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Home My WebLink About2004 - P07921 - vacuum breaker • 1 PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P07921 Crystal Bay, Minnesota 55323 Permit Type: Vacuum Breaker (952) 249-4600 Date Issued: 9/7/2004 SITE ADDRESS: 2775 White Oak Cr Long Lake,MN 55356 PID: 04-117-23-42-0015 DESCRIPTION: Proposed Use: Residential Permit Class: Plumbing Permit Type: Vacuum Breaker Permit Sub-type(s): Vacuum Breaker DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Backflow to lawn irrigation FEE SUMMARY: Permit Fee: $ 15.00 Valuation: $ 150.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 15.50 APPLICANT: Leon Duda Plumbing OWNER: James&Jackie Larson 208 17Th Ave N 2775 White Oak Cr Hopkins,MN 55343 Long Lake,MN 55356 THE UNDERSIGNED HE.. BY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO PO AL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA B i I I GI .DE REQUIREMENTS. t I , g1 APP IC•NT 'ERMITEE SIG ATURE ISS D BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1 CITY OF ORONO APPLICATION FOR PLUMBING PERMIT Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. 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 the State Code requirements. 6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice required. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call (952) 249-4600. Please check one: New Addition Repair Replace Residential Commercial JOB SITE: ,2-795- 1,31.1",4e, Dpik -r L Zip: SS-317 Owner's Name: �;� LA-?so 3 Telephone Number: (d Ye-/4r/ Mailing Address: ��75 �.,i ,`k n�lL l r� City: p go(-) 0 Zip: ,s-53// Contractor's Name: Le:h 2L'D P/, . Telephone Number: 9f gI ,r0 Mailing Address: n — eve. el City: Zip: 5-5-3g 3 PLUMBING FIXTURE SCHEDULE FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSM 1 S 2ND OTHER TYPE FL FL TYPE T T FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks liSt) ? , � r �/ i ',i --/ , '0 PERMIT FEE CALCULATION(S) 2002 State Statute 1 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 licenced contractor. Skip next section; Cost of Permit $ 15.00 State Surcharge $ .50 Mail In Fee $ 1.50 If above does not apply, follow guidelines below: 1. Contract Price* is .0125 % of job with a Minimum Fee of ($35.00) 730, oo x .0125 $ (contract price) (minimum$35.00) 2. State Surcharge. ** Add the State Building Code Division a (Minimum Fee of $ .50) x .0005 $ (contract price) (minimum$ .50) 3. Postage and Handling (Only mail-in applications) $ 1.50 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 installation 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 Department of Inspection Services for the price. The undersigned hereby applies to the ity f•r issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordi cis • the City and the regulations of the State of Minnesota, and certifies that all statements made • h 1 . ••lic. ion are complete, true and correct. Applicant's Signature: i�� + Date: q , 1 - f ,, s 7 Reset Form M -1--r". DATE TIME CITY OF ORONO CALLED IN — —1 INSPECTION NOTICE SCHEDULED " — ' I PERMIT NO. PO ]12-/ COMPLETED MO,—o 1,0 ADDRESS ,-,7775 L0h�TC- 00.....kC/ /e OWNER CONTR. �-e U'- aDur f?G-4- Phi 447 TELEPHONE NO. 952 9'33 S&3 Co DESCRIPTION tack /QGc) 6r /a6%)i7 //%ter`C�(1-rr04 W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING LL. 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS cl) O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 14.1 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL PLUMBING FINAL 36 FOUNDATION/REMOVAL TO MEET YOU: YES NO COMMENTS:CC l G -- be(4k r j,J 1'0\ / Q. o _ h:it=, P ;^ Sys cc 0 W cc Q cnW Z W cc 0 WQ C7ElWORK SATISFACTORY:PROCEED PROJECT COMPLETE LU CORRECT WORK&PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP 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/Con actor on si Inspector. White Copy/Inspector's File Canary Copy/Site Notice