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Home My WebLink About2012-00053 (water heater) CITY OF ORONO PERMIT NO.: 2012r00053 2750 KELLEY PARKWAY ' ORONO, MN 55356- �ATE [SSUEn: OU25/2012 952 249-4600 FAX: 952 249-4616 ADDRESS : 2732 CAROLINE AVE PIN : 20-117-23-24-0041 LEGAL DESC : REG. LAND SURVEY NO. 1451 : LOT 000 BLOCK 000 PERMIT TYFE : PLUMBING(<$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : WATER HEATER APPL[CANT PLUMBING FIXTURE FEE(<$500) I5.00 CHAMPION PLUMBING LLC STATE SURCHARGE PLBG (<$500) 5.00 3670 DODD ROAD-SU[TE 100 EAGAN, MN 55123- MAIL-IN FEE 2.00 O MISC FEE 0.00 TOTAL 22.00 OWNER PERCIVAL,CI-iARLES& SUSAN 2732 CAROLINE AVE WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,applicabie City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. 7'he applicant is responsible for assunng all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for dueLause. �iV� VY�. l l � l l Applicant Pennitee Signature Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A OVE. � � � 4 ' �.�,�� ity of Orono FOR CITY USE ONLY P.O.Box 66 Date Received: Pennit# �750 Kelley Parkway '' ` '� � Ci�-stal Bay,NfN 55323 ' ' � Approved By: Amount$: t�kesxo�wU (952)2=}9-4600—Main <,,.._- ,.. (9��)?49-4616—Fax �I Y II �� 1�� — ��lJ1tlHE3IlV ls F�.��Y� (AI I Commercial Permits IO�ust be Ap�roved by the St�te Prior to City Approval) `,:: ,��<t��.��€.s��.��w/�;�;'L�I�a��J��, � l�E��t��•e��.�e��`' GBNERAL 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 wil]be sent by return mail after a review is completed. PERMTTS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGiN UNTIL THE PERl1'E{T C.4R�dS POSTE�ON THE JOB SITE. 3. Plumbin�permits may be issued ONLY to licensed plumbing contractors and to property owners residi!�g in tl;e dwe;li»g. 4. Wlien 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 ��-ork 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 ly) �Residential ❑Commercial(Approval Required) r � ❑ New ❑ Additional ❑ Repairs �Replace ❑ In Accessory Structure? *You H�ill need prior anDroval and may need CL'P.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: � �-�� C(��l l n� f\� Owner:r�'A�(l�S ��(,vG,` MailingAddress: SC�+�r��2 c�ry: _ (��vl U z�p: S S�GI 1 Home Pl�one: E�� Alternate Phone: Contractor Information: Contractor: Champion Plumbina Contact Person: ��(\ Address: 651-365-1340 State Bond#: Eagan, MN 55123 1 City: Zip: Expiration Date: ��,� � � � Phone: Alternate Phone: ❑ Insurance—Current: 1 � , � t PLliMBII�TG FIXTURES�EING INSTALLED FIXTURE BSMT 15� 2�D OTHER FIXTURE BSMT 15 2i'`� OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater ' Disposal ener 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 appliance that meets all three of the following requirements: l. Does not require modification to electrical or�as 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 licensed plumbing contractor. Sl:ip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $�=vV (Perrniat F'ees Contir�ued On 1!'eat Page) 2 i � � � PERMIT FEE CALCULATION� S �-J�BS O�ER $�00.00 �� If above does not apply, follow guidelines below: l. Cf3N'➢'R.�CT'PRICE � is 1.25%of contract price with a(1�'dinimum Fee of�50.00) x.0125$ (contract price) (minimum Si0.00) 2. ST,4Ti E SURCFI,�RGE '�*Add the State Bldg Code Div. Surcharge(Minimum Fee of�5.00) x.0005 $ (contract price) (minimum� 5.00) 3. POSTAGE&HANDLING(Only on Mail-1n Applications) $ 2.00 _ 4. TOT��..PEEt10'��T FE�(Add Lines 1-3 Above) $ • * CONTRr�,CT PRICE or JOB COST means the actual or estimated dollar amount charged for the pernlitted worl<including materials, labor,profit, and other fi�ed 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 tlle 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. • *'` The ST.ATE SURCHARGE is .0005 of the contract price under$],000,000 or$5.00—whichever is greater. For valuations over�1,000,000 call the Building Department at(952)249-4600 for the price. PLUMBING PERMIT APPI.ICATION AGREEMENT' The undersiQned liereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strici accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicant's SiQnature: �r'G"" Date: � � � 1� �� 2SG$ F�56�'3 3 O"" ' �_ D/�TE TIME CITY OF ORONO CAL�ED IN � INSPECTIONNOTICE SCHEDULED a-3- �� /.'30 PERMIT NO. aDl�- 400�`.3 COMPLETED ADDRESS �7 3 2' Q'��`� OWNER �� TELEPHONE NO. �5 Z `f7� �SZ� CONTRACTOR �; DESCRIPTION (�� Q��- � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOFi TO MEET YOU:_YES_NO � COMMENTS: � W C � � O � � O � W � Q � 2 W � W � � d W� ❑WORKSATISFACTORY:PROCEED OJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on site: Inspector. ��o� , r� White Copyllnspector's File Canary CopylSite Notice