet, Ra clue Zip: 56677/Expiration Date: /<,I '3/-
Phone: a 75-1- ..5-g1/ Alternate Phone: 6/22 'JJ /-17,57
El Insurance—Current:
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PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory l Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal j Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF-2002 STATE STATUE
0 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
I
PERMIT FEE CALCULATION(S)—JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
a30o9 x.0125$ (0'5' 3 8
(Contract price) (minimum$50.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
S :�a � x.0005 $ . L ;•.
(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.
PLUMBING PERMIT APPLICATION AGREEMENT
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.
.01.
Applicant's Signature: 4 Date: `' - t"/
Reset Form
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F-5- de TIME /
CITY OF ORONO CALLED IN 5/AJ
INSPECTION NOTICE SCHEDULED 5-/B-D? I.D 6'
PERMIT NO..1949 ODd COMPLETED
ADDRESS d -DDeV7d R7i 0 &)74-e-*-‘ t C .>
OWNER ./4-7 Cp JJ�. UQ /4/'i/D�
TELEPHONE NO. 952 - - e,/2 -ZZ/-!,7`-/
DESCRIPTION /er P/unnb/ni 7 .Cas LLitQ_
Lj ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q 0 FRAMING ❑ MECHANICAL FINAL 9 LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
O 9 TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP 9 SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
❑ DEMO-SITE ❑ SEPTIC MAINT. 9 COMPLAINT
--1 ❑ DEMO-FINAL 9 SEPTIC INSTALL. ❑ FOLLOW-UP
_ 9 PLUMBING RI ❑ SEPTIC FINAL 9 HARD COVER REMOVAL
v 0 PLUMBING FINAL 111FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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LuORK SATISFACTORY:PROCEED El PROJECT COMPLETE
W• CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site: J
Gj/���Inspector. (
White Copy/Inspector's File Canary Copy/Site Notice