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Home My WebLink About2010-00013 - water heater CITY OF ORONO PERM IT NO.: 2010-00013 " 2750 KELLEY PARKWAY • ORONO, MN 55356- DATE ISSUED: OU07/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3393 CRYSTAL BAY RD PIN : 17-117-23-44-0020 LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING (<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICAIVT WATER HEATER 15.00 NORBLOM PLUMBWG CO. STATE SURCHARGE PLBG(<$500) 0.50 2905 GARFIELD AVENUE S. MINNEAPOLIS, MN 55408- MAIL-[N FEE 2.00 (612) 827-4033 TOTAL 17.50 OWNER PRICE, MARY 3393 CRYSTAL BAY RD WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The��ork for�chich this permit is issucd shall be performed according to thc approved plans and specifications,applicable City approvals,and the State Buildinc Code. This permit is for only the work described and does not grant permission tor additional or related work which requires scparate permits. All provisions oC laws and ordinances governing this type of work shall be compied with whether or not specified herein.'fhis permit will cxpire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applicant is responsible for assurine all required inspections are requested in conformance with the State[3uilding Code.This permit may be revoked at any time for d�e cause� `%�/Y�l�--t—e �- l l l l Applicant Permitce Signature Date Issucd By Si turc ate_ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A OV . ,. FOR CITY USE ONLY , ,�0�, City of Orono P.O.Box 66 DateReceived: Permit# �� 2750 Kelley Parkway � a !�?�r'' C stal Ba MN 55323 A roved B Amount$: � r� rY Y> � PP Y� ��Y�� (952)249-4600 EBHO CITY OF ORONO—PLUMBING PERMIT (All Commercial permits must be approved by the Building Official or Inspector) 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 will be issued within two working days. 2. Perniit 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 pernuts 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 inust be inspected and air tested before it is covered. Cail(952) 249-4600. (24-48 hour notice required) TYPE OF PERMIT (Check All That APP1Y) �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: _ lane Price 3393 Crystal Bay Road Owner: iress: Orono,MN55391 Clt}�: q5�741�R(l� Home Phone: Alternate Phone: Contractor`Information: Contractor: i�1�CI��b"Y}� ��,b(JZC� Contact Person: u Address: 2�� a��d � St�, State Bond#: D�Y' �� City: � �S ZipS�� Expiration Date: ( J ��I� 1 Phone: f�f 2��'7� `t`a3�3 Alternate Phone: � � Insurance—Current: 1 ':�'�`��"�°,;�`�'�`"�`, �,�� x`�:: PLT:TMBING FIXTURES BEING 1NSTALI.ED 4t a �a� FIXTiJRE BSMT 1 2' OTHER PIXTURE BSMT 1' 2 OTH�R TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater I Disposal Water Softener I Dishwasher Wet Bar Sillcocks Miscellaneous �� PERMIT FE��CALCL'L,�TION(S) � BASED OPP - 2002 STATE STATLTE ❑ Yes, this section applies The replacement of a Residential fixture or a�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. Is improved, installed or rep'.aced by the hoiiieo�nier or iicensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ , r (Permit Fees Continued On Next Page) 2 . i��`��' 1 .: :PERIVIIT FEE;CAL��UI,ATIQN(� ��k<�J,OB�S��_�'�� R,t$500.00•' '�' 'F �`� �'s�,. � • f,�� 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 price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50) x.0005 $ (contract price) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 I l 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ !� S G • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged far the pernutted 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 pernut 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 $.50—whichever is greater. For valuations over$1,000,000 call the Building Deparhnent at(952) 249-4600 for the price. P�, ,,�. �A �� PLUMI3ING 1'ER�MIT��APPLICATION AG�REElV1ENT �� 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 I � / I �� 3 5� /� DA,�E TIME \ / CITY OF ORONO CALLED IN � �'� v INSPECTION NO I E SCHEDULED � � PERMIT NO. DOl� COMPLETED ADDRESS 3 OWNER CONTR. �Ji"�J�� TELEPHONE NO. �.SZ S�S � t�DS 7 � DESCRIPTION W� I—"��( � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ 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 Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ P MBING FINAL ❑ FOUNDATION/REMOVAL � WNER/ ONTRACTOR TO MEET YO�—NO � OMMENTS: � W � � J O � � O � W � Q � Z W � W � j GW ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE � ❑CORRECT WORK&PROCEED '— I SUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN -] CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (J52� 249-46�� OwnerlContractor on site: Inspector. i I' l� White Copyllnspector's File Canary CopylSite Notice