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Home My WebLink About2015-01151 - plumbing � � 1 CITY OF ORONO * z 0 1 5 - 0 1 1 5 1 * 2750 KELLEY PARKWAY DATE ISSUED: 09/09/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1629 BOHNS POINT RD PIN : 17-117-23-I1-0005 LEGAL DESC : REG. LAND SURVEY NO. 0565 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NOTE: (3)WATER CLOSETS,(4)LAVATORIES,(1)BATHTUB AND(2)SHOWERS VALUATION OF PLUMBING 6900 APPLICANT PLUMBING FIXTURE FEE 86.25 STATE SURCHARGE PLBG (VALUATION) 3.45 VAN WINKLE PLUMBING TOTAL 89J0 5430 TEAL ST BIG LAKE, MN 55309- Payment(s) (612)599-2124 CREDIT CARD 3870 89.70 Minnesota State License#: plbg-005756 OWNER AMPLATZ,CAROLINE 345 LEAF ST WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only[he work described and does not grant permission for addi[ional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construc[ion authorized is not commenced within I80 days of the date of issuance,or if construction is suspended for a period of l80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be � revoked at any time for due cause. - �- ls � , ,l�S Applicant Permitee Signature Date Issued Signature Da e ' F CITY USE ONLY City of Orono �j �'" �^ �O�O P.O.Box 66 Date ceid d:�`S Permit#�.�/(J�S� � 2750 Kelley Parkway p/, � i Crystal Bay,MN 55323 Approvcd By: Amount$:� (952)249-4600—Main � �. (952)249-4616—Fax F �� CITY OF ORONO -PLUMBING PERMIT ��kESHo�� (All Commercial Permits Must be Approved by the State Prior to Ciry Approval) htt�://��.dli.n�n.��o��/CCI:D/1'lll��/�c �lumb�lanre�°� > >. �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 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 Appl ) 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: % � � -� � � � � �(�r�:�� Owner:�a�(� �,I n �. /�4�I,p�Q�l�� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: � rt 4 � � /��"��act Person: �� ,� I �.��.-i f?� -�' � PAddress: S�� j� � �'�° � �� State Bond #: � G` � '��/ City: �; �� Zip: S S j�jExpiration Date: �� ' �l - �� Phone: �� / �'2 �� y Alternate Phone: � ❑ Insurance-Current: 1 i. 1 PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1�T 2�D OTHER FIXTURE BSMT 1 � 2�D OTHER TYPE FL FL TYPE FL FL Water Closet 3 Floor Drains Lavatory Sewer Ejector Bathtub ' Laundry Tray Shower - Washer : Kitchen Sink Water Heater 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�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; excludine 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 $ 1.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 PERMIT FEE CALCULATION(S —JOBS OVER $500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) �y� x .0125 $ (contractprice) (minimum$50.00) 2. STATESURCHARGE 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, labar,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 City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ardinances 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. �� / � S Applicant's Signature: � �/-�. �lJ � Date: � �` / 1 i � I I i � � i 3 I, � V / � � DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED , ��_ ' PERMIT NO.�G'I.�7'C� I5� COMPLETED ADDRESS / C� 2��' l��`�� S �� "`X/ OWNER TELEPHONE NO. ��"��L�� CONTRACTOR � DESCRIPTION ' �LC�Y( �f �C�/�• 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL /�UMBING RI ❑ EXCAV/GRADING/FILLING O ❑ 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 _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE S PTIC INSTALL 2 OWNERICONTFUCTOR TO MEET tl�U: YES_NO y COMMENTS: � a2 L �o� �,r.r. �3. r �r..�o�P� l j l.!-G- 1/,5�r.�G o (�� f� ! _ � � '`� V I V� SGn - �� lCao � � (�d l S�'�,! �v�- SG�C-�f C� ' W � Q 2 c �c �—�� W � 3 W �'VVORKSATISFACTOR�PROCEED ❑PROJECT COMPLEfE � ❑CORRECT W'ORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERING PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTO TAKEN INSPECTOR NfILL REfURN ❑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 OwneHContractor on site: Inspector:`��' /� T� White Copyllnspectw's Flle Canary CopylSite Notke � � � DATE TIME C{TY OF ORONO CALLED IN 9��-�� INSPECTION N TICsF SCHEDULED — � � PERMIT NO. S MPLETED ADDRESS l Z-� OWNER � NO�� "� CONTRACTOR � DESCRIPTION W ❑ FOOTING ❑ -FINAL ❑ SEPTIC FINAL � ❑ POURED WALL LUMBING RI ❑ EXCAV/GRADING/FILLING y Q ❑ FOUNDATION WATERPROOF P UMBING 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 ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: o� W � � J —' ! � � 1 � 0 � W � Q � 2 W � W � J / GW q'�NORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � '�l CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN I�ISPECTOFi WILL REfURN ❑S P ORDER POSTED.CALL INSPECTOR �CITATION ISSUED INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours" advance. 52� 46�� OwnerlContractor on site: Inspector. White Copylinspector's Ffle Canary CopylSite Notice aµ��0 C rs - �►,�.�F� .t.��e� ni t TIME , / CITY OF ORONO CALLED IN V INSPECTIO OT C� -7 CHEDULED PERMITNO D� —OC3 / � OMPLETED ��iS �o=o� ADDRESS � � • ��' OWNER TELEPHONE NO. CONTRACTOR V�h��l� � DESCRIPTION ��9� ��QL `v ?►�t��s ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �3 ❑ FOUNDATION WATERPROOF �MBING 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 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: W e _ - obl5/ - � oI��rK �o wt.0��e - �w.�� na�c� -_i �. � 0 Qo? �� a-��dtb�✓1 t- / - ��h�-�!� �-" �"C`n c �- / rw /�f � .i�w7 .G "7ti / - -O f 7 7 -�I �ec� � W � � � ❑WORK SATISFACTORY:PROCEED ��W ECT COMPLEfE � ❑CORRECT WORK 3 PROCEED ❑I E CERTIRCATE OF OCCUPANCY O ❑CORRECT YVORK�LL FOR REINSPECTION TEMPORARY V BEFORECdVERIN(3 PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION�SSUED ❑INSPECTION REQUIRED.CAII TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-48�� OwnerlContractor on site: Inspector. � �^�"'� White Copyllnspector's FNs Canary Copyl3fb Notks