HomeMy WebLinkAbout2004-P07615 - plumbing CITY F R N PERMIT
O O O O Permit Number:
2750 Kelley Parkway - PO Box 66 po�6is
Crystal Bay, Minnesota 55323 Permit Type: FiX�ures
(952) 24�-4600* Date Issued: 6izli2oo4
SITE ADDRESS: 775 Brown Rd S
Wayzata,MN 55391
P I D: 03-117-23-34-0001
DESCRI PTION:
Proposed Use: Kesidenhai
Permit Class: Plumbing
Pern7it Type: Fixtures Permit Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation• $ 1,000.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: City View Plumbing&Heating OWNER: Mr. &Mrs. Peterson
1880 B Wayzata Blvd W. 775 Brown Rd S
P.O. Box 150 Wayzata MN 55391
Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANTPER 1 S NATURE ISSUEDBYSIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMTT
Box 66 (2750 Kelley Parkway) �
Crystal Bay, MN 55323
GENERAL INFORMATION
1, Xou may apply for plumbing permits by mail or in person at the City o�ces.
2, Permit cazds will be sent by retum 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.
g 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.
(: All work must be inspected and air tested before it is covered. Call 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 PROCESSEI�. If you have
questions, call 249-4600.
Please check one: New x Addition Repair Replace
Residential Commercial
� �� ; z�P: S S 3.�-�
JOB SITE: ��� ��D��
Owner's Name: GG,Ur I e� -�TA�e.,�' ���'e.s S;�� _ Telephone Number:
Mailing Address: City: Zip:
Contractor's Name:C,'�-}�1 �2� � �^^ "� Telephone number:� 7
Mailing Ads3re5s: Q 0 d.'�o x I�C� City: Lor! ���( Zip: S�3.��
:y.�T1ViBING FIXTURE SC�T�"�� �'_=.
FIXTURE I BSMT � 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet � Floor Drains �
Lavatory � Sewer Ejector �
Bathtub . Laundry Tray
Shower Washer �
Kitchen Sink Water Heaeer
Disposal Water Sofrener
Dishwasher Wet Bar
Sillcocks Misc (list)
�, � � � ly �-�- ��;� �,r�
�a�l� �r,
PERMIT I�EE CA�,CUL,ATION
1. 1.25% of Contract Price* or Minimum Fee ($35 00)
— S��(7 v� x .0125 $
2. State Surchar e ** (�ontract price)
� Add the State Building Code Division °
Surcharge to each permit. x .0005 $ �
9
or $.50, whichever is greater �contract price)
3• Posta�e and Handlin� (Only mail-in appiications)
4• TOTAL PERMIT FEE (Add lines 1-3 above) $ 1.50
$
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged 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 fumished by the owner,
tenant or any other party the reasonable mazket 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 Ci�y 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 Inspectional Services for the price.
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: � /� a
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DATE TIME
CITY OF ORONO CALLED IN ;��,—,
INSPECTION NO�JCE SCHEDULED _�'L�� _��_- �Z•��SD
PERMIT NO. /�' (� ��� �,� COMPLETED
ADDRESS �7 7 J� %���Z-.-v /'J /C�� �,
OWNER CONTR. f" � E'
TELEPHONE NO.
�j u.tnr� G/2-�FsS-z73(� � ,,� / ^
� DESCRIPTION / ��
ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/ RADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WAIL 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMB�NG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED f� PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED !1 ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR � CITATION ISSUED
� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the e t inspection 24 hours in advance. (952� 249-4600
Owner/Con a ite:
Inspector.
White Copyllnspector's File Canary CopylSite Notice