HomeMy WebLinkAbout2015-01078 - water softner ;"i'Y OF ORONO * z 0 1 5 - 0 1 0 7 8 *
� � 27.�`1 KELLEY PARKWAY pAT� [SSUEn: 08/24/2015
UIZOI�'O, MN 55356-
(�`"�''_'9-4C00 FAX: (952) 249-4616
ADDRESS : 80 CR[:I F: R I I�C�! "nSS
PIN : 03-117--�- -12-OOI�
LEGAL DESC : CREEKSI!)I? IN �'�� �?NO
: LOT 007 13L0(��: 001
PERMIT TYPE : PLUM�31V'G (>�� �)
PROPERTY TYPE : RESIDI:�: i�InL
CONSTRUCTION TYPE : WATER SOFTN I���
VALUAT[ON OF PLUMBING �uUU
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.50
AQUARIUS WATERCONDITIONING, i':C. TOTAL 51.50
3180 COUNTRY DR Payment(s)
LITTLE CANADA, MN 55117- CHECK 5085 51.50
(651)777-0448
Minnesota State License#t: plbg-WI50110?_'�
OWNER
Hometime Video Publishing Inc
4355 PEAVY RD
CHASKA,MN 55318-
AGREEMENT AND SWORN ST�'�"I f:'I(:�
The work for which this permit is issued shall be per`� ����:�I acc��,�'�n�to �
the approved plans and specifications,applicable City a�iprovals.�� t thc '
State Building Code. This permit is for only the work described a� :docs i
not grant permission for additional or related work«hid�r�quir�> r.,�.c �
permits. All provisions of laws and ordinances govcrnina(his ty����'f work �
shall be compied with whether or not specified herein.7,,;,pu i���� ��ill
expire and become null and void if construction authorizcd i,rn�t
commenced within 180 days of the date of issuance,or if c��n;u��,::����n is
suspended for a period of 180 days at any time after work has co�������n,ed. �
The applicant is responsible for assuring aIl required in,�irctinn�,
requested in conformanc with the State Building Go�l�,.l�;,i,pcn, �:n�.���bc
revoked�any ty�ne fo�Clue cayse. j��F�
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App ant Pe, ite���i�nature � ,,� '� Issued By Signature Date
FOR CITY USE ONLY
/���� City of Orono —7�/
/ �o�O Y.O.Box 66 Date Received: ' o��/Lf'�ermit#�dl�—� � < E
� 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved f3y ��� Amount$:
(952)249-4600—Main
�� � (952)249-4616--1�ax
�`� � CITY OF ORONO-PLUMBING PERMIT
��k�sNn��� (All Commercial Permits Must be Approved by the State Prior to City Approval)
htt�://www.dli.mn.Qo�/CCLD/PllF/ e lumb lanrcva � . 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 warking days.
�'. 1'crnii( cur�(s ��,�ill l�c ��n' h�� rcl�nn mail n�tcra r����i.��� i� r�,m�ilc�c�l_ PI�R\i[TS _�RI� \C)T
VAl,lll UN"I,IL YOU RL'CE[VE A PERM['I'. WORK MUST NO"1'13EGIN UN7'1L THE
NERMI"I'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
(Checl�All That A 1 )
�Residential ❑ Commercial (Approval Required)
�New ❑ Additional ❑ Repairs ❑ Replace
❑ [n Accessory Structure?
*You will need prior approval and may need CUP.(Per Orono City Code,Chapter 78,Article [V)
Job Site/Owner Information:
Site Address: 7'�>� � z��- Q��c!l C- ��S S
Owner: ��(xb1 �ca�V�.J�'�1 Mailing Address: �a �� P
City: _�i v� �ti�' Zip: ,SS �,��°
Hame Phone: 1 SZ- z,���'3��( �� Alternate Phone:
Contractor Information:
Contractor: �c�y�v 5 �G.��,V Cc�L�.Contact Person: �(;�Ve �L
Address: � (4;� C�� w�-r c� State Bond #: �� � rJ � � �0�J.��
City: (,r t'-f'1 E �4nu�5 Zip: ;SI ��� Expiration Date: � � � � �
Phone: (c1�( -7�Z �' `t`��= Alternate Phone: (p��"���-'��I��
� Insurance- CtirrenL• Q��. {�..��(,L��� 1(�i ��(,�/'��
, �
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PLUMBING FIXTURES BE1NG INSTALLED
FIXTURE BSMT l�� 2'D OTHER FIXTURE BSM"C 1�� 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
- - - _ � - - - - - - -
Liatlitub � � �� , � Lauudry'I�ray �
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener �
Dishwasher Wet Bar
Sil(cocks 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 a(1 three of the following
requirements:
l. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excluding 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 $ 1.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
PEKMIT FEE CALCULATION(S)—JOBS OVER$500.00
If above does not apply; follow guidelines below:
1. CONTRAC"f PR[CE * is 1.25%of contract price with a(Minimum Fee of$50.00)
C �J
, �ce' X .o�2s $ So,
(contract price) (minimum$50.00)
2. S"CATE SLIRCHARGE
3, ��0 � x .0005 $ ����
(contract pricc)
3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2�l
4. TOTAL PERMIT FEF,(Add Lines 1-3 Above) $ ��°��
■ * CONTRACT PRICE or JOB COST means the actual or estimated doilar amount charged for the
permitted 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 instailations 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.
PLUMBING PERMIT APPLICATION AGREEMENT
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.
i
Applicant's Signature: V�� Date: �� Z�� � �"� ��
�
3
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DATE TIME
ITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � Z= �
PERMITNO.�UI�S-����� COMPLETED
ADDREss �D �h � �L�i d�,,� ��.�
OWNER TELEPHONE NO. ��l- �7�d���
CONTRACTOR ah/u S�
� DESCRIPTION � '� - ,
l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEP FINAL��ijh�/
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC I ALL
2 OWNERICONTRACTOR TO MEET YOU:_YES�O
� COMMENTS: `� l,t 1�.Q�1 I,��� �,�-� �N�-��
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W ❑WORK SATISFACTORY:PROCEED ,�,p�C11ECT COMPLEfE
W ❑CORRECT WORK 8 PROCEED ��ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractoronsite: �',l�il
Inspector. - �✓ '�'�
White Copyllnspector's Flle Canary CopylSite Notice