HomeMy WebLinkAbout2005-P08544 - water heater = PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P08544
Crystal Bay, Minnesota 55323 Permit Type: FiXtures
(952) 249-4600 Date Issued: 3i23i2oos
SITE ADDRESS: 122 Che�y Chase Dr
WAYZATA,MN 55391
PID: 36-ll 8-23-41-0038
DESCRIPTION:
Proposed Use: Kesidential
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: � 15.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: Roto Rooter Services Co. OWNER: JOANNE C CARLSON
14530 27th Ave.N. 122 CHEVY CHASE DR
Minneapolis,MN 55447 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�yc.•u� �. 67��a—�.
APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-Assessing, 1-Finance Page 1
,�ar-17-2005 �3:19pm from-CITY OF ORONO +9522494616 T-T19 P.002/004 F-819
^�~ -r� EOR CC'[�([!SE OtvLY '
pctmit# �,'''
patc tt��tived: ..:-.��
C;�y of Orono • �' Amounc S=_-r---�
• �O j+rQ p.0.�ox 66 AP?t°vad B�: r�r
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� 4��c�`r CrYsml BaY�
• � ��� (952)2a9-46o0 �gI1�G pERN�T
�,��� ector)
CXTY�F��ON Q��a by the Building��ci&l or i�sp
(A11 Comrtucial p��iu m"St 1x aPPro
GEN�R:P�L IN�'��M`�''TYON offices. App�ations willbe
1, you may app1�Y for plumbing p
emuts by mail or in person a<<he City
Ie�iewcd and a permit wi11 be issuen`*�aRe a��z�gcompleted. PERMIT
g�NOT
2. Pernu[cards`�'1 YOU�R�CE1.V�A PERMIT- WOI2K
MYJST NO'�gEG'IN��'�
VAT.IA UNTIL IS Pc3S'T�D oN TIFIE 10n S_�� , • R cantxaccors and to properiy owners
pggMYT CARD ��,y to lic�:nsed pLur'.�ua,
•r_ .,..�+e i_�icd O.
3. s'i�oz,^.b'ye��===�:
tesiding in thz d`'�'elu11g. is involved,a separate buildinB pern�t must be
4. W11cn a,ny new construerion or rcmodeling
obcained.
S, q11 work must be dane in accordance`�'ith Sffite Code requi�ements.
6, A,11 work musi be inspected aud air tesc�d before it is covered. Call(952)249-4600.
(Z�-48 hour notice required)
T'�'PE OF PERIV.EIT .
(Check A11 That A�ly) �� --
{�Residenrial ❑Cammercial(f�pproval Requiz�d)
� ❑Ncw ❑Addi�ionxl �I��eva�� �Replace
I. (� In Accessory Srtuctuxe?
� *You v+���need nrior RAProvai and .r;�sy need CUF.(Prr t�rc��,��:ity CodE,Chspter 78,Arucle N)
� Job Site/Owrier�brmation:. ��
� Site Address: ����'�� �h�L �� �1`�� �-.
�
� Mailin Address:
Owner: Js`���� Cc..+^St� . �\ g
,,,,,., c,� c� �
�..��y. C�!'sz�'��. 7i�: � �� , _ �
i Home Phone; �5�`_`��3."c�:��� I A.lternate Phone:
i Conuactor�nfomzation:
i
Contractor: �tL� �c,X;1�z r'- Contact person: �c;c v� LC,��ti'�^c.� v�r�
Address: ��i 5:�: ���'`` �� r�� State Bond#: (�� �(P ���7 ��
City; �i �v���,c;,,�r� Zip: 5 Syy 7Expirarion Date: c�L C� �
�
Fhone: ���3�`i 1�( ' ���jG`'1 A.lternate Phoue: __
' � Insurance—C�zrrent: ��S
� 1
� �ar.-1T-20�5 03:19pm From-CITY OF ORONO +9522494616 T-719 P.003/004 F-819
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�:i�:�:k�; ^f` �.' f[7., �.�.�4.�''�i�'.�.+�? �' -
pIX'FU1tE BSMT 1 2 dTHEk FIXTUR� BSMT 1 2 OTHER
TY�� FI. �'L TYP� FL FL
Wat�r Closet Floor Drains
L.ava[ory Sewer Ljector
Bathxoom ���'Y T�y
Shower Washer
Kitchen Sink Water Heatzr �
�
Disposal Water Softener
D'uhwashr.r Wzt aar
Sillcocks Niiscelianeous
__ _
__ _ __ .
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'..:.i. •r:JHi�s �(wr.;�'I(i;i.�l�."�y.;d�:iti�.1�6�, ��'i' ��'i��.—�. •r._`t.�,.� :i.�e�.� . ..�i.% AL" �` ',�•h�, ' .1
'd.r � ' .� �. ' (� y. i „Str,.'..�r.n��.,n r�
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[� Yes,this sectzon applies
The replacement of a Residenrial fixture or a�sgliance ihat meets all three of the following requirements:
1, . es not require modificarion to electricai or gas service.
