HomeMy WebLinkAbout2014 - 00149 - plumbing CITY OF ORONO II 11111111 II II 1111111111
2750 KELLEY PARKWAY * DAT
T 1 4 - 0 0 1 4 9
ATE ISSUED: 02/19/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 860 WINDJAMMER LA
PIN : 07-117-23-11-0011
LEGAL DESC : PIRATES COVE
: LOT 007 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: INSTALL DISPOSAL
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG(<$500) 5.00
APPLIANCE CONNECTIONS MAIL-IN FEE 2.00
12850 CHESTNUT BLVD
SHAKOPEE, MN 55379 MISC FEE 0.00
(952)445-4803 TOTAL 22.00
Minnesota State License#: BUIL-057209PM Payment(s)
CHECK 20576 22.00
OWNER
ETAL, DANIEL KELLY
860 WINDJAMMER LA
MOUND, MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By 'gnature Date
FOR CITY USE ONLY
040)0 City of Orono
P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
if'? t Crystal Bay,MN 55323 Approved By: Amount$:
4S.41' (952)249.4600
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 0 Additional ❑ Repairs 0 Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Infformation:
Site Address: 8 6 0 (,L)I n j xrr me r L.n
Owner: Kelly fl tni el Mailing Address:
City: Zip:
Home Phone:q60-41a-3 3 9, Alternate Phone:
Contractor Information:
Contractor: Appliance Connections In�ontact Person: JCZlytict2iwe(
12850 Chestnut Blvd.
Address: Shakopee, MN 55379 State Bond#: 057.201
952-445-4803
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
1
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1`T 2h1p OTHER ' FIXTURE----1 BSMT 1ST 2xo I OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal I Water Softener
Dishwasher �L Wet Bar
Sillcocks Miscellaneous
_ IERMIT FEE CALCULATIONS)
ATION(S)
l BASED OFF =2002 STATE STATUE
❑ 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 cast 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 $ 0
(Permit Fees Continued On Next Page)
2
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00)
x.0005 $
(contract price) ' (minimum$ 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ v
■ * 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$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
� s
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.
r
Applicant's Signature: Jit -e- Date: 4=VARAV
' /I
3
V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.a611-1 - 9 COMPLETED / 3--/St
ADDRESS FAO !V/II;V " Zee_
OWNERTELEPHONE NO.
CONTRACTOR q450I440't e L'o 4�Le-Act
DESCRIPTION
«/oS1
0 FOOTING ,,24:12.IUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q 0 POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
H ❑ FRAMING 0 MECHANICAL FINAL ❑ TREE REMOVAL
❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q 0 RADON SLAB ❑ WATER HOOK-UP 0 PROGRESS
• 0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. .OLLOW-UP
LU 0 DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL
• ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTORRTO MEET YOU:_YES_NO
9 COMMENTS: Ar., " Ao h e-- F4./ " c 4,
• cicSir 4' " ;70-1 / /rIS� �C
CC
kJaf� G�',04 e
CCW
CC
Q
W
LU
CC
LUCIWORK SATISFACTORY:PROCEED c. ROJECT COMPLETE
0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ 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) 249-4600
Owner/Contractor on site:
Inspector // �`•... 7�—
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