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Home My WebLink About2100-00398 - plumbing CITY OF ORONO PERMIT NO.: 2011-00398 2750 KELLEY PARKWAY r ORONO, MN 55356- DATE�SSUEn: OS/27/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 145 BROWN RD S PIN : 03-]17-23-21-0007 LEGAL DESC : UNPLATTED 03 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING (>$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NOTE: BASEMENT: 1 WC, 1 LAV, 1 SI-IOWER VALUATION OF PLUMBING 900 APPLICANT PLUMBING FIXTURE FEE 50.00 ROARK PLUMBING INC. STATE SURCHARGE PLBG (VALUATION) 0.45 2415 WEST INDUSTRIAL BLVD. SUITE NO. 5 TOTAL 50.45 LONG LAKE, MN 55368- (612) 867-2521 OWNER W INTON,JOHN M. 145 BROWN RD S LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMEIYT The work for which this permit is issued shall be perfornled according to the approved plans and specifications,applicable City approvals,and the S[ate Building Code. This permit is for only the work described and does not grant perm�ssion for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction auUiorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applicant is resp nsible for assuring ali required inspections are reques ed in co � r ance with the Sta[e Quilding Code.This permit may be revo� a ny ti e 'r due cause. � � � i � i �s�/z�!'�'�. / / Applicadt ermi ee Signature Date Issued By S' ature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . r � � F+OR CITY USE ONLY � ,�` Clt)'Of�I'OIlO . O�O`Y� P.O.Box 66 Date Received: Permit# � 2750 Kelley Parkway �a� �1��;'��. ti Crystal Bay,MN 55323 Approved By: Amount$: ��^ ��:��i�4.�o` (952)249-4600—Main � �sexa� (952)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Coinmercial Permits Must be Approved bv the State Prior to City Approval) htt�:/Iv��v��.dli.tnn.�ov/CCI..D/YDF/ e � lt�mb lanreva �.�df' 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 RECENE 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(9S2)249-4600. (24-48 hour notice required) TYPE OF PERMIT (Check All That Apply) �Residential ❑ Commercial(Approval Required) � ❑ New �Addirional ❑ Repairs ❑ Replace ❑ In Accessory Structure? *You will need prior appro��al and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/ Owner Information: ,— Site Address: �� '� �� ` Owner: Mailin� Address: c�ty: ��c �C c� z�p: ��3.�� Home Phone: Alternate Phone: Contractor Information: Contractor: � t�JU�I - �ontact Person: r`�l��Z� . � Address: ��•��11%r�1�- r�lJState Bond #: :� 12 - � � - � City: � Zip Expiration Date: p� �53�� Phone: ��Z-QG��Z�?r� AlternatePhone: ❑ Insurance– Current: 1 � w � PLUMBING FIXTURES BElNG 1NSTALLED � FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 � OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory � Sewer Ejector Bathtub Laundry Tray Shower i Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous � PERMIT FEE CALCULATION(S) � � � �� BASED OFF - 2002 STATE STATUE � Y ❑ es,this section apphes The replacement of only one Residential fixture or ap lipp ance that meets all three of the following requirements: 1. Does not require mod�cation to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractar. 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 $ (Permit Fees Continued On Next Page) 2 f ' PERIVIIT 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) �Q � �� x .0125 $ (conh-act price) (minimum$50.00) 2. STATESURCHARGE �ob ° � X.000s $ (contract price) 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 puiposes. 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. j 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. _ ; / � � � ` �—� ' � Applicant's Signature: �,.�� Date: 3 � � D�� TIME � CITY OF ORONO CALLED IN ✓-� INSPECTION NOT CE6 SCHEDULED �3� � PERMIT NO. � COMPLETED ADDRESS � � OWNER TELEPHONE NO. lo/Z-' �jZ�S"�p� CONTRACTOR �� >; DESCRIPTION �� _ Y � � ❑ FOOTING ❑ PLUMBING FI ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS 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 v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q ti Z W � W � � d � �lORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALLINSPECTOR ❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on �te: � � Inspector. l'�t � � �-�T� White Copyllnspector's File Canary CopylSite Notice