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Home My WebLink About2011-01340 - plumbing , CITY OF ORONO PERMIT NO.: 2011-01340 . 2750 KELLEY PARKWAY ORONO, MN 55356- nATE ISSUED: 10/27/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1635 BOHNS POINT RD PIN : 17-ll 7-23-11-0006 LEGAL DESC : REG. LAND SURVEY NO. 0565 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING (>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: BASEMENT: 1 WC, 1 LAV, 1 SHOWER, 1 LAUNDRY TRAY, 1 WASHER, 1 WATER HEATER, 1 WATER SOFTENER 1ST FL:2 WC,3 LAV, 1 TUB, 1 SHOWGR, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER, VALUATION OF PLUMBING 13000 ��—-_ APPLICANT PLUMBING FIXTURE FEE 162.50 PH MECHANICAL STATE SURCHARGE PLBG(VALUAT[ON) 6.50 5056 SULGROVE RD TOTAL 169.00 MOUND,MN 55364- (612)418-1 l23 OWNER KOZLAK, STNICK&JODEE 1635 BOHNS PT RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which[his permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State Building Code. "Chis permit is for only the work described and does no[grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specired herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of l 80 days at any time after work has commenced. The applic �s responsible for assuring all required inspections are requeste m onformance with the State Building Code.This permit may be revoke at ny time fo<�cause. ' %d l 1-?l // ��YCQ�''L l l Applicant Permitee Signat Date Issued By Si n ture ate SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED AB . ,/ , FOR CITY G'SE ONLY . 0,��0 City of Orono P.O.Box 66 Date Received: Permit# �,�•, 2750 Kelley Parkway a ��r. +. Crystal Bay,MN 55323 Approved By: Amount$: ��o� (952)249-4600—Main aeso$ (952)249-4616—Fax CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt :1/www.dli.mn.Rov/CCI�D/PI)F/ e lumb tanreva i. 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 pernut will be issued within two working days. 2. Pernut cards 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. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construcrion or remodeling is involved,a separate building pernut 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(952)249-4600. (24-48 hour notice required) TYPE OF PERMIT (Check All That Apply) .�esidential ❑ Commercial(Approval Required) ❑ New ❑Additional ❑Repairs ❑ Replace ❑ In Accessory Structure? *You will need arior annroval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site /Owner Information: Site Address: 1��5 ��:.;��v�� C'�� - ��-� Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �.l-�. �lt�.�.�.��c,�-� Contact Person: �/�-(/ I._- }-t-L�J � Address: 5F25 6 S;,I�,,��rc �/ State Bond #: ��y� � �� City: ��v�-�� Zip:J53G�y Expiration Date: /��..-._,�/- 1/ r- Phone: (yl�--�}(Y- I��-� Alternate Phone: ❑ Insurance—Current: 1 . � ,._�..��`„��`�1'�; ` �; '�3T1�1 �, S BEING INSTALLED � �p�,,� �� .' 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 Washer ` l Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous I PERMIT FEE CALCULATION(S) I BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture or appliance 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;excludinQ the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed 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 , . • , ;� � �,� . � �� r,.,`.. PERMIT FEE CALCUL�`��0�1'� . !C�.$�, VER$500.00 ,:�.,,3�� If above does not apply; follow guidelines below: l. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) /�, ��d" J� x.0125$ (contract pnce) (minimum$50.00) 2. STATE SURCHARGE l� Q��•�� x .0005 $ (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 pernutted 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. - '.r•, �� .�'+��—,�.�.��.`�'� +��-�" ' '� � "„WIM7,.r ��. �x ',°s'i�: 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 �� C,.j(//� DAT r1� TIME V CITY OF ORO�O �ALLED IN � / INSPECTION OTI�t,E SCHEDULED �.� PERMIT NO.��/� ��/� �COMPL TED ADDRESS � OWNER TE�LE�P�HONE NO. � �� CONTRACTOR L�/[ >; DESCRIPTION � � ❑ FOOTING ❑ PLUMBIN INAL ❑ EXCAV/GRADING/FILIING Q ❑ POURED WALL � MECHA AL 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 � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W � � J � � o .a� r_��r� �C� � U � � 0 � W � Q � z w � w � j d W� ❑WORKSATISFACTORY:PROCEED �"PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED C\SSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnedContractor on sit : Inspector. � White Copyllnspector's File Canary CopylSite Notice `� A TIME V CITY OF ORONO CAL ED IN �� INSPECTION NOT E u SCHEDULED � `� '.-30 PERMIT NO. !� COMPLETED ADDRESS � � u �� OWNER TELEPHONE NO. `� " `� CONTRACTOR � � >; DESCRIPTION r � �-- � ❑ FOOTING ❑ PIUMBING FINAL ��/�� V/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z 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 v ❑ PLUMBING RI ❑ SEPTI FINAL ❑ FOUNOATION/REMOVAL � OWNERICON RACTOR TO MEET YOU: YES_NO � COMMENTS: � W a � J O �— � _ �� - �l o - � w � Q � Z W � W � � /�/ GW�iQ`14JQRKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �952� 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice