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Home My WebLink About2011-01089 - plumbing ^ CITY OF ORONO PERMIT NO.: 2011-01089 . 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: 09/20/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 930 COX FARM RD PIN : 27-118-23-33-0013 LEGAL DESC : SHADOWOOD FARM : LOT O10 BLOCK 001 PERMIT TYPE : PLUMBING (>$500) PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NOTE: BASGMENT: 1 WC, 1 LAV, 1 SHOWGR, 1 KIT SINK, 1 D[SPOSAL, 1 DISHWASHER, 1 FLOOR DRAIN 1 ST FLOOR: 1 WC, 1 LAV, � VALUATION OF PLUMBING 6400 � APPLICANT PLUMBING FIXTURE FEE 80.00 NRH PLUMBING INC. 6460 153RD LN STATE SURCHARGE PLBG (VALUATION) 3.20 RAMSEY, MN 55303- TOTAL 83.20 (612)245-7280 Minnesota State License#: 067436 PM OWNER K[LLINGSTAD, MR. & MRS. 930 COX FARM RD LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for oniy the work described and does not grant permission for additional or rclated work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied wi[h whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of�180 days at any time after work has commenced. The applicant is responsible for assuring all r uired inspections are requested in conformance wilh the St te B il ing Code.This permit may bc revoked at any ti e for due cause. � �� l t ��7u�� Applicant Permitee Signature Date Issued ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . � ^ FOR CITY USE ONLY ,►` City of Orono - O4O`�`O P.O.Box 66 Date Received: Permit# �ry.�, 2750 Kelley Parkway .� ��.�;��. a Crystal Bay,MN 55323 Approved By: Amount�: �d� '�'�''�.6� (952)249-4600—Main �ass$� (952)249-4616—Fax CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://rr��w.dli.mn.<=ovICCI.D/Pl)F/ e � lumb 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. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECENE 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 pernut 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 ply) �Residential ❑ Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs �Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: ,�._�t.-� �c�X �M /�L� Owner: I`1iZ. ��, w�K c�; t rY?(� Mailing Address: 5,4v►.�e.. City: ��"v�� o Zip: Home Phone: Alternate Phone: � 1 Z '3 Co l0 3 �7� Contractor Information: Contractor: �t1��} �'�v�N��c:. ContactPerson: /U,�i,C �-f-uS�'�f-� Address: G� y� �� /5�3 " ��/ State Bond #: /2�S�yv City: ��i Zip: �53��> Expiration Date: / 2 • �j. i z Phone: C>�z zyS �Z�C� Alternate Phone: ❑ Insurance— Current: y�s 1 � + PLUMBING FIXTURES BE1NG INSTALLED `<k`��`s�, �� . ;;�� a 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 1 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;excludine the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed plumbing 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 �� "x�`P'�� ., �?E�IT`FEE CALCULATION(S)-JOBS OVER$SO�f t� .°;� , . .,` i If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) � �P��x .0125$ (contract price) (minimu m$50.00) 2. STATE SURCHARGE � -��—b a x .0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ , 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� • ` " ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the perrrutted 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 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 request the submission of a signed copy of the actual contract. � PL�:IT��fi �ERNITT AP"��` ,�CATION AC�r�E�NN�I.EEI�rT,,��w:� � ��'��` , ��"'''�� 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 regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. � e� i A licant's Si ature:�'I� � Date: �Z � PP � , 3 �� DAT TIME V CITY OF ORONO CALLED IN /0-� INSPECTION NOTI�j E SCHEDULED /� � � � PERMITNO.a��/-�� COMPLETED ADDRESS I� �� K�- OWNER ��L�E NO.� �Z Z�'S 7Z� C�NTRACT�R >; DESCRIPTION � /-�'" v �� ❑ FOOTING ❑ PLUMBING FIN ❑ EXCAV/GRADING/FI�LING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHAN�CAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ 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 �� '—� �J.- �- A S � .".�,//�' � �� 0 � W � Q � z W � W � j d W �PURK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �J PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL{NSPECTOR �--� CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. � ✓"�� White Copyllnspector's File Canary Copy/Site Notice �c�� DAT TIME � CITY OF ORONO CALLED IN -�I Z� INSPECTION NOTICE 9 SCHEDULED `I''Z�-�� J PERMIT NO.J��J�� I COMPLETED ADDRESS g3 O Cp�( �a.�''m P-�_ OWNER TELEPHONE NO.�� Z� 5 7 Z�D CONTRACTOR �� l��b��--�'i �; DESCRIPTION ��e� G�� ❑ FOOTING ❑ PLUMBING FINAL ADING/FILLING Q ❑ POURED WALL ME HORENV LANDS 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � ti � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑C ECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN NOURS. ❑ pHOTO TAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours irt advance. �952� Z49-4600 Owner/Contractor on s' e: Inspector. White Copyllnspector's File Canary CopylSite Notice