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Home My WebLink About2016-00004 - plumbing CITY OF ORONO * Z 0 1 6 - 0 0 0 0 4 * � � � 2750 KELLEY PARKWAY DATE ISSUED: OU05/20�� ,� ORONO, MN 55356- � °''" ' (952) 249-4600 FAX: (952) 249-4616 - ADDRESS 12 BRIAR ST PIN : 10-117-23-31-0075 LEGAL DESC : MAXWELLS ADDN CRYSTAL BAY LAKE : LOT 000 BLOCK 002 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: 4 WATER CLOSETS,5 LAVATORY, 1 BATHTUB, 1 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER,2 SILCOCKS 1 FLOOR DRAIN, 1 WASHER, 1 WATER HEATER, 1 WATER SOFTNER VALUATION OF PLUMBING 10000 APPLICANT PLUMBING FIXTURE FEE 125.00 STATE SURCHARGE PLBG(VALUATION) 5.00 BEN SCHERER PLUMBING& HVAC INC. TOTAL 130.00 4520 85TH STREET SE DELANO, MN 55328- Payment(s) (763)972-8137 CREDIT CARD 4343 130.00 Minnesota State License#:mech-MB003633,p1bg-PC648530 OWNER NITZBERG,KEVAN&LAUR[E 1212 BRIAR ST WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or reia[ed work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is no[ commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. ��y'� � � � � � '�`_ �� C � � � � �`�>�--�1 � � � � � � -�,� 1 +_ Applicant Permitee Signature Date Issued By Signature Date � L • FOR CTTY USE ONLY , , O City of Orono • �- � P.O.Box 66 Date Received: Permit# � �� 2750 Kelley Parkway ^ � Crystal Bay,MN 55323 Approved By: Amount$' (952)249-4600—Main � � " � (952)249-4616—Fax F �� CITY OF ORONO—PLUMBING PERMIT �9KFSHo��" (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://wtii�w,dli.mn.nav/CCLD/PD.F/ e )IUITII3 laiu�eva� . 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 permit will be issued within two 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. Plumbing permits may be issued ONLY to licensed plumbing contractors and to properiy 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 Apply) �Residential ❑ Commercial (Approval Required) .�tew ❑ Additional ❑Repairs ❑ Replace ❑ In Accessory Structure? I C��a *You will need_prior approval and may��,d��UP.(Per Orono City Code,Chapter 78,Article N) � Job Site /Owner I ormatio . '�� A SiteAddress: ;i�� Z- f��e��" �� / Owner: Mailing Address: City: �-/ ��'to Zip: �� Home Phone: Alternate Phone: Contractor Information: ` l' Contractor: �j�.� ��r�T �� } Contact Person: t�" J��Cv Address: ��5 2�% �-S r✓5��'� State Bond#: �� ^ -3�=' City: �� Zip: /�� Expiration Date: � �' �/-/ , Phone: ��L" �-3;" �� E�� Alternate Phone: ❑ Insurance—Current: ��} 1 T 1 PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet � / %� Floor Drains d� Lavatory / / � Sewer Ejector I Bathtub / Laundry Tray Shower / Washer i Kitchen Sink Water Heater � r Disposal i Water Softener p � / Dishwasher i Wet Bar Sillcocks .z Miscellaneous PERMIT FEE CALCULATIOI�F(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;excludinQ the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner ar licensed plumbing contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 1.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 � � � . ,.�.� �� ,.�,;p� PERMIT FEE CALCULATION(S)—JOBS OVER $SOO.Ofl �+�� _. If above does not apply; follow guidelines below: `'�--�-._,.,,� 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) �d�� C-� x.0125 $ (contract price) (minimum$50.00) 2. STATE SURCHARGE 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 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 FERMIT APPLICATION AGREEMENT 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: d Date: � — � �>� 3 . �� DATE TIME � CITY OF ORONO CALLED IN � INSPECTION TICE , JSCHEDULED ^ PERMIT NO. ' '` `"rr PLETED ---.__ ADDRESS �- � ' �� OWNER �� TELEPHONE NO.��1� '-��y, CONTRACTOR ��G��re/z._. � DESCRIPTION � � - — � ❑ FOOTING ❑ DEMO-FINAL �p,,�_� � SEPTIC FINAL Q ❑ POURED WALL �BING RI � ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ �NSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: a � Gv �/ - /�v� S��ro - . � � ��r � c 5'� rs p��t� " � -�? �ra v r� e �1.�.L �!� �o v 3 �, �� /rv �p. �•W.�y � W ,y� ` . � (0/ �r�/C Ib'� Q��vi(4 C� �j Ls�I'�i �O✓ Q z i�fJ ✓ i N- l G• �/r� �� sS�,s � � = f'j'I. L. —� /�� L, . Q� -ts c o�v � —" Gci�! �v r ► K�i�A cc��:.., bh L .f. �hov� a c°o w� p r� � — W ❑WORKSATISFACTORY:PROCEED G PROJECTCOMPLEfE � �RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call f next inspection 24 hours in advance. (952) 249-460� Owner ontractor on s' ' Inspector. �--- � � �C� DATE TIME� CITY+DF ORONO CALLED IN INSPECTION NOTIC SCHEDU�ED PERMIT NO. COMPLETED ADDRESS Z 1 OWNER TELEPHON O. �l2-��-�S� CONTRACTOR ` �� / � DESCRIPTION lC-� �� ll� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ 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 _ J ❑ DEMO-SITE ❑ S PTIC INSTALL 2 OWNERICONTAACTOR TO MEET YOU: YES_NO � COMMENTS: ' ��S S � � � - .�- D��. ��I c� -�> �a.� :S/t�- � � 0 � � o ,, .. � r� � W � Q � 2 W � W � � d W RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY w ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE CWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in adva 52) 249-4600 OwnerlContractor on site: Inspector. � White Copyilnspector's File Canary CopylSite Notice � � ��- ��. DATE TIME CITY OF ORONO CALLED IN � I 1 i 1� � INSPECTION NQTICE SCHEDULED PERMIT NO. �L�� COMPLETED ADDRESS 1 ZZ� G3 r� � r �+ • OWNER TELEPHONE NO. CONTRACTOR �� l��ret� plu� � DESCRIPTION c� ��-YYl YJ ��.�� W ❑ FOOTING ❑ DEM INAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ MBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF LUMBING 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 _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDAT�ON/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � �`_VleG�- I � c� 61'1�R_ '1—C�Ir �• � , W � � J O >. � f O � W � Q � 2 W � W � � J O W ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WOHK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in adva �49-4600 OwnerlContractor on site: ' �� Inspector. � White Copyllnspector's File Canary CopylSite Notice