HomeMy WebLinkAbout2005-P09101 - kitchen sink PERMIT
CITY OF ORONO Permit Number:
2750 Kr Iley F�arkway- PO Box 66 Po9101
Crystal Bay, Minnesota 55323 Permit Type:
Fixtures
(952) 249-4600 Date Issued: 8/23/2005
SITE ADDRESS: 128 Chevy Chase Dr Unit#
Wayzata,MN 55391
P��� 36-118-23-41-0041
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Fixtures Permit Sub-type(s): Kitchen Sink
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
&Gas Cooktop
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 1,200.00
State Surcharge Fee: $ 0.60
TOTAL FEE: $ 35.60
APPLICANT: Midwest Plumbing OWNER: Todd&Jana Nelson
12485 Rhode Island Ave 128 Chevy Chase Dr
Savage,MN 55378 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 DE REQUIREMENTS.
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L RMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
� FOR C[TY USE ONLY
,�` City of Orono
Q�O`rO P.O.Box 66 Date Received: Permit#
, �;,�,a 2750 Kelley Parkway
` a '�j�`'�,�'�'_ �. Crystal Bay,MN�5323 Approved By: Amount$:
���'����..$o` (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Uispector)
GENERAL INFORMATION
1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be
reviewed and a pernut will be issued within two working days.
2. Pernut cards will be sent by retuin mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL TAE
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 A ly)
Residential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑Repairs /[�I Replace
, �
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
�b Site/ Owner Information:
� /` �
Site Address: � �� `-�-"�� `/1C�-�C �- �
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
��/
Contractor: ���i�.�t.�T ��cGir��j� Contact Person: �'�� ��'`�'y,�`�—
Address: �Z�`�`� �+�� 1���-� ���State Bond#:
���k
City: ��T''��- Zip:�' Expiration Date:
Phone: ��Z��� " �`��'7 Alternate Phone: L�fZ- �'7- ��C�`�
❑ Insurance— Current:
1
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PLUMBINGFIXTURES BE1NG INSTALLED
FIXTURE BSMT 1 2` OTHER FIXTURE BSMT 1 2' OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks iscellaneous
AS ��i
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all tluee of the following requirements:
1. Does not require modification to electrical or gas 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 contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
1
' : 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$35.00)
� C- ��-1' x A125 $
(contract price) (minimum�35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
,�� x.0005 �
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
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 inarket value of such items must be added to the
estimated cost or contract price for pemut fee puiposes. 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 conn•act.
■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.SO—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952) 249-4600 for the price.
PLUMBING PERMIT APPLICATION AGREENIENT
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in sh-ict accordance with the ordinanc s of the City and the regulations of the State of
Minnesota, and certifies that all statement made on this application are complete, true and
correct.
Applicant's Signature: Date: �� 7� ���
3
�,,. � CJ�'I�� �. � ✓
DATE TIME
CITY OF ORONO CAL IN dS
INSPECTION NOTIC �1�C ' SCHEDULED '� -`� �
PERMIT NO. � COMPLETED � � ��7�i�[Z
ADDRESS
OWNER CON .�f1� ���.v��1�--
TELEPHONE NO. l D(� � ��7"3fDCS Y��
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCA /GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINA� 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ CO ECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
Owner/Contractor on site:
Inspector._�� rZ��/y
White Copyllnspector's File Canary CopylSite Notice