2. Has a total cost of$500.00 ox less;cxch�dinQ rhe cost of the fixture or appliance;and
3. �;;�„o�eu,i:,;;3i:cti Gr i�i�RC�Cl�j�T�]c IlOR1f:3�iGi oI liG�'A���7 cQn�BCial.
Sldp next Sccu4n,if ihis applies; Casc of Perniit �15.00
State Surcharse $ .50
Iv�ail-In Fc:e(If Applicable) $ 1.50 .
Total Permif Fee $ 7-oa
(Permit Fees Continued On Next Page)
2
• Nsr-17-2005 03:ZOpm From-CITY OF ORONO +9522494616 T-719 P-004/004 F-819
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. l"��;�'�,; �`�.����'�''�„��r:`�E��:�F''CAI:CY:3;'i:A'T'I � �"� �''� '����,::�
�?�1' i^:�0.���4);�$'.'��.40;�o;,y:� .���- ..�.
Yf above does not appiy;follow guidelines below;
1. CONT'Rp,CT pRICE *is 1.25%of con�act price with a(Minimum�'ee of$35.00)
x,0125$
(conEracc pricc) (minimum S3S.00)
2. STA'Y'E SUR,CT�TA1tGE **Add the State�ldg Code Div.Surchar�e(Minimurn Fee of 5.50)
x.OQOS $
(conUact prica) (minimum$ .50)
3. POSTAGE&HANDI,ING(Only an Mail-Tn Applicaiinns) g 1,54 ,_
4. TOT,A,L T'�12MI'���(Add�iaes 1-3 Above) $____ L'1.�'�
■ * CON2'RAC�' PRIC� or JUB COST means thc actuaI or estimated dollar amount chargcd for the
permitted work includiug materials,labor,prof�t, and other fixed cosu. Tr is the amouzu to be eharged
to the customcr for the work dor.e. Lf any matcrial,equipm�,t, labor or installauons arz furni.shed by
ihe owner,tenant or auy other parry, the reasonable market value of such items must be added to the
estimated cost or eonuact priee for permit fee purposes. Iu the event that there is a dispute on the
arnount of rhe job cost,tho Gity may rcquest the submissioa of a signzd copy of nc� actual eon�act.
' **The STATB SU'�ZCHARGE is .00OS of rhz coutract price under$1,P00,000 or$.S4—whicbever is
greater. For valuatioY�s over$1,000,�04 call the Building Aeparnneut at(952)249-�k600 for the pric�.
,; .,,.. ���.,, � :,_�; , ,, , „
;, �� .,. .,:.;-:<<,������,�s����x�vu��;APPL�G,�TIQN�.a�����x��:�:.� ��,;'=a:�� �;;:�;.,<,
The und�signed herzby app�ies ta the City for issuance of a 1'lumbing permit, agrees w do all
work in strict accordance with the ordinanees nf tI�� Cicy and the regulations of the State of
Minnesota, and certifies that all statements mad� on this application are eomplete, true and
correct.
Applicant's Signazure: t � ������ Date; �3 `�� � �`' �
3
� '.
MINNESOTA DEPARTMENT OF HEALTH - BOND CERTIFICATE
This is to certify that David T. Lohmann, Master Plumber License No. PM002695.
representing Roto-Rooter Services Company has filed a $25,000 bond with the
Commissioner of Health on December 29. 2004 for the year 2005 in accordance
with the provisions of Minnesota Statutes . Section 326.40.
BOND NO_ 103622785
Travelers Casualty & Sp,�rety
Har�:ford. Connecticut
MR DAVID T LOHMANN �
ROTO-ROOTER SERVICES COMPANY �� �. �`�o^,�,
14530 27TH AVENUE NORTH
MINNEAPOLIS MN 55447-4804
Patricia A. Bloomgren. Director
Division of Environmental Health
Dianne Mandernach, Corr�nissioner
�tacte of �i��e�ot� ' .
�et��e�ota� ���a�rtr��nt of ���rt�j
PLUMBING UNIT, BOX 64975
121 EAST SEVENTH PLACE, ST. PAUL, MN 55164-0975
Master Plumber License
LICENSE NO 002695PM BF TESTER ID NO 00855T
��' David T. Lohmann
613 Kingsview Lane North
Plymouth, NII�I 55447 �
I
EFFECTIVE DATE EXPIRATION DATE
O1/Ol/2005 12/31/2005
I
V
A TIME
CITY OF ORONO CALLED IN " �U
INSPECTION NQ C , / SCHEDULED ` - � I„ 1 CUU.
PERMIT NO. �✓ SY COMPLETED
ADDRESS /o�� �/Le�l/�.i C�.�s'�. ,[/�•
OWNER T7�r�✓1 �a i IS6Y� CONTR. /�'�-o ��''Z'�%
TELEPHONE NO. �W�1'' �l.�o�- ��7 � � Cv l
� DESCRIPTION l�/L✓��-/� J��� ��Zfl�T
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLIN
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLAN�S
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTAL.L. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v BING FINAL �� 36 FOUNDATION/REMOVAL
� OWN ONTRACTOR TO MEET YOU:_'�YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REfNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W{LL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (952� 249-4600
Owner/Cont�or sit :
Inspector. �
White Copyllnspector's File Canary CopylSite Notice