HomeMy WebLinkAbout2015-01128 - water softner CITY OF ORONO * z � 1 5 - 0 1 1 2 8 *
2750 KELLEY PARKWAY DATE ISSUED: 09/03/2015
' ORONO, MN 55356-
r (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2780 COUNTRYSIDE DR W
P[N : 04-117-23-12-0010
LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN
: LOT 002 BLOCK 002
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RES[DENT[AL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: NGW WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG(<$500) 1.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULL[GAN WAY
M[NNETONKA, MN 55345- TOTAL 18.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 18.00
OWNER
PETERSON,TIM
2780 COUNTRYSIDE DR W
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing[his type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. �� �
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Applicant Permitee Signature Date Issued By Signatu e Date
09/02/2015 14:�0 F�T 9529a35049 CULLIGAN MNTKA �002
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� FOR CIT'Y CJSE ON�,Y
�p'�, City of Or000 ' �a �J��(C (j�/
' �O¢ �Q` P.O.Box 66 Dn:e Received:��Permit# v �
r �,�,�,., 2750 Kelley Parkway � j d c�
� ��t�� �� Cryst3l Bay,M�i 5�3:3 App:ovcd 13y: Amoun�$:�
N , ���',.���� (952)249-4640
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CTT'Y OF ORONO—��tiMBING PERIVXYT
(All Commeroinl permi[s must be approvcd by[hc Buildirtg Official or fnspecror)
GErrEx��rr�a�arroN
1. You may apply for plumbing pelmit5 by mai] or in person at the City offices. Appllcations will be
revi�wed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail a$et'a review is completed. PERMTTS ARE NOT
VALID UNT1L'YOU RECEIVE A P�RMIT, VVpRK MUST TOT BEGXN CJNTIL THE
PERII'�X'�CA�tb�S POS7ED ON TFIE d0�5XT�.
3. plumbing permits may be issued ONLl'to licensed plumbing eonEractors and to property owner5
residing in thC dwelling.
4. When any new constructioo or remodeling is involved,a separate bvilding permit must be
obtained,
5. All work must be done in accordance with Statc Code requiremenu.
6. A11 work must be inspected and air tcstcd before it is covered. Call(952)249-4600.
(Z4-4$hour notice required)
1"Yl'E OF PERMIT
Check All That A 1
�Residential ❑Commercial(Approval Required)
�New ❑Adtlilional ❑Repairs ❑Replacc
❑ In Accessory Struchtre?
'�You will need rior a roWal and may need CUP.(Pcr Orono Clry Code, �hapter 78,Articic IV)
3ob Site/Owner rnformation:
Site Address: a��$� ��S�d� �'� `^'
Ov�nler: 1�. �'S 0 h Mailing Address:
City: Zip� SS 3 S (e
Home Phone: ��� � �`� ��K �6�� AIternate Phone:
Contractor Znformation;
Contractor: Contact person:
����dGa� w�r�R C�N�ITipN_►�a State Bond #:
��0 CU� WAY
MSNf��TQNKA, MN 5534�,ip: Expiration Date�
C�ty: (952}
Phone: Alternate Phone: 45� - �I�- y3 f 7
❑ Insuranc�—Curre�.t:
I
09/02/2015 14:�0 FAX 952�J3a5049 CULLIGAN hiNTI�A C�00�
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� ,�,�,,PL�LTNI��1�i Cr FI�TIC�'S`�E�NG�I�TST�i�T�E�' ��"
.#;`,: _ � :r;J��,.� ��v�..
FIXTUR.E B5MT 1` ?' ' OTHER FIXTURE 6SMT 1' 2' OTI-IER
TYPE �'L PL TYP� �'L F�,
Water Closet Floor Drains
�avatory Scwer Ejeaor
Bathtub Laundry Tray
Shower Washer
� !
