HomeMy WebLinkAbout2015-01021 (Plumbing) CITY OF ORONO * z 0 1 5 - 0 1 0 z i *
2750 KELLEY PARKWAY DATE ISSUED: 08/12/2015
ORONO, MN 55356-
(952 249-4600 FAX: 952 249-4616
ADDRESS : 2205 ABINGDON WAY
PIN : 03-117-23-24-0005
LEGAL DESC : ABINGDON GLEN
: LOT 004 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00
STATE SURCHARGE PLBG(<$500) 1.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 18.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 18.00
OWNER
BRUCE, ROBERT&CHRISTINE
2205 ABINGDON WAY
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By Signature Date
08/11/2015 14:18 FA� 9529�35049 CULLIGAN MNTKA C�002
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' FOR CITY USE ONLY
d�'�� City of Orono
//0�' ��a� P.O.Box 66 Datc Received: Permit#
�� �„s;,r :75�Kelley Parkyvay
�a "�7 � C st�l Ba MN 553:3 Approved By: Amount$'
��±�;��. o�/ (9S'.)249-4b00 , -
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CYT'Y OF ORONO—PLUII�ING PERIVZZT
(All Cammcrcia]permi[S muSt bC&pproved by che Building O�cia]or Inspcctor)
GE?�ERAL INFORMATION
1. You may apply for plumbing pernlits by mail or in person at the City officcs. Applications wiIl'be
reviewed and a permit will be issued within two working days.
Z. Permit cards will be sent by return mail af�er a review is completed. PERMITS ARE NOT
VALID UNT1L YOU REC�IVE A PPRMIT. �'VORK MtiST NOT SEGI]V UNTIL THE
P�17MrT CAYtT]XS POS7"�n ON'T'HE JOB SITE.
3. Plumbing permits may be issucd ONLY to licensed plumbing eontractors and to properry owners
residing in the dwelIing.
�. When any new construction or remodelina is involved,a sepazate building permit must bc
obtained.
5. AIl worlc must be done in accordance with State Code requirements.
6. AlI work must be inspected and air tested bcfara it is covcrcd. Csll(95Z)249�600.
(24-48 hour notSce re�uired)
T�S'PE OF PERMIT
Check All That A 1
�Re5identia] ❑Commercial(Approval Required}
❑NeW ❑Addi�ional ❑Repairs �Replace
❑ In Accessory Shvcture? �
*You will need nr�or ap»ro'va�atld may need S'"Up.(Per Orono City Code,Chapter 78,Article IV)
J'ob Site/Ovvncr Inforn�atian:
SiteAddress: c�a�5 Q�',� �-,Gr�o� �tiay ,
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Owner: t'�o��,r� l��r+..�c� Mailing Address:
City: Zip:
I-Iome Ahone: �i5 a- ��LI C- I ?�� Alt�rnate Phona:
Contractor Information:
Contractor: Contact Person:
�U���:vV�T�#� �f�I�i�'�+��� State Bottd #:
�03G CU� iGAPV 1+VA`�
�N��ONK,4, MN 5`���zip: Expiral;ion Date:
. (952) - p
�hone: AIternate Phone:
❑ Insurance—Current:
1
08/11/2015 14:18 FAY �5293a5049 CULLIGAN MNTKA C�003
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�D lJ�� �7�1����liL�1J'""�
F17{TURE BSMT 1 2 OTHER FIXTURE SSMI' 7 2 OTHER
TYPE �'1. F�- TYPE FL FL
WaZer Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Loundry Tray
Shower W asher
iCitcl�en Sink Water Heater
Disposal Water Softener �
Dishwasher Wet Bar
5illcodcs Miscellaneous
���^n. �I I ' '' � +i.b, h'I'i'r �.Y..'i +�a y-,� ry �,�. �r , �,'ii Cn" F �l ��` � � ;�,/
'j(�,.,.�� 1 �,jt� � i v.ci .i!�,,.1�' i��i . ��.�'f� �����Cl�'�J�r ��'� �., � i,:' C.��;�I'.. ,�.r�.�,i�� ' �
'� I :VI���`.'� y` 1� ��� , :I]I�S��Vi."P �,Q��,�131��T���J�� �� �, ,"',�` � ;1 i i���i,,,x,
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❑ Yes,this seciion appIies
The replacement of a Residential fixture or avAliance that meets all three of the following requiremenrs:
