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Home My WebLink About2013-01188 - plumbing ' CITY OF ORONO � 0 1 3 - m 1 1 e 8 * 2750 KELLEY PARKWAY DATE ISSUED: 1 U06/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1 165 BROWN RD S PIN : 10-117-23-24-0020 LEGAL DESC : UNPLATTED 10 1 17 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING (>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NOTE: PLUMBING FIXTURES: WA"I�ER CLOSET,LAVATORY, SHOWER AND WASHER VALUATION OF PLUMBING 1500 APPLICANT PLUMBING FIXTURE FEE 50.00 NIELSEN, ERIC STATE SURCHARGE PLBG(VALUATION) 0.75 P.O. BOX 54 CRYSTAL BAY, MN 55323- TOTAL 50.75 PAID WITH CC# 0134 OWNER NIELSEN, ERIC P.O. BOX 54 CRYSTAL BAY, MN 55323- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall bc pertormcd according to the approved plans and specitications,applicable City approvals,and the State Building Code. This pennit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of la�vs and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null v id if construction authorized is not commenced w days f the date of issuance,or if construction is suspended � r a p io of 1 days at any time afrer work has commenced. The appl cant i res onsi e for assuring all required inspections are requested c e with the State Building Code.This permit may be revoked at an me r due cause. � , < < � C� � � 3 � �1 � � � �3 Applica ermitee' ' nature Date Is d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , FQ CI Y USE ONLY � City of Orono �� - �O P.O.Boxbb DateReceive : Permit#p�D1,�-� `� 27�0 Kelley Parkway ` Crystal Bay,MN 55323 Approved By: Amount$: O � ✓ (952)249-4600—Main y � (952)249-4616—Fax �' �` CITY OF ORONO —PLUMBING PERMIT ��KESNo��' (All Commercial Permits Must be Approved by the State Prior to Gity Approval) htt ://wvv��.dli.m��. ov/CC:LD/PDF/�e �lumb� lanreva� . tlf 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 maii 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 ar remodeling is involved, a separate building permit must be obtained. 5. All wark must be done in accordance with State Code requirements. 6. All wark 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 [�-Additional �Repairs ❑ Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78,Article IV) Job Site/ Owner Information: Site Address: � � � S �f"-�'�� K—� � Owner: ��L 1�l �-��'-�-� Mailing Address: �� " � City: W 1�� Zip: �3 Z� Home Phone: � S � " �� S ��I Alternate Phone: (�I.Z ' Z�U '�'"S �S! Contractor Information: Contractor: Contact Person: Address: State Bond #: City: Zip: Expiration Date: Phone: Alternate Phone: ❑ Insurance—Current: 1 PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet X Floor Drains Lavatory X Sewer Ejector Bathtub Laundry Tray Shower � W asher � Kitchen Sink Water Heater Disposa] Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes, this section applies The replacement of only one Residential fixture or a�pliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less; excludin�the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or]icensed 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 $ (Permit Fees Continued On Next Page) 2 , . PERMIT FEE CALCULATION(S)-70BS OVER$500.00 If above does not apply; follow guidelines below: 1. C01�1TRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) �r l 5�� `'�= X.oi2s � �0 (contract price) (minimum$50.00) 2. STATE SURCHARGE , �� x.0005 $ (contrac[price) 3. POSTAGE&HANDLING (Only on Mail-ln Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � �Z � ■ * 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. PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the C' r issuance of a Plumbing Permit, agrees to do all work in strict accordance wit e in nc s of the City and the regulations of the State of Minnesota, and certifies th all tatem made on this application are complete, true and correct. Applicant's Signature: Date: � � ` � � �7' 3 INSPECTION NOTICE � O �a� DATE TIME CITY OF CALLED-IN SCHEDULED PERMIT NO. � 3 "dil�S� COMPLETED��_ ADDRESS //(o S ��o r.J.t_ 2� SL OWNER/CONTR. � ❑SITE INSPECTION ❑MECHANICAL RI ❑REINSPECTION ❑CONC SLABS ❑MECHANICAL FINAL ❑FOLLOW-UP ❑ FOOTING ❑ INSULATION ❑COMPLAINT ❑ POURED WALL ❑ RATED ASSEMBLY ❑FIREPLACE ❑ FOUND. DRAINAGE ❑BUILDING FINAL ❑SPRINKLER SYSTEM ❑ FRAMING ❑SEPTIC INSTALL ❑ � ❑SHEATHING ❑SEPTIC FINAL ❑ 1'e�"Pt�MBING RI ❑S&W HOOKUP ❑ � ❑PLUMBING FINAL ❑GAS LINE MANOMETER ❑ o COMMENTS: Q l,�. L. ��h .r- �,�.� wO� - � W �k1 v - P�/C sc�i• �a - _ J Z � �v✓l� �t A n ur S � � � W � � � O � � O W � Q � Z W � W � � C7 � FURT ORRECTIONS MAY BE REGIUIRED ❑ PERMIT FINALED W ORK SATISFACTORY: PROCEED ❑ PHOTO TAKEN p ❑ CORRECT WORK& PROCEED U ❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING ❑ CORRECT UNSAFE CONDITION IMMEDIATELY. ❑ STOP ORDER POSTED. CALL INSPECTOR ❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS. TO SCHEDULE YOUR INSPECTIONS PLEASE CALL: (763) 479-1720 Metro West Inspection Services Inc. Owner/Contr. on site: Inspector: �� ^--- 3�3 C� DATE TIME ' - ITY OF ORONO �`� CALLED IN INSPECTION NOTIC - scHEou�eo --� �`�'� PERMIT NO. COMPLETED ADDRESS f � �1'�� l.l�� S• OWNER ��SL% ��TELEPHONE NO.��a'�7�'7�t'j CONTRACTOR �; DESCRIPTION T�'l�6 %�� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ $EWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑�PTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO —,r—• v�, COMMENTS: � W G. � � O �. � O � W � Q � 2 W � W � J d W ❑WORKSATISFACTORY:PROCEED OJECT COMPLEfE � ❑ CORRECT WORK&PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2 hours in adva 49-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice