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Home My WebLink About2011-01287 - water heater CITY OF ORONO PERMIT NO.: 2011-01287 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUED: 10/20/2011 ' 952 249-4600 FAX: 952 249-4616 ADDRESS : 240 CYGNET PL PIN : 04-117-23-23-0020 LEGAL DESC : SWAN LAKE ADDN : LOT 000 BLOCK 003 PERMIT TYPE : PLUMBING (<$500) PROPERTY TYPE : RES(DENT[AL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CHAMPION PLUMBING LLC STATE SURCHARGE PLBG (<$500) 5.00 3670 DODD ROAD- SUITE 100 EAGAN, MN 55123- MAIL-IN FEE 2.00 O MISC FEE 0.00 Minnesota State License#: 61770PM TOTAL 22.00 OWNER WIFE, EUGENE DETERLING& 240 CYGNET PL LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT "I�hc work for�vhich this permit is issued shall bc performed according to the approved plans and specitications,applicable City approvals,and the State[3uilding Code. This permit is for only the work described and docs no[grant pennission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if consVuction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applican[is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due ca6se. i� � / / / / Applicant Permitee Signature Date Issue By gnature - te SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . � ^ � , O.¢,Q� City of Orono FOR CITY USE ONLY � ��O�66 Date Received: Permit# � �7�0 Relley Parkway �'� '��p' '� (�n�stal Ba�°.MN 55323 .Z� .�.:a >� . � . �t �� `��'-'1?-19-4600-Main APp�oved By: Amount$: °krsxoQ�� I`>��)?19-a616-Fax CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) __�_ `.�``��'=��s�.�§['s.�s�n.Ut�v/C'��L.D1P3_iFi�c �Eu€�� la�s•ev�z � . ,��' GENERAL INFORMATtON � 1. You may� apph� for plumbing permits by mail or in person at the City offices. Applications will be revie�ved and a permit will be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMTTS ARE NOT VALID �TrT1L 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 residin;in the dwelling. 4. When an�� new cc�nsCruction or remodeling is involved,a separate building permit must be obtained. 5. All �vork 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-�8 how•notice required) TYPE OF PERMIT ______ (Check All That A l '�Residential ❑ Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs `�Replace / ❑ In Accessoiy Structure? *You w�ill need nrior anoroval and may need Ct;N.(Per Orono City Code,Chapter 78,Article 1 V) Job Site /O�vner tnformation: � 1 , Site Address: �� J �; ' C � ��;� � , � � � Owner: , ��1 1r'� Mailing Address: �G��Vl-e, City: V—��_�J Zip: G��?��"�� Home Phone:�j�,' ��' ��0��j Alternate Phone: Contractor Informatio�l: _� Contractor: Contact Person: Charnpion Pfumbing Address: # 61770-PM State Bond #: - - a city: 3670 D d Rd. ---�� Expiration Date: Phone: Alternate Phone: ❑ Insurance–Current: 1 1 U�Z� `� 1�� , � , _ PLUMBING FIXTURES BEING INS'I'�,�:��;. ------ F[XTURE BSMT l�' 2�`D 07'HER FIXTURE BSMT 1 2ND 01'HER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer I Kitchen Sink�j Water Heater Disposal � � ; Water Softener Dishwasher � Wet Bar � Sillcocks Miscellaneous � r-------__. PERMIT FEE CALCU�;AT20N(S) � �� _ _BASED OFF -2002 STATE STATUE� � �� Yes,this section applies The repiacemcnt of only one Residential fixture or anoliance that meets all three of the fo!lowing requirements: 1. Does not require modification to electrical or gas service. Z. 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. Skip ne�t section, ifthis applies; Cost ofPermit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(IfApplicable) $ 2.00 7'otal Permit Fee $ ZZ Vl� (Permit Fees Continued On Next Page) 2 � � . ' �--- PERMIT'F�E CALCi.TLAT�pN(S)`Jp�3S OVER $500 00 � If above does not apply; follow guidelines below: 1• CON'fRACT PRICE * is 1.25°/o of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum 550.00) ?. ST,1TE SURCHARGE **Add the State Bldg 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. TO"I AL PERVIIT FEE(Add Lines 1-3 Above) $ ' * CONTR:aC I� PRIC� or JOB COST means the 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 ihe job cost, the City may request the submission of a signed copy of the aetual contract. ' ** The Si�.aTE SliRCHARGE 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. C' " ____PLUMBING P�RMIT APPLICATION AGREEMENT' The undersinned 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: � � ' � ��, Reset Forcn 3 � � D E TIME Y ITY F O ONO CALLED IN ��/� C O � INSPECTION OTICE SCHEDULED � ` PERMIT NO. ��Z�� co PIETED 2.� ADDRESS �G� OWNER L PHO CONTRACTOR � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � � FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z 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: � W � � � O � � O � W � Q � Z W � W � � GW ❑WORK SATISFACTORY:PROCEED �OJECT COMPLETE W ❑CORRECT WORK&PROCEED � Cl ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN � CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 Owner/Contractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice