HomeMy WebLinkAbout2009-00013 - water heater „ CITY OF ORONO PERMIT NO.: 2009-00013
, 2750 KELLEY PARKWAY
' ORONO, MN 55356- �ATE ISSUE�: OU13/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 1115 COX FARM RD
PIN : 27-118-23-32-0016
LEGAL DESC : SHADOWOOD FARM
: LOT 004 BLOCK 001
PERMiT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER
NOTE: WA"CER HGATER
APPLICANT WATER HEATER 15.00
NORBLOM PLUMB[NG CO. STATE SURCHARGE PLBG (<$500) 0.50
2905 GARFIELD AVENUE S.
MINNEAPOLIS, MN 55408- MAIL-IN FEE 1.50
(612)827-4033 TOTAL 17.00
OWNER
KOSTIAL, BRADFORD& SARAH
1 115 COX FARM RD
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEMENT
The�vork for which this permit is issued shall be performed accordina to
the approved plans and specifications,applicable Ciry approvals,and the
State k3uilding Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if cons[ruction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
"l�he applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Pennitec Signature Date Issued By Si n ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESC D ABOVE.
.
FOR QTYUSE'O1YI.S' '
� �� '�-. City of Orono
Q J DateReceive� Permrt#
; g" '�� P.O.Box 66
�� ��i 2750 Kelley Pazkway
,I A rovad.:H Amount$:;'
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CITY OF ORONO–PLUIVIBING PERIVIIT
(All Commercial permits must be approved by the Building Official or Inspector)
.
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` GENERAL INFORNIATION ; - ,;'
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 wiil 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. A�work must be inspected and air tested before it is covered. Call(952)249-4600:-
(24-48 hour notice required) -
„ TSIPE 0��-:PERlV1iT ' ,
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Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUY.(Per Orono City Code,Chapter 78,Article I�
"Job::Site(Owner Information . x -
S ite Address: ( I I 5 C�x ��r w� 1�na��
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Owner: �ra�t ��5��'�' Mailing Address:
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Home Phone: � I � li �� Alternate Phone:
Contractor Inforriiation '
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Contractor: ����� Contact Person:
Address: ��� ��� S . State Bond#: lJ�—�I ��' V J
City: �-�.E,� �� ZiP���Expiration Date: � (J�
Phone: � ��a J ���^L�U33 Alternate Phone:
� Insurance–Current:
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FUYTURE BSMT I 2 OTHEIZ FIXTURE BSMT 1 T 2r1D OTF�R
T�'E FL FL TypE
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Water Closet Floor Drains
Lavatory Sewer Ejector
Bathroom Laundry Tray
Shower --- --
Washer
Kitchen Sink Water Heater
Disposal
Water Softener
Dishwasher Wet Baz �
- Sillcocks I
Miscellaneous I
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Yes,this section applies i
The replacement of a Residential fixture or ap�liance that meets alI three of the following requirements; �
1. Does not require modification to electrical or gas service. i
2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance:and '
3. Is improved,installed or repiaced by the homeowner or licensed contractor.
Skip neact section,if this ap�plies; Cost of Permit
$ 15.00
State Surchazge � 50
. Mai1-In Fee(If Applicable) $ 1.50
Total Permit Fee $��
' � . I
(Permit Fees Continued On Next Page) .
2
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-�� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC�( �c,�., SCHEDULED 2/ ��
PERMIT NO. ��Q7! �W��� COMPLETED
ADDRESS �
OWNER CONTR. �
TELEPHONENO. I o I � ' -1� l — �.�� �
� DESCRIPTION L/�-�-{..�� �GQ� L'/'�;
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING ��j /
❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS ���
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE � ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTHACTOR TO MEET YOU: YES_NO
� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED ' PROJECT COMPLETE
W ❑ CORRECT WORK&PROCEED �:i ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. J PHOTOTAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (J52� 24J-46��
OwnedContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice