HomeMy WebLinkAbout2009-00516 - plumbing CITY OF ORONO PERMIT NO.: 2009-00516
` 2750 KELLEY PARKWAY
ORONO, MN 5535C- DATE ISSUED: 08/24/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 625 DEBORAH DR
PIN : 31-118-23-23-0003
LEGAL DESC : MCCULLEY FARM
: LOT 003 BLOCK 001
PERMIT TYPE : PLUMBING (>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES- MULT[PLE
NOTE: 4-WATF.,R C[_OSE"1',6-LAVATORY, I-BATHTUB, 1-SHOWER, 1-LAUNDKY"I'RAY, 1-WASHER, 1-WE"I'BAR
VALUATION OF PLUMBING 14000
APPLICANT PLUMBING FIXTURE FEE 175.00
SUNDERLAND PLBG INC STATE SURCHARGE PLBG(VALUATION) 7.00
24380 RIVER BANK LANE
ISANTI, MN 55040- TOTAL 182.00
(763)753-2845
OWNER
ARNESON, RANDY&CHRISTINA
625 DEBORAH DR
MAPLE PLAIN, MN 55359
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this rype of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 1 AO days at any time after work has commenced.
The appiicant is responsible for assuring all required inspections are
reques[ed in conf nce with the S e Building Code.This permit may be
revoked at an ime r au . //�
�� �iZ<( i �( �C t ��'1� �� , �_`'��/
Ap icant Permitee Signature Date Issued B Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
•
- FOR C1TY USE ONLY
� ,�p�,�� Cit��of Orono
P.O.Box 66 Date Received: Permit#
�' �� 2750 Kelley Parkway
�! �;cr�.
� ���',�r` ti� Crystai Bay,MN 55323 Approved By: Amount$:
�"����r$$o�j (952)249-4600
CITY OF ORONO —PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
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 YOli RECENE A PERMIT. WORK MUST NOT BEGIN L'l�'TIL 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 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. Al] 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 Ciry Code, Chapter 78,Article IV)
Job Site/ Owner Information:
Site Address: �p�� (�?�J�1� I� �
Owner: �12f/�.�Sp/.� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Infornlation:
Contractor: S�I�I�e��p�,,,(6 ���vG Contact Person: 7o�t1��
,�
Address: 2��j� ��ve�?�� