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Home My WebLink About2011-00452 - residential CITY OF ORONO PERMIT NO.: 2011-00452 2750 KELLEY PARKWAY , ORONO, MN 55356- �ATE issUEn: 06/13/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 120 CREEK RIDGE PASS PIN : 03-117-23-12-0014 LEGAL DESC : CREEKSIDE IN ORONO : LOT 003 BLOCK 001 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES -MULTIPLE NOTE: 5 WATF..R CLOSETS,7 LAVATOR[GS,2 BATHTUBS,2 SHOWGRS, 1 KITCHGN SINK, 1 DISPOSAL, 1 DISHWASHER,2 SILLCOCKS,3 FLOOR DRAINS,2 LAUNDKY TRAY, 1 WASHL:R, 1 WATER HF,ATF,R,2 WET BAR VALUATION OF PLUMBING 25000 APPLICANT PLUMBING FIXTURE FEE 312.50 BLUE WATER PLUMBING STATE SURCHARGE PLBG(VALUAT[ON) 12.50 5026 ALPHA ROAD PRINCETON, MN 55371 TOTAL 325.00 (763)238-1002 OWNER GUSTAFSON, MICHAEL& SUSAN 1000 SHELARD PKWY#300 MINNEAPOLIS, MN 55426- AGREEMENT AND SWORN STATEMENT _ The«ork for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or rclated work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorizcd is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any[ime atter work has commenced. "Che applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. /�� - :i :�--�-��- 6 / i 3 / �/ �=,��.--� � �`�'Y� C �%� � � ��.� /� � icant Permitee S�gnature Date lssued�y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. •` FOR CITY USE ONLY 0A�� City of Orono �� `r� P.O.Box 66 Date Received: Permit# ��;; 2750 Kelley Parkway � �i�'��`. ti Crystal Bay,MN 55323 Approved By: Amount$: ��A�.�G` (952)249-4600—Main (952)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Co�nn�ercial Permits Must be Approved by the State Prior to City Approval) htt�://wvvw.dli.�nn.�*ov/CCI.,D/YDI;i e � liimb lan►•eva �. �df' GENERAL INFORMATION I. You may apply for plumbing permits by mail or in person at the City offices. Applicatioi�s 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 iJNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN U1�TTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbinb contractors and to property owners residing in the dwelling. 4. When any new consnuction 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 approval and may need CUP. (Per Orono City Code, Chapter 78,Arricle IV) Job Site/ Owner Information: Site Address: �o�f� Gr'e-e-)L 2 �-�C� �e�Ss �(�� ► Owner•_�, ��L�� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Inforn�ation: Contractor: ��U� �� f�2 Contact Person: ��`��2 ' �'� Address: 5��6 A�P�� State Bond #: �3 s`��3 ��y City: ��%'��=�'�� Zip: ��5� 7�Expiration Date: � " �`� ` ��- Phone: 7�j -�� - �� Altemate Phone: 7 6 �"� �'�� -� U�� ❑ 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 t I z Floor Drains � g ✓ � Lavatory � ( � � Sewer Ejector Bathtub � Laundry Tray i � I Shower ,-L Washer l �' Kitchen Sink � Water Heater Disposal I Water Softener Dishwasher Wet Bar ( � Sillcocks � Miscellaneous ��, PERMIT FEE CALCULATION(S) -� � BASED OFF - 2002 STATE STATUE � � . ❑ 1 es, this section applies The replacement of onl}�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 contractor. Sldp 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 ♦ , , PERMIT FEE CALCULATION(S)-JOBS OVER�500.00 ; If above does not apply; fol]ow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a (Minimum Fee of�50.00) � S p � � x .0125 $ (c6ntract price) (minimum�50.00) 2. STATE SURCHARGE x.0005 $ (contract pri ce) 3. POSTAGE &HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual ar estimated dollar amount charged for the permitted wark 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 esrimated 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 PERIvIIT APPLICATION AGREEIVIENT � � � � � The undersib ed hereby applies to the City for issuance of a Plumbing Permit, agrees to do all warlc 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: � ` �� ' / � �_ , �. 3 DATpE TIME V CITY OF ORONO CALLED IN 4 �� INSPECTION NOTICE SCHEDULED 9�3 2; 3 � PERMIT NO. �� COMPIETED ADDRESS � �� ✓�y OWNER L� CONTR. ��.e.hQ/1� U'_.�-e'-1'C� TELEPHONE NO. �CO � � o�.�K' �o O a' � DESCRIPTION �.-r��' /'L � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FR,4MING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNEfl/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING fil ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J �PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � �(. � �l.O .�t�,c��CS' � S'}' d � 0 a � 0 � W � Q � Z W � W � j d W� ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ IS UE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-46�� OwnerlContractor on site: Inspector. `S White Copyllnspector's File Canary CopylSite Notice �� C.% � �J TIME � CITY OF ORONO CALLED IN �� /� INSPECTION TICE SCHEDULED � •'� • �"� PERMIT NO. � J U S� COMPLETED I( �� ADDRESS � � OWNER LEPHONE NO. 7 ��7��7� CONTRACTOR /�� f 4 � , �C.�1 /►'�� DESCRIPTION %' l�-�� /��f-- ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS � O ❑ FRAMING ❑ MECHANICAL 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 ❑ SE yIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO �� COMMENTS: � � W C o ,�'i�2 _ Z� � �� ,, � � 0 � W � Q � Z W � W � � GW �lORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE �0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContrac Inspector. -� White Copyllnspector's File Canary CopylSite Notice