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Home My WebLink About2012-01178 - plumbing , CITY OF ORONO * 2 0 1 2 — fd 1 1 7 8 * , 2750 KELLEY PARKWAY DATE ISSUEll: 1U16/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3443 CRYSTAL PL PIN : 17-117-23-43-0005 LEGAL DESC : NAVARRE HEIGHTS : LOT 002 BLOCK 002 PERMIT TYPE : PLUMBING (>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTIOIV TYPE : FIXTURES- MULTIPLE NO"1'E: YLUMI3ING FIXTURES: (2)WATGR CLOSETS,(2)LAVATORIES,(1)BATHTU[3,(1)KITCHEN SINK,(1)D[SNOSAL,(1)DISHWASH�R,(1)SILLCOCK (2)PLOOR DRAINS,(1)WASHER AND(I)WATER HEATER VALUATfON OF PLUMBING 4000 APPLICANT PLUMBING F[XTURE FEE 50.00 CHARLES WICKENHAUSER STATE SURCHARGE PLBG (VALUATION) 2.00 265 WINKLER TRAIL COLOGNE, MN 55422- TOTAL 52.00 (763)221-5441 PAID WITH CASH 52.00 OWNER GULLICKSON, FRITZ 3443 CRYSTAL PL WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT 'I'he work for which this permit is issucd shall be perlormed according to the approved plans and specitications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires scparatc permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This perniit will expire and become null and void if construction autho '� is not commenced within I A ays of the date of iss e if construction is suspended for a p � of 180 da� t an� me er work has commenccd. The applican � esponsible � s 'ng equired inspcctions are reque i� onfonna � � S e � i ing Code.'This pennit may be r oked any ti o ue c � �/ / �� / /Z A licant Permitee Signature Date Issu By Signature Datc SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , FO ��USE ONLY " �� City of Orono �� .-� �� P.O.Box 66 Date Received: �ermit# ��, ,� �� 2750 Kelley Parkway .� � '�1;�;�:_ F Crystal Bay,MN 55323 Approved By: Amount$:� ��'��c.�o� (952)249-4600—Main �aeso (952)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Priar to City Approval) htt ://ww�r.dli.mn.�ov/CCI.�D/PI)F/ e lumb Ianreva �. df� GENERAL INFORMATION 1. You may apply for plumbing perniits 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 retum 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 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,Article IV) Job Site / Owner Information: SiteAddress: ,.�� /'�� /��,� Owner: C�7 G� L �-�� S C�/� Mailing Address: `7��.,,�(,� �� c�ty: �,��-��1- t> z�p: J�3/�� Home Phone: �� /,5%�� Alternate Phone: �f�' ��1� � Contractor Information: � Contractor: ��j�,��5 ��G�/('��1/�",�-�ntact Person: � �1; � � Address: ��j��,/.+, '��,�,�A�C State Bond#: ��?�1 �)(,y(, .�,� City: ��,U� Zip��Z Expiration Date: � � � � �i Phone: �� '� �� Alternate Phone: �� T(C� ��Zd �,'�� . , Insurance-Current: "9 , �� a J �. 7 � l�,' ��C ' > 1 . � \ , . ` � �� PLLTIVIBING FIXTURES BEING INSTALLED � '� � �� FIXTURE BSivIT 1' 2 OTHER FI7�TURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains � � � � Lavatory � Sewer Ejector � � �. Bathtub C Laundry Tray �, � � � Shower W asher � C Kitchen Sink Water Heater c � Disposal Water Softener �, / c c Dishwasher � ` Wet Bar � �� Sillcocks � Miscellaneous Z� � '� �� PERMIT FEE CALCULATION(S) � � � li BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture ar 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; 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 Pernut $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 , . i'� ...� t�.h r r., ��.�` 7 T :�. ��LCVLATTON(S =.JOBS OVER$500 00��; ..� ':.w. ;,��E a�...� � If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) `� �` c� � x .0125 $ •�L'� � 1 contractprice) (minimum$50.00) 2. STATE SURCHARGE � � C� � �� .� "— x.0005 $_�• (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 2.00 � 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ '7�f� ■ * CONTRACT PRICE or JOB COST means the actual ar estimated dollar amount charged for the pemutted 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. � �� .� .��s$T��`��;, � � ,,F��1��,� �� C�� ; `� }�.:;�;� �x.,.,;� 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: �� — I� —� 3 DAT� TIME �/ CITY OF ORONO CALIED IN ��2— INSPECTION NOTICE Q� SCHEDULED � Z �- � PERMIT NQ:��--��I 7 C� MPLETED ADDRESS -3 � OWNER T EPHONE NO.�� a`�� CONTRACTOR W� Q- �� : DESCRIPTION � � ov , _ � t� ❑ FOOTING ❑ PLUMBING F AL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANI L RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANI INAL ❑ 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 � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � ! �7 � � �-�- �'�' 0 � � 0 � W � Q � Z W � W � j GW;�iO�ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W��CORRECT WORK&PROCEED ❑ ISSUE CEATIFICATE OF OCCUPANCY O ❑Cl7RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for ihe next inspection 24 hours in advance. �95Z� Z49-4600 n OwnerlContractor on site: Inspector. i �' ��j�...�!� White Copyllnspector's File Canary CopylSite Notice �� \ ? DATE TIME �/ CITY OF ORONO �� GALLED IN ._.�� c�� INSPECTION NOTI/C �� 7Q SCHEDULED � � �� PERMIT NO. -��,(� `� COMPLETED ADDRESS --� 1��.-`5 l !�(�/C'�' � �C��' OWNER ",��( �7 ('�(-��IC'f�L�`�'E EPHONE NO.�-`�=� ��?� CONTRACTOR ��-� L ��r '� h � �'y �� .�t ,�;� �. -� >; DESCRIPTION ��< <��y ��%��C� � � ❑ FOOTING ❑ PLUMBING 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 v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SE��FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS:� � W � O �f /� �i' ir'� � "�(1 / C J � �� a � O k W � Q ti Z W � W � � GW ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLEfE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN �� CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cat1 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice