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Home My WebLink About2012-00183 - plumbing CITY OF ORONO * 2 0 1 2 — 0 0 1 8 3 * ' 2750 KELLEY PARKWAY �pTE �ssuE�: 03/12/2012 ' ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1950 CONCORDIA ST PIN : 18-117-23-14-0016 LEGAL DESC : FAGERNESS : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING (<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMB[NG FIXTURE FEE(<$500) 15.00 APPLIANCE CONNECTIONS STATE SURCHARGE PLBG (<$500) 5.00 1313 DAN[TA CR. SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 (952)445-4803 MISC FEE 0.00 Minnesota State License#: 057209PM TOTAL 22.00 OWNER PETERS, WILL[AM & KAREN 1950 CONCORDIA ST WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall be performed according to the approved plans and specifications,applicable City approvals,and [he State[3uilding Code. This permit is for only the work described and does not gran[permission for additional or rclated work which requires separatc pemiits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applicant is responsible for assuring all required inspections are requesled in conformance with the State Building Code.This permit may be revoked at any time for due-cause. `7'ucL� �-n- l l l l Applicant Permitee Signature Dale Issued By Sig ure te SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRiBED AB E. • I FOR CITY L'SF.ONLY �,¢�� Citv of Orono PO.Bo�66 � Datr Reccivod: Petmit# Z��O Kcllc��Park��ac � a �'-v. Ciy,t�il 13a MN 55323 �� '�ry�� (`)�'-)-'-�9--1600-viain APProvedBY� Amoun[$: �saxo8-'� (vi?I�-t9-4616 Fas CiTY OF ORONO — PLUMBING PERMIT (All Commercial Pcrmits Ylust be Approved by the State Prior to Ciry Approval) ;aid��:;:�n�rre.�lli.n��.��u��;[�(_�l.f311'{)1��c �ia�a��h ��ans-c��x > >.�df GENERAL INFORMATION I. You may apply for��lumbing permits by mail or in person at the City oftices. Applications will be rcvicwed nnd a permit�vill be issucd��ithin tw��vorking days. 2. Pcrmit cards will be scnt b_y return mail aftcr a review is compicted. PERMTTS ARE NOT VALID UNT[L YOU RECEIVE A PERMIT. �'ORK MUST NOT BEGiN UNTIL THE PER�11T C:1RD IS POSTF,D ON 'I'HE JOB SITE. �. Plumbin�;prrmits may bc issucd(�NLY to licensed plumbing contractors and to property owners residing in the d�elling. -4. When anv ne�v consti�ction or rernodeling is involved,a separ<ite building permit must be � obtained� 5. All work must bc done in accordancc with State Codc requircments. 6. All work must be inspected anci air tes[�d before it is covered. Call (952)249-4600. (24-48 hour notice required) TYPE OF PERMiT (Cl�eck All That A 1 ) �Residenti�ll ❑ Cominercial (Approval Required) ❑ New ❑ A��{itional � ❑ Repairs Replace ❑ in Accessory Structurc'' *Y"ou will need prior auproval and may need l_l_�I'. (Per Orono CiCv Code,Chapter 78,Article iV) i Job Site/Owner Information: Site Address: � I� C�'"�.�' �,� ��` � Owner: ��`'�t � �i �'1'� ��,'� � . Mailin Address: _ (�1� �,�.;��1.�.L•�Y��-C �-�fi. City: �'15Y1� Zip: �� Home Phone: ��'`t-{�1 � �� , � �];� �2-J � Alternate Phone: � Contractor Information: i Contractor: �Q�u � ��,�� Co�ltact Perso�l: Address: APPII�lCi�� COt�il@Cto�P�SS��Bond#: �'S �J7i'c`,�'1-- f��-1 ani � �rG�� City: �J�� &i��xpiration Date: �Z�3)'� Z— Phone: �-- �`�j �-(�Sti_7 Alternate Phone: � [nsurance— Current: 1 _PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1�'� ��r' OTHER FIXTURE BSMT ]s� 2'D OTHER TYPF FL FL TYPF, FL FL Water Closet Floor Drains � Lavatory Sewer Ejector Bathtub Lnundry Tray �---- -- --__ --- -- ____-- hawcr Washer - Kitchen Sink Water Heater � � Disposal Water Softener � Dishwasher Wet Bar I � Sillcocks Miscellaneous I � PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Ycs, this scction applics The replacement of unly une Residential fixtw-e or appli�nce that meets all three of the following requirements: 1. Does not require modification to electrical or gas seivice. 2. Has a total cust of�500.Op ur�ess;excludine the cost of the tixturc or appliance: and 3. Is improved, installed or r-eplaced by the homeowner or licensed plumbing contractor. Skip ncxt scction, if this applics; Cost of Pcrmit S 15.00 Statc Surcllargc S 5.00 ;�1ail-In Fee(If Applicab(e) S 2.00 Total Permit Fee �__,��L,r� (Permit Fees Cuntinued On Next Page) 2 ' PERMTT FEE CALCULATION(S)-JOBS OVER $500.00 If abovc docs not apply; follo��guidclines bclo�a�: 1. CONTR.4CT PRICE * is I.2i°�;,of contract price with a(Minimum Fee of$50.00) x .0125 S (contract pricc) (minimum$50.00) ?. STATE SURCHARGE x _0005 $ (connact pncc) 3. POSTAGE R HANDLING(Only un Mail-I�Applications) $ Z.pp 4. TOTAL PERMIT FEE (Acid Linrs I-3 Abovc) � • * CONTRACT PRTCE or JOB COST means tl�e actual or estimated doliar amount charged for the permittcd work including materials, labor, profit, �tnd otl�er fixed costs. it is the amount to be charged to the customer for the ��ork done. if any material, equipment, labor or installations are furnished by the owner, tcnant or any other parry, thc rcasonable market valuc o�f such itcros must be added to the estimated cost or contract price for permit fec purposes. in the event that there is a dispute on the amount of the job cost, the Ciry may request the submission of a signed copy of the actual contract. PLUMBING PERMIT APPLICATION AGREElN1ENT —� 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 rcgulations of the State of Minncsota, and certif�ies that all statements made on this application are complctc, true and correct. � � Applicant's Signature: _ _ '� � Date: � � � i Reset Form 3 � � / � DAT TIME CITY OF ORONO �- CALLED IN � Z INSPECTION NOTICE SCHEDULED ,��30 PERMIT NO.Q�O�o�-�G��.3 COMPLETED ADDRESS �'�l`_J`� C��G�/ G� -�/ OWNER T EPHONE NO. �-�7�`��DS� CONTRACTO �� : DESCRIPTION �� -�'��`�' ``�R""-�-�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q � RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � 2 W � W � � d W ❑WORKSATISFACTORY:PROCEED R�Tf�OJECTCOMPLETE � ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 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 advance. �95Z� Z49-4600 OwnerlContractor on sit : Inspector. � ��_ White Copyllnspector's Fiie Canary CopylSite Notice