Kitchen Sin1c Water�-leater
Disposal Water Softener �
Dishwasher Wct Bar
Sillcocks Miscel]aneous �
l�d�.r....i��t1'�f��F, In �� � p�'�4I`�^�?�{; � ('T �1 ri �r � ! I`f II � '
�. Yj"��117_�, ���,( h ���" �� �.l'I 1ICJ.:J.1.L•�'���.���S'������1������17�,1. �� � � ' .I .I f 1� �1 Y�'If
; :� , BAS'EI7 Ql?�` ZOb2 SZ"AT'��TA�, � '
,.,; , ,-,;,,� � �-; I',�arl
❑ Yes,this section applies
The replacement of a Rcsidcntial fixturc or epplianCe thst meets all three ofthe following requirements�
1.., Does not require modification to electricaI or gas service:
2. Has atotal cost of��00.00 or less;excludin�the cost ofthe fixture or appliance:and
3. Ts improved;installed or replaced by the homeowner or lieensed eontractor.
Skip ncxt section,if this applies; Cost of Pernlft $ 15.00
` State Surcharge $ 5.00
Mail-In Fee(3f ApplicAble) � 2.00
Total Pcrmrt Fec �
(Permif Fees Continued On Next Page)
�
09/02%2015 14:31 FA1 �J52�J�3504�J CULLIGAN bitiTIiA C�004
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�:.��,,-,,��;,;,:'?��;,� �� ,P��?vJ��'�'EE'.�����T.�O�T S —,�fa3��=:OVER �� .�d���.''�"'�,; ';u '
�,,, $, ��;; � ,'.
Zf abo�ve does not appIy;folIow guidelines below: � -
1_ COI�TTRAC'I'�'�LTCE *is 1.25%o�contract pricc with a(11'�inimum Fee of g5Q.00)
x.O1ZS $
(canGact pricC) (mi71I11UITl$�D.00)
2. ST,�#T�SC%12CHARGE '''"Add the Statc B[dg Code Div.Surchargc(A�Iinimum Fcc of 55.00)
x.0005 $
{conRoct pYiGe) (minit11U�17$ 5,00)
3. P�STAGE&HA?VDLING(Only on Mail-In Applications) � 2_00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��-0 U
■ * COhTRACT PWC� or JOB COST means the actual or estimated dollar amount charged for the
permitted worlc including materials,labor, profit,and othcr fixed costs. Yt is the amounY to be charged
co the customer for the work done, (P any matenal, oquipment, labor or installations are fumished by
the owner,tenar,t or any other pariy, the reasonable market value of such itcros 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 City may requesi the s'ubrztission of a sib ed copy of the actual contrao�.
■ '�*The STATE SURCHARGE IS ,OOOS of the contract price undet$1,OOQ,000 or$5.D0—whichever is
greater_ For valuaYions o�ei'$1,000,000 caIl thc Building Department at(952)249-4600 for the price.
s ,, �S.�U��B1�7G�BRlY1Z��,A���`��LA-'�'Ii�I�.T��AGREE1vx�:� �a . '�,,i`�„w�i�t4;�� �',�'�
T1�e undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
wor}: in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this applieati�n are complete, irue and
correct.
Applicant's Signature: Date: l' a- ��
�!�'��'��,i�ii�cr��l;'ITf�;1�nr�„��
�,F��Swet'vF;01'111
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3
DATE TIME
CITY OF ORONO ca,L�IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. �/S -O//a Sf COMPLETED '/C� -/�
ADDRESS o�7�O C'ar�-is Lry vr,r�,v �•�' •
O'WNEA TELEPHONE NO.
CONTRACTOR �
� DESCRIPTION l�Um�-�v Gd��t �i sn�°r 6/•
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q [� POUPED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FHAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑WATER HOOK-UP �EOLLOW-UP
V1 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
? d�N8YC0lfTRACTOR TO MEET rOU:_Y�_NO
� coMM�r�
�
j Permit has expired per MN Building Code Sec. 1300.120 subp. 11
� Expiration, no record of a Final inspection.
0
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W ❑WOfiK SATISFACTOfiY`.PFIOCEED ❑PROJECT COMPLETE
� ❑COqqECT NIORK 3 PROCEED ❑ISSl1E CEPITIFICATE OF OCCUPANCY
W
o ❑CORRFCTYM�RK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CdVERINO pEqMANENT
❑(bqqEC'Tt1N$AFECONOITIONWffHIN HOURS. ❑pHpTOTAKEN
{NSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR ❑qTATION ISSUED
O INSPCCTION REOUIRED.CALL TO ARfiAN(3E ACCESS.
caN ta u�e�e�ct tispe�t�on za na,�s�ac�r�ce. (952) 249-4600
on sR«
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�spector: Q ��- - --
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