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Home My WebLink About2011-01254 - plumbing �• . � CITY OF ORONO PERMIT NO.: 2011-01254 � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �SSUED: 10/17/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 753 BOULDER DR PIN : 33-118-23-11-0074 LEGAL DESC : STONEBAY THIRD ADDITION : LOT 002 BLOCK 002 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NO'I'E: WATER SOFTGNER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00 6030 CULLIGAN WAY MINNETONKA, MN 55345 MAIL-IN FEE 2.00 (952)912-7379 TOTAL 22.00 PAID WITH CC# 0597 OWNER MASCHOFF, JOHN& DEBRA 2670 KELLEY PKWY ORONO, MN 55356- AGREEMENT AND SWORN STATEMEIVT The work for which this permit is issued shall be perfonned according to the approved plans and specifications,applicable City approvals,and the State Building Code. This pcnnit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type ofwork shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be r�ked at��r�cause. /d l /� / �� /Dl/ 7 / / Applicant Permitee Signature Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 10/17/2011 13:18 FAX 9529335049 CULLIGAN MNTKA 1�002 �` FO Ci Y USE ONLY ,�" l�` City of Orono / �s�� /�p`r P,O,Box 66 Date Receive� � Pcrmit�1 ��l'' �` �l-� ;(�:ii;;, � 1 2750 Kelley Parkway n� j� 11.+ n$'1�,�;:'_ Crys[al eay,MN 55323 Approved By; Amount S: '_�(h v U ��; �.c� (952)249-4600 � '��' i ��::�...• CITY OF ORONO—PLUMBTNG PERMIT (All Commercial permits must be approved by the Building O�cial or lnspector) GENERAL TNFORMATION 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 twa 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 UNT1L 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 inspectad and air tested before it is covered. Call(952)249-4600. (24-48 6our notice required) TYPE OF PERMIT Check All That A 1 �Itesidential ❑Commerciai(Approval Required) �New ❑Additional ❑Repairs ❑Replace ❑ In Accessory Structure? *You will need arior aparoval and may need CUP.(Per Orono City Code,Chapter 78,Article 1V) Job Site/Owner Information: SiteAddress: `�I53 �o��.a-✓ �r+V� Owner; ��!� �45��^�� Mailing Address: c��y: z��: 55 3 5 b Home Phone: 95a•�110 - `�51q Alternate Phone: Contractor Information; CUL�9��jqT Contact Person: �.t)i. 6030 CULLIGAN WAY �G '`��TON State Bond#: (952) 933-720p City; Zip: Expiration Date: Phone: Alternate Phone: �1 S a - `I��- �3 I 1 ❑ Insurance—Current: 1 10/17!2011 13:19 FAX 9529335049 CULLIGAN MNTKA C�003 '','` ; kli:��$:I�G.�'I�'I'�E�:.$��TG:11�5�'T�1LI��L1.; . � FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Flo or Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous :r�:�•'�.,�4'�1x��,�F,��,{�l��a;;�S,;:�t.�.EF}r..k.r�(jY�a`4,�x �+'� �j .. . SI' 77� :�:(�•7t�is:,:.�,•r�„c�in;1'.�t j. I�4�.�[i� °�i �i si ,r� ,I 3 4r S �� 1��(� k 'a �1GJ�� ii��.L��t.y �ti� `[� �! � p'Y,}i 1 �� ° , A � i� � 1� �„z-�y "Fy �r r I ..� ' � S xrt., e ,� ¢P lf�i� 'r' �r� h p��"�qT ��'��' '� '1� � }' ��S �� ti �-.t �'}�3 /� � � ` i � ' ',i ' e. s i��' - �' � � �-�-a F �2�,n�C v!�11t, �.� s� � �Ll,��.9� -,�� , ,1",'{ ,�_ 'i u N':t i Y� .i .� ..t.. � Yes,this section applies The replacement of a ReSidential fixture or ap�liance that meets all three of the foifowing requirements; 1. Doas not require modification to electrical or gas service. 2. Has a tota cost of$500.00 or less;excludine the cost of the fixture or appliance: and 3, ls improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 I � 10/17!2011 13:19 FAX 9529335049 CULLIGAN MNTKA �J004 ; , . .PE�viIT` ;C�1�.Ci�:�;t�'�'IOA1:`.S -�:JOBS.O�JER:$�U:0:00' [f above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1,25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum 350.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 55.00) x.0005 $ (contract price) (minimum$ 5,00) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �c�. U V ■ * 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. tt 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 oti�er 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 Ciry may request the submission of a signed copy of the actual contract, ■ *"`The STATE SURCHARGE is,0005 of the contract price under$],000,000 or$5.00-whichever is greater. For valuations over$1,000,000 call the Building Deparhnent at(952)249-4600 for the price. �K',}: �+��ST'�hix�i..�:��`lt�� .�` S � �v�: I .� .t. ��_.,,7,.;IS,. ;�" G 'i;,��..:5:' '�.'jh`�iW7'if',''1�:7�f'? L'i,t� � The undersigned heraby applies to the City for issuance of a Plumbing Permit, agrees to do al! work in strict accordance with the ordinances 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. Applicant's Signature: �c� Date: �d � 17 - j � � ��.��iihi�'t��; m� -� uRese��`�,q�rk�i� .,:�,:��,r�.��,-N��.�..:.�..,��:.�,�„� 3 I � i �`:� DATE TIME � CITY OF ORONO �--��-�►r^� INSPECTION N IC SCHEDULED / -�y� PERMIT NO. �—O/ COMPLETED ADDRESS � OWNER ELEPHONE NO. �-S� �7� ��g CONTRACTOR >; DESCRIPTION � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/ LLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ 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 _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ING RI ❑ SEP FINAL ❑ FOUNDATION/REMOVAL WNE TRACTOR TO MEET YOU: _NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � � � ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �952� 249-46�0 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary Copy/Site Notice