HomeMy WebLinkAbout2016-00066 - plumbing CITY OF ORONO * Z 0 1 6 - 0 0 0 6 6 *
2750 KELLEY PARKWAY DATE ISSUED: OU19/2016
'' ORONO, MN 55356-
� (952 249-4600 FAX: 952) 249-4616
ADDRESS : 1199 ELMWOOD AVE
PIN : 07-117-23-14-0059
LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: REPAIRS OF: 1 WATER CLOSET, 1 LAVATORY, 1 SHOWER, 1 MISCELLANEOUS
VALUATION OF PLUMBING 2500
APPLICANT PLUMBING FIXTURE FEE 50.00
SICORA INC STATE SURCHARGE PLBG(VALUATION) 1.25
5601 WEST LAKE STREET MAIL-IN FEE 2.00
ST LOUIS PARK,MN 55416- TOTAL 53.25
(952)929-0098 Payment(s)
Minnesota State License#: BUIL-BC253425 CREDIT CARD 0973 53.25
OWNER
HARVEY,MR.&MRS.
1199 ELMWOOD AVE
MOUND, MN 55364-
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 onty the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of Iaws 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 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.
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. � �l�J
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Applicant Permitee Signature Date Issued By Signature Date
FROM:T0:9522494616 01/20/2016 00:48:16 #24338 P.001/002
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� — Ctty of OronQ FOR CITY US�ONLY
J' Q P.O.Box 66 �ate Received:„ � -- 1 q — (l�
��� ` 2750 KeUey Parkway
- � Crysta!8ay, MN 55323 Permit# ZG 1 l� - �,���.
'�'� c>/ (952)249-4600 mm Main
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,, Amount$: �-� => Z ��
CITY p�' ORONO— PLUMBiNG PERMIT
(Alf Commercial Permits Must be Approved by the State�ripr to City Approval)
httn:llwww.dli.mn.pov/CCL0/PDF/oe plumb�lanrevanp pdf
� GENERAL. INFORMATION ., �������� . -. . "n at the C...��.�
1. You ma a E for lumbin -.� µ�.Vµ y p �" ity oFfices. Appfi. �on�
y pp y p g permlts b maii or in erso �� cai' w�ll be
reviewed and a perrnit wdl be �ssued w�th�n iwo work�ng days,
2, Permit cards will be sent by return mail after a r�view is camplsked, PERMlTS ARE N�7 VALID
UNTIL YOU REC�IVE A P�RMIT. WORiC A�(�$"�NOT BEGIN UNTIL 7H� PERMIT CARD IS
POSTE N TWE JOB SITE. "
3. Plumbing permits may be issued ONLY to licensed plumbing contractars and to prop�rty owners
residing in tha dwelling.
4, When any new construction or remade}ing is involved, a separate building permit must be obtained,
5. AH work must be done in accordance with State Code requirements,
fi. AU work must be inspected and air test�d before it is covered. Call (952)249-4600,
(2411$ hour notice required)
..._,.,_ .,..... ..._.T_ �.._._
TYP� OF PERMIT(Check All That Apply)
[�Residential � Commercial (Approvai Required) � ��
❑ New ❑Additional �epairs [j Replace
❑ In Accessory Structure?
�You will need nriQr ap,proval and may need CUP. (Per Orono City Code, Chapter 78, Articie IV)
L. -�...�
�ob Site/ C�wner lnformation:
___ .�.,�_.
Site Address: ��7 C �� I�t70� �JL �
Owner:_ ��C.o'l"r �rrJ .� Mailing Address: .. �� �� ��,n���,ftx���
City: �IV���hc� ��Zip: � 3Gu
Home Phone; Alternate Phone:
_..., _..... ...��.
Contracfior Information:
.,. ,,,..�. __ _.__ Y..,,,.,....�
Contractor; s���-��- Contact Perspn: ���- 1v°�✓l�r`=
Address: �(a�l !,c). t� �c. ,,��State Bond#: � �/U ��
.,. ,
Cit �i • c��S �� Zip: ��y� � Expiration Date:
Y� --- �.- �
Phone: G!� � S� 7��g „_�,Alternate �hone:
�nsurance—Current: �„ ���a� ���L���
Paga 1
FROM:TO:D522494616 01/20/2016 00:48:30#24338 P.002/002
�
. „. _
��,,,� ;� PLUMBlNG FIXTURES BEING (NSTALLED �
._ _.�...� �
FlXTURE BSMT 15� �2ND OTHER mm� FIXTURE ���'�W 6SMT 1sr �No d�j::��R
TYP� Flnor Floor TYPE Floor �'loar
Water Closet �� Floor brains Mx� �.� M�
Lav�tory ✓ Sewer Ejector �
.... ,.�. .�...� ..._.„ ..�..
Bathtub Laundry 7'ray
..�,..... .....,.
�
Shower ,� Washer
...,_ �..�..._
,,,,_. �,,,,.
Kitchen Sink Water Heater
bisposal Water Softener W ��
.��.� __.,..
Dishwasher , Wet Bar
_.�.,... _ _......... ..._�.
5illcpcks Miscellaneous �j
PE�2MIT FEE CALCULATIUN
1. CONTRACT pRICE " is 1.25% of contract prfce with a (Minlmum Fee af 554.00) / ��
2�? �7� � �
���' ~ x .012 5 � � �j 1. �. ,n
(contract price) (mi�imum �50:��)
2, STATE SURCHARGE
��`''�' � x .0005 $ �• � �
(contract price)
3. P05TAGE� HANDL,ING (Oniy on Mail-In Applications) $ Z.00
, �5 �
4. TQTAL P�RMfT FEE (Add Lines 1-3 Above) $ � �� _ --
" CONTRACT PRICE or .306 COST means the 2�ctual or �stimated dqll�r amount charged for the
permitted work including materiais, labor, pr�fit, and o#her fix�d costs. It is the amount tn be charged to
the customer for the work done. If any material, equipment, labor pr instaUations are furnished by the
owner, tenant or any other party, the �easonable rrcarket value of such items must be added to fhe
estimated cost or coniract price for permi# f�e purposes. In the event that there is a dispute pn the
amount of the job cost, the City may request the submission of a signed copy of the actual contract,
� PLtJMBiNG P�RMiT APPLICATIQN AGREEMENT �
7'he undersigned hereby applies to the City fvr issuance of a Plumbing Permit, agrees to do all work in
strict accprdance with the ordinances of the City and the regula#ions of the Siate nf Minnesota, and
certifies that all statements made on this pplication are complete, true and correCt.
Applicant's 5ignature: Date: ����"'�`�
Building Official!Inspector: Date:
F'A9e 2
1,�� C-�� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION OTICE SCHEDULED �
PERMIT NO. "` ����COMPLETED � �
ADDRESS �� � � � ��-1;C��-� �`�
OWNER TELEPHONE NO.� � �~��'z��
CONTRACTOR � i C� E i� �4
�; DESCRIPTION
� �1��Yb1,,�j\� y� -� _
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING 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 ❑ PTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� RR OFiK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail forthe next inspection 24 hours in advance. (g52) 249-4600
OwnerfContractor on site: �'� � �
Inspector. ��
White Copyllnspector's File Canary CopylSite Notice