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Home My WebLink About2013-00618 - water softner . � CITY OF ORONO * Z 0 1 3 - 0 0 6 1 8 * 2750 KELLEY PARKWAY DATE ISSUED: 07/08/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 315 CRESTVIEW AVE PIN : OS-117-23-14-0030 LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK : LOT 000 BLOCK 005 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER SOFTNER NOT�: WATF.R SOFTENER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 5.00 6030 CULLIGAN WAY MINNETONKA, MN 55345 MAIL-IN FEE 2.00 (952)912-7379 TOTAL 22.00 PAID WITH CC# 0597 OWNER ENGEBRITSON, REGINA 315 CRESTVIEW AVE LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work dcscribed and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the S[ate Building Code.This permit may be revoked at any time for due caus � �� v �� / / Applicant Permitee Signa ure Date Iss d By Signature Date SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 07/OR/2013 11:53 FAX 9529335049 CULLIGAN MNTKA C�002 OR TTY USE ONLY � �4�� City of Orono 7 8 �/� y �p� 0�` P.O-Box 66 Date Receiv� � Permit#Ou/�J ��;;,E�, �, 2750 Kelley Parkway � (�/ 5� }>> Crystal Bay,MN 55323 Approved By: Amount$ � '�`�� :;� a�j�� (952)249-4600 �:.,�� k�go CTTY OF ORONO—PLUMBING PERMIT (nll Commercial permits must be approved by the Building Official or]nspector) GENERAL 1NFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit wi11 be issued within two working days. 2. Pcrmit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MiJST NOT SEGIN UNTTL THE PERMIT CARD IS 1'dSTED ON THE JOB SiTE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to properry 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 requircments. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) TYFE OF PERMTT Check All That A 1 �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: � l S �re.5�V��.w I�oL Owner: 1��.o. C-��✓� �5 0� Mailing Address: c��y: z�P: ss 3 5 ( Home Phone: �,I� `��3-�`(I a Alternate Phone: Contractor Information: : Contractor: Contact Person: �� CUt„�t�3v��;WATER CONDITIpNING State Bond#: fi�30 CULIIGAN WAY �yNNETONKA, IV1N 55345Zip; Expiration Date: �-_. - (952) Phone: Alternate Phone: `�5,� � 7 I]-��i 17 � ❑ Insurance—Current: 1 07/08/2013 11:53 FAX 9529335049 CULLIGAN MNTKA �j003 � �PT,C1Iv1��NCrFIXTU.R��BEINGIl�tST'1�'LET) . ,'��' FIXTURE BSMT 1 T 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor I�rains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Silicocks Miscellaneous �,;�� z� t ��,�; r �� prRMrr��E cA��;A�zo�{s) � r�t � � ��;�' � , �.��n o�-�oo� s�t�.T�s�� - ti � -� ,, � , , ; � r � :.:��Fti,�, j,,��N'')`I�; , - i r�� t tt ,a�,`,��.;' 'it? — ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not reyuire modification to elecirical or gas service. 2. Has a total cost of$500,00 or less;excludin�the cost of the fixture or appiiance:and 3. Is improved,installed or replaced by the homeowner or licensed eontractor. 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 07/08/2013 ll:53 FAX 9529335049 CULLIGAN MNTKA f�004 =.. ;� . .T{�PE��:e�cur�T�o�v.s. ��as.o�:�sao:oo . . ,�;� . . _ , If above does not apply;follow guidelines below: 1, CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of�50.00) x.0125$ (contract pnce) (minimum$50,00) 2, STATE SURCHARGE **Add the State Bidg Code Div.Surcharge(Minimum Fee of�5.00) x.0005 $ (contract price) (minimum$ 5.00) 3. POSTAGE&HANDLING(Only on Mail-In Applications} $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �a•�� + * CONT}tACT PRICE or 70B COST means tha actual or estimated dollar 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 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. ■ **The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or�5.00—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. ��^�'��.��I� ?�ki'.�`+,' '� ��f�� 1' .�r �yi�:7i�+�i �7 �p d,�/�nr� t i 3�4pI�I �'�.fil�lt�,±ktF:im:;i �'4i,�i+'�i.�"lsf'".`�iA�o��.F.it,�(..1.EU:1�/'�� ^�{,P��1�� I",4-�:[,3`=�A'i;;l�l�l tl'U1�:1��1�, r,�; �.t,�;'{��+rt.. ,{ 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. Applicant's Signature: �� Date: ! ' � " r 3 ,��e�„��i1�t��' �F �.��:;T�,,.,,t,��,�.'�;`: 3 DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED _ PERMIT NO.v7G/� "'Z�/�S COMPLETED '� � ADDRESS �%S� �`�-� s�v; ��.� r�P OWNER TELEPHONE NO. CONTRACTOR C��4 ' �; DESCRIPTION d�/�'t�� s�-��*`! f•.-'� � � ❑ FOOTING (�UMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. � FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: ar'-c�i vH.� !�G-``G��':- ��i/c��/ /G'� ��r /��`"b' � � � ' � O // �7�i � //� !�c��/C�✓� � � � �tJ�t� So�Ker re��. " W � Q Z Q'� y"a� P�'v v ra e� - � G��'k cr�,�,<<0%6� - � �✓�"' ``t' -.�-r'!.�l�,00 J � ❑WORKSATISFACTORY:PROCEED �QJECTCOMPLEfE W ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-46�0 OwnerlContractor on site: Inspector. Wh' Copylinspector's File Canary CopylSite Notiee �! p�TE � TIME ✓ CITY OF ORONO CALLED IN I��> INSPECTION N TICE SCHEDULED D: D PERMIT NO. � ��COMPLEfED ADDRESS OWNER LEPHONE NO. �P�� l !S�'J�'�a CONTRACTOR � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 � ❑ 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. � J O � � O � W � Q � 2 W � W � J d W� ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ E CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952� 249-4600 OwnerlConVactor on site: Inspector. White Copyllnspector's Ffle Canary CopyfSite Notice