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Home My WebLink About2012-01257 (plumbing) � CITY OF ORONO * Z 0 1 Z — PJ 1 2 5 7 * - 2750 KELLEY PARKWAY pATE lssu�n: 12/19/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4010 BAYSIDE RD PIN : 06-117-23-11-0006 LEGAL DESC : POPOV ADDN : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER SOFTNER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 12850 CHESTNUT BLVD SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 (952)445-4803 TOTAL 22.00 Minnesota State License#: 057209PM OWNER LEVANG, CURTIS& ELIZABETH 4010 BAYSIDE RD MAPLE PLAIN, MN 55359- ACREEMENT AND SWORIY STATEMENT The�vork for which this permit is issued shall be perfornied according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only thc work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this rype of work shali be compied with whether or not specified herein.This permit will expire and become null and void if consVuction au[horized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requcsted in conformance with the State Building Code.This permit may be revoked at any time for due cause. � ` v Y v .��'� / / / / Applicant Permitee Signature Date Issued By S'= ature �ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . ' O�(��O Cih�of Orono i FUR CITY l?SF,ONL1--- �'O HO��'�' Date Received: Permit# 2?SO Kellcy Pzu�kway � � -+ '� r� Crystal Bay,MN 5532_ A y� _ Amount$: � �� o' I)52)249-4600 Main � PProvcdT3 . �Resxo� �95��249-4616 Par � -- - CTTY OF ORONO - PLUMBING PERMIT (All C��mmercial Pcnnits Must be Approved by the State Prior to City Approval) ;�, , .,. , , ,-, o- _-. s>',;;�: ,..;r ;;; . ,•, ;r: ---_ �:__: �.� __ � .i.,i� ,�_ ---...--- i GENERAL INFORMATION I l. You may apply for plumbing pennits by mail or in person at the City oftices. Applications will be rcvicwcd and a pcnnit will be issued within twu working days. '_. Pennit cards will be scnl by rcturn mail after a review is completed. PERMiTS ARL NOT VALID UNT1L YOU RECENE A PERMIT. WORK MUST NOT BEGIN UN7'Il THF PER;�IIT CARD IS POSTED ON THE JOB SITE. �. Plumbing permits may be issued ONLY to licensed plumbing contractors and to C,roperty��wners residing in the d�t�elling. -�. When any new construction or remodeling is involved, a separate building pern�it must be obtained. 5. All work must bc done in a��cordance with State Code rcquirements. 6. All work must be inspected and air tesred before it is covered. Call (952)249-460U. (24-48 hour notice required) ', TYPE OF PERMTT �__ __ _ (Check All That A 1 ) �-Residential ❑ Coinmercial (Approval Require�l) ❑ Ncw ❑ Additional ❑ Repairs � Replace ❑ In Acccssory Structurc:' *1'ou will need arior approval and may need( l_,i'.(Per Orono City Code,Chapter 7R,Article IV) Job Site/Owner Information: Site Address: � � � � �S lC�ei �Gt Otimer: l..l�l-r�lS l-f,�/O�,V�(� Mailing Address: T� J� �G(- SI�P.�I`�-f c�t�: N�o�,pl� ��o�.in �� 5 z��: 3 � Home Phone: �S�-" l�w" `P�Z�j Alternate Phone: f� Contractor Information: � Contractor: Contact Person: QYhI?J�� . ei �ddress: ��. State Bond#: ��j�� Apptiance Connections I�c. L�tY� 12850 CheStnUt BIVd: �xpiration Date: �--�- �U �-�- Shakopee, MN 55379 —�— �" -�— Phone: 952-445-4803 Alternate Phone: ❑ Insurance- Current: 1�� 1 -----.. PLUMBING FIXTURF,S BF,ING INSTALLED FIX I UItE BSMT I'T 2'�D C)THER FIXTURE BSMT I� 2� ' OTHER TYPE FL FL TYPF, FL FL �tcr Closct Floor Drains Lavarory Sewer Ejector Bathtub Laundry_ Tray --—� - -- - Shower Washer Kitchen Sink Water Heater I�isposal � W�ater Softener ' � I Dishwasher Wet Bar � Sillcucks Misccllaneotts ,- - — — — —__---- — ; PERMIT FEE CALCULATION(S) ' BASED OFF - 2002 STATE STATUE ❑ Yes,this scction applics The replacement of only one Residential iixture or appliance that meets all three of the following requiren�ents: I. Does not require�r�odification to electrical or gas service. 2. Has a total cost of 5500.00 or less; excludin�the cost of the fixture or appliance: and 3. Is improved,installed or�replaced by the homeowner or licensed plumbing conh-actor. Skip ncxt scction, if this applies; Cost of Pcrnlit �; �S.pp Statc Surcharge 4,' S.pp Mail-In Fee(If Applicable) ;� 2.0(1 Total Permit Fee $ �1-�.•'00 (Permit Fees Cuntinued On Next Page) 2 PERMiT FEE CALCULATION(S)-JOBS OVER $500.00 ►f abovc docs not apply; follow�uidclines below: 1. CONTRACT PRICE * is 1.25"%of contract price with a(Minimum Fee of$50.00) x .012� S (contract pricc) (minimum!FS0.00) 2. STATE SURCHARGE x .0005 S �conn'act pnce) 3. POSTAGE& HANDLING(Only on Mail-ln Applications) $ Z.pp 4. TOTAL PERMIT I�EE (Add Lines 1-3 Abuvc) $ • * CONTKACT PRiCE or J08 COST i»eails the actuai or estimated dollar amount charged for the pcnnitted wurk including matcrials, labor, profit, and other fixed costs. Tt is the amount to be charged to the customer tbr the worlc done. Tf an_y 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 ro d�c cstimatcd cost or contract pricc for permit fcc purposcs. 1n the cvcnt that thcrc is a dis�iutc on thc amuunt of the job cost, the City may request the submission of a signed copy of the actual contract. ---- ---- -------------- PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the Ciry for issuai�ce of a Plumbing Permit, a�rees to do all work in strict accordance with the ordina�ices of the City and the regulations of the State of Minncsota, and ccrtitics that all statcmcnts made on this application arc complctc, truc and correct. Applicant's Signature: � � � ��j��g��(� Date: Reset Form 3 ��j� pATE TIME ✓ CIT OF ORONO CALLED IN � / / -7 ��J INSPECTION�NO�T��IC� ^E� ^y-�--�SCHEDULED 1 � � PERMIT NO.v��'��'.��COMPLETED I� `1 ADDRESS �� (� f �.�' C/�P �a/ OWNER ' TELEPHONE NO�>�L7 7� �� CONTRACTOR �� DESCRIPTION �� (1� =�C'-'�� I-7�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL G RI ❑ SE�C FINAL ❑ FOUNDATION/REMOVAL OWNERIC TRACTOR TO MEET YOU: YES_NO � COMMENTS: � W C � � O a � O � W � Q � Z W � W � � / � XJ WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE W�O CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED �INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the ne t inspect' 24 hours in advance. (952� 249-4600 OwnedContractor s' : Inspector. White Copyllnspector's File Canary Copy/Site Notice