1. Does not require modification to electrica]or�as service.
2. Has�iotal cosr of$500.00 or less;excludin�the cost of the fixture or appliance:and
3. Zs improved,installed or replaced by the homeowner or licensed contractor.
Skip next scction,if this appli�s; Cost ofPermit $ I5,00
State 5urcharge � S_�p
Mail-In Fee(If rlpplicable) � 2.00
Total Pei•mit Fee $
(Permit Fees Continued On Neat Page)
2
08/11/2015 14:18 FAX 95293�5049 CULLIGAN MNTKA �004
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If�bo��e does not ap�iy;folIow guidelines bclow: , •
1. CONT�CT Pk�C� * is ].?�%o�cantract price with a(Aqinemum Fee of�50.00)
x.0125�
(contraci price) (.ninimum$50,00)
2, STAT�_SY.i�iCY�Al2C� **Add the State Bldg Code Div.Surcharge(Minimum�ee of�5.00)
x.0005 $
(contract pricc) (minimum$ 5.00)
3. POSTAGE&HANDLING(Only on MaiI-In Applications) � �,00
4. TOTAI.,�EYt114TT�'EE(Add Lincs 1-3 Abo�c) �_ � t� , d V �
■ K CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chargcd for tho
perRiitted worlc inciuding materials, labor,profit, and other fixed costs. It is the amount to be eharged
to the customer for the work done. [f any material, equipmenC, lt�bor or instAll2�ions are furnished by
tl�e owner,tcnant or any other pazty, the reasonable market value of such itesns must be added to the
csCimaied cost or contract price for permit fee purposes. ln the event that there is a dispute on the
amount of Ehe job cost, the Ciry may request the submission of a signed copy of the actual contract.
■ '"*The STATE SURCHARGE is.0005 of the contraet priee under�1,000,000 or$5.00—whichever is
greatcr_ For valuations ovcr$1,000,000 call�hc Building Depanment 0.t(952)249-4600 for the piice.
�:ti��„U I M1�,N,.��u,,r,:�,� y�q ii,�. „ .�.. �,����y �. - _
y � �.��,,B�Y n.ii �1 I�Il (`�'h �Y 1 r(���-+ � � I n � Yn T i� '�A��'1��"��`�y��'��. �1��4I I���,Y � Ir��i��
�:I�S��I�?�hIM „Z�n 4�A . .4�..4'�J—nWI�JJ.�1��1J.�L^����Y�-[T ,L � I,��t�"�, ',L�,I, ,a�, �;M1„t,i.J�,. ,N�
The undersigned hereby applies to the City for issuance of a 1?lumbing Permi� agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the 5tate of
Minnesota, and certifies that a1] statements made on this application are compiete, true and
correct.
Applicant's Signature: � �c�.�z Date: X - I I - I�
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T ,/� TIME
CITY OF O ONO CALLED IN ' �
INSPECTION N TIC SCHEDULED �
PERMIT NO. �� ���'� COMPLEfED
ADDRESS ���5 /�'l
OWNER � L HONE NO. � �- ys g30
CONTRACTOR
� DESCRIPTION ����
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
��FM}AL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ' ROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CARRECT WORK,CALL FOR REtNSPECTiON TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WFLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
II for the next inspection 24 hours in advance. (952� 249-460�
tractor on site:
Inspector. rl �����
White Copyllnspector's File Canary CopylSite Notice