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Home My WebLink About2013-00503 - plumbing CITY OF ORONO * Z 0 1 3 - 0 0 5 0 3 * ` 2750 KELLEY PARKWAY DATE ISSUED: 06/13/2013 ` ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2435 COUNTRYSIDE DR PIN : 04-117-23-11-0005 LEGAL DESC : COUNTRYSIDE MANOR : LOT 001 BLOCK 002 PERMIT TYPE : PLUMBING (> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : F[XTURES - MULTIPLE NOTE: BSMT: 1 WC, 1 LAV, 1 SHOWGR, I FLOOR DRAIT�' 1S�1'Fi,: 1 KITCHGN SINK, D[SPOSAL, 1 DISHWASIIER, 1 WASIIER 2ND FL: 1 WC, 1 LAV, ] TUB VALUATION OF PLUMBING 7200 APPLICANT PLUMBING FIXTURE FEE 90.00 MARK MAAS PLUMBING STATE SURCHARGE PLBG (VALUATION) 3.60 1 1599 KRAMEL AVE NW ANNANDALE, MN 55302 MAIL-IN FEE � Minnesota State License#: PC643489 TOTAL /.� .,., PAID WITH CC# 6078 �360 OWNER FULLERTON &ANDRIA MOLDZIO, JOHN 2435 COUNTRYSIDE DR LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to � the approved plans and specifications,applicable City approvals,and the State E3uilding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of la�vs and ordinances governing this type of work shall be eompied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within I80 days of the d�te of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible Yor assuri g all required inspections are requested in conformance w� c ate Building Code.This permit may be revoked at any tim for e ca ,G � / / / / App ic Per itee S gnature Date Issued By Sign re SEPARATE PERMITS REQ[1IRED FOR WORK OTHER TH N DESCRIBED ABO : FOR CITY USE ONLY t City of Orono � �O�O P.O.Box 66 Date Received: Permit# 2750 Kelley Pazkway Crystal Bay,MN 55323 Approved By: Amount$: (952)249-4600—Main y �. (952)249-4616—Fax F c,` CITY OF ORONO- PLUMBING PERMIT �'�KssHOR�' (All Commercial Permits Must be Approved by the State Prior to City Approval) htt :Uw��.dli.mu, rov/CCLD/PDF/ e _lunib lanreva� . df GENERAL INFORMATION 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 two 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 UNTIL 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 inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) TYPE OF PERMIT (Check All That Apply) ❑ Residential ❑ Commercial (Approval Required) ❑ New �Additional ❑ Repairs �Replace ❑ In Accessory Structure? *You will need prior anproval and may need CUP. (Per Orono City Code, Chapter 78,Article IV) Job Site/ Owner Information: 6 Site Address: �y,3� C'-�> u-•�� `�� , (`�-�' Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �'� /L� � ` .��.:s�,�,%1 Contact Person: i�� Address: /��',�/�-��.-_�-;��= .t.�c� State Bond#: City: ��i /t�;��r Zip:.`'� S�� Expiration Date: Phone: ��) 3 �l� %"7 Alternate Phone: �,?v �/i� �/ �77 ❑ Insurance-Current: 1 ` ., PLUMBING FIXTURES BEING 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 Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three 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 plumbing contractar. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(lf Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 ' PERMIT FEE CALCULATION S)—JOBS OVER $500.00 lf above does not apply; follow guidelines below: l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) C%U `?,��,p '� X .oizs� (contract price) (minimum$50.00) 2. STATE SURCHARGE x .0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-ln Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PWCE or JOB COST means the actual or estimated dollar amount charged far the pertnitted 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 market value of such items must be added to the estimated cost ar 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. PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City far issuance of a Pfumbing Permit, agrees to do all 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: ��• �� Date: �� ,,.�o�C> �3 3 �— DAT�j, TIME f CITY OF ORONO CALLED IN �� e[ INSPECTION TI E /�� SCHEDULED �G�� _,/ .� PERMIT NO. �� DD�"'" COMPLETED , ADDRESS Z�3 S C��-K-�7" /� OWNER TEL HO E NO. �Z 7Z 3 �/ �7 CONTRACTOR Q-� � � DESCRIPTION � � � ❑ FOOTING ❑ PLUMBING FIN ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q � Z W � W � � GW�VORK SATISFACTORY:PROCEED L7 PROJECT COMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR � CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on s e: Inspector. �� White Copyllnspector's File Canary CopylSite Notice