HomeMy WebLinkAbout2015-00732 (plumbing-fixtures) CITY OF ORONO * 2 0 1 5 - 0 PJ 7 3 2 *
" 2750 KELLEY PARKWAY DATE ISSUED: 06/08/2015
' ORONO, MN 55356-
952) 249-4600 FAX: 952 249-4616
ADDRESS : 2490 CARMAN ST
PIN : 20-117-23-12-0065
LEGAL DESC : LEHMAN LAGOON
: LOT 2 BLOCK 1
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RES[DENT[AL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: 5 WATER CLOSET,7 LAVATORY,3 BATHTUB,4 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL,2 DISHWASHER,4 SILCOCKS,4
FLOOR DRAINS,
1 LAUNDRY TRAY, 1 WASHER, 1 WATER EIEATER, 1 WATER SOFTNER, 1 WET BAR
VALUAT[ON OF PLUMBING 40750
APPLICANT PLUMBING FIXTURE FEE 509.38
STATE SURCHARGE PLBG(VALUAT[ON) 20.38
SPRING PLUMBING LLC MAIL-IN FEE 2.00
11473 KENYON COURT
BLAINE,MN 55449- TOTAL 531J6
(763)614-7963 Payment(s)
Minnesota State License#: plbg-066807 PM CHECK 09918 531.76
OWNER
Lakeshore Holdings LLC
153 E LAKE ST
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this rype of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature T Date Issued By Signature ' Date
,
FOR CITY USE ONLY
� " � `' City of Oronn ��/
� �
� �O� P.O,Box 66 Date Received: � � Pennit# _�- �J�3
, 2750 Kelle�r Parkway
Crystal Bay,MN 55323 Approvecl By: � Amount$:��i ��
� � �� (952)249-4600-Main
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�f � � ` � CITY OF ORQNO—PLLIMBING PERMIT
\�'��'����E+�'�t-�/ (All Commercial Permits Must be Approved b,y the State Prior to City Approval)
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GENERAL INFORMATION
1. You may appiy for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within ri�o working days.
2. Permit cards will be sent by return 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. Piumbing permits may be issued ONLY to licensed plumbing conuactors 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(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
Check All That A 1
�Residential ❑Commercial(Approval Required)
�New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need urior anqroval and may need CIJP. (Per Orono City Code,Chapter 78,Article N)
Job Site/Owner Infonnation:
Site Address: � � � � ( ��� �(,�. � D
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
�2C,. P c,� ''��.Q�Y�°S� �r�-�rr�-,
Contractor: Contact Person:
Address: �( �1 � I�K(/Y�� State Bond#: l�C �o �1 3(�-7�
City: Zip:»`��'7 Expiration Date: ���/ ���/�
Phone: ��3�'�P l'7 —7�6 3 Alternate Phone:
❑ Insurance— Cunent:
1
PLI7MBING FIXTURES BEING INSTALLED
FIXTURE BSMT ls 2�' OTT�R FIXTCJRE BSMT ls� 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet � . Floor Drains
Lavatory ' /^ Sewer Ejector
Bathtub Laundry Tray �
Shower 1 Washer ,
0�
Kitchen Sink ` Water Hea,ter I
Disposal ` 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�piiance 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�acture 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
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DAT TIME V
CITY OF ORONO CALLED IN
INSPECTION NOTICE S HEDULED — —! //:.�
PERMIT NO.o�I S�7J� OMPLETED
ADDRESS � �1� � ��"�
OWNER TELEPHONE NO. ���
CONTRACTO
� DESCRIPTION
� ❑ FOOTING ❑ E O-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL UMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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� ❑CORRECTIMORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL REfURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail ion 24 hoursjn advance. (952� 249-46��
Ow Vactoronsite: r�Q-
Inspector. ►�—'
�te Copyllnspector's File Canary CopylSite Notice
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DATE TINE
CITYOFORONO CALLEDIN �/���5 �
INSPECTION aODT��. ,�^�`-�� �yCHEDULED S� �
PERMIT NO� « %?�C/�OMPLETED
ADDRESS � �
OWNER PHONE NO.�����Jd��
CONTRACTOR �
� DESCRIPTION —
ly ❑ FOOTING ❑ -FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL MBING RI ❑ EXCAV/GRADING/FILLING
Q
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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J ❑ DEMO-SITE ❑ SEPTIC INSTALL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�, COMMENTS:
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� ❑ RECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advan ) 249-46��
OwnerlConVactor on site:
Inspector.
White Copyflnspector's File Cenary CopylSite Notiee
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� � TIME
CITY OF ORONO cnLLED IN -�
INSPECTION TIC � �HEDULED � L� � ,.3c�
PERMIT NO. ����7��'coMPLETED
ADDRESS ��91� � ��'il�p�
OWNER �EPHONE N0.7�J� �-b7 g5
CONTRACTOR
� DESCRIPTION ��Z-r��� � l
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET Y�OU:_YES_NO
y COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
W O CORRECT W'ORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORECONERING PERMANENT
�CORRECT UNSAFE CONDITION WRHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDEH POSTED.CALL INSPECTOR ❑CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952) 249-460�
OwnerlContract site:
Inspector:
White CopYMnsPecMr's Fik Canary CopylSite Notice
� V� �''� � (�i� l DATE TIME
CITY OF ORONO v�/l � �� CALLED IN
INSPECTION NOTIC �� HEDULED �
PERMIT NO. COMPLETED �_��
ADDRESS a 7" 7 O C� ,S�
OWNER TELEPHONE�O. ��:��7�'�-7l�f
CONTRACTOR .
� DESCRIPTION ���� ����� /
t� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF �LTIIVIBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
�U ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE EPTIC INSTALL
2 OWNERICONTRACTO �OF� MEEf l^�OU: YES_NO
y COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED O ISSUE C�RTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTiON REQUIREO.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-460�
OwnerlContractor on site: �: `l r
Inspector: H--
White Copyllnspector's Ffle Canary CopylSite Notke
.
� PERMIT FEE CALCULATION S —JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is I.25%of contract price with a(Minimum Fee of 550.00)
� (.�, � 7� , � x.0125$ � � V! ' J �
(contract price) (minimum$50.00)
2. STATESURCHARGE (,� �7
�1 �, ! , U� x.0005 $ ���_
-T(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � � � . t b
■ * 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 turnisheci by
the owner, tenant or any ather 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.
PLIJMBING PERNIIT APPLICATION AGREEMENT �
The undersigned hereby applies to the City for issuance of a PlumbinD 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: ���`'VV��U��' Date: � ( a I( �
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