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Home My WebLink About2014-00426 - fixtures ' ' CITY OF ORONO 2750 KELLEY PARKWAY * � 0 1 4 - PJ 0 4 2 6 * DATE ISSUED: OS/09/2014 ORONO, MN 55356- (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 : PLUMB[NG (> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NOTF,: PL.UMB[NG FIX['URF,S (1)WA'I�ER CLOSET,(1)LAVATORY. (l)SHOWt:R AND(1)SINK VALUAT[ON OF PLUMBING 1000 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG (VALUATION) 0.50 GUSTAFSON, MICHAEL& SUSAN TOTAL 50.50 1000 SHELARD PKWY#300 Payment(s) MINNEAPOLIS, MN 55426- CHECK 50.50 OWNER GUSTAFSON, MICHAEL& SUSAN 1000 SHELARD PKWY#300 MINNEAPOLIS, MN 55426- AGREEMENT AND SWORN STATEMENT The work 1<�r which this permit is issued shall be performed accurding to the approved plans and specitications,applicable City approvals,and the S[atc Quilding Code. �I'his permit is for only the��ork described and does not grant permission for�dditional or related work which requires separate permits. All provisions of laws and ordinanees governing this type of work shall be compied w�ith whether or not specified herein.'1'his permit will expire and become null and void if construction authorized is not commenced within l80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. rhe applicant is responsible for assuring all required inspections are requested��c formance with the State Buildin� This permit may be revoked a� time for due cause �� . _ � � — %. �� _. i ...�� '��-�(/�C._��L��r � � � !� �. p icant 1 ermitce Signature Datc Issued�3y Signalure Date v . ti � FOR CITY USE ONLY �O A' City of Orono ,� _. / � ��j �yO P.O.Box 66 Date Received: Permit# _�� 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: �di (952)249-4600—Main � � � (952)249-4616—Fax F �� CITY OF ORONO-PLUMBING PERMIT l�k�SH�� (All Commercial Permits Must be Approved by the State Prior to City Approval) f�stt��:iJE��«��.dli.mi►.t�u��t�C�l.!)/PI)F% �c �lu��zlr �lanre��:i >>. xlf� 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. Permit cards will 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. 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 1 Residential ❑Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs ❑ Replace ❑ In Accessory Structure? *You will need arior approval and may need� l'P.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: �� CV'-�-e- �� SS Owner: ' " l �� "�-- ��S"►��s0!-� Mailing Address: �S`��-� " City: � (/v�1n p Zip: �� !o , Home Phone: � �a - ��- �� Alternate Phone: �� l2- - �� "��"� � Contractor Information: Contractor: 5��-- �S `��'�" Contact Person: Address: State Bond#: City: Zip: Expiration Date: Phone: Alternate Phone: ❑ Insurance-Current: 1 . � . , PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1 T 2ND OTHER FIXTURE BSMT ls 2ND OTI-�R TYPE FL FL TYPE FL FL Water Closet ( Floor Drains � Lavatory i Sewer Ejector Bathtub Laundry Tray Shower I Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher �bet Bar / � l��c... / Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture or a_p,pliance 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. 1s improved, installed or replaced by the homeowner or licensed plumbing contractor. Skip neact 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 M V � � PERMIT FEE CALCULATION(S)—JOBS OVER$500.00 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Miniroum Fee of$50.00) � � �. � � ,�� x.0125 $ °�� (contract price) (minimum$50.00) 2. STATE SURCHARGE � � L� x.0005 $ � (contra t price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ Z.A6`�� l/� (� L �ti 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� ` ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor, profit, and other fixed costs. [t 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 reasonabie 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 ordin nces of the City and the regulations of the State of Minnesota, and certifies that all statem nts made on this application are complete, true and correct. -- Applicant's Signature: Date: � � � 3 � �DAT TIME V CITY OF ORONO CALLED IN �_ INSPECTION NOTICE '/ SCHEDULED �- - S_'lll� PERMIT NO. a�/ 7'��COMPLEfED � ADDRESS OWNE ��LTELEPHONE NO��- �Z� CONTRACTOR � DESCRIPTION � � ❑ FOOTING ❑ PLUM N FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MEC CAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB O WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J �.pLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: l/�Str�L C �''�! �� 6�t/C - � ,�✓ S/H e ' � � 0 � ,pWV� P1/C � . �ro ' 0 � Q UK� � z W � W � � J d W� �9Y6Rit3lkTISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hpurs in advance. (g52) 249-4600 Owne ontractor on site: �' �� . Inspector. �'-' White Copyflnspector's File Canary CopylSite Notice �� C i�:../J DATE TIME CITY OF ORONO CALLED IN ��_ INSPECTION NOTIC� � ./2� SCHEDULED 7�9�'S g."� PERMIT NO.�v� 5` COMPLETED ADDRESS �O�v L��a�� OWNE /Y�fELEPHONE NO��-�9�T� CONTRACTOR j. DESCRIPTION � `-�� ly ❑ FOOTING ❑ DE O FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PL ING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF (J5{„Y'•LUMBING 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 J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTiiACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � /' � - a .� N�� ?l�'�4Jc.S � SeL` Y SG�C.� -- � ` V� �/Ca �r�� C ✓ ��t� �tGl� $/�p�Q✓' �. � ° �ll ��k ��vl��- W � Q k' !Je�,,.�.� �,,r g�e� W � W � � � ❑WORKSATISFACTORY:PROCEED �&AdECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED ❑INSPECTtON REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on site: � i Q Inspect ��"' White Copyllnspector's File Canary CopylSite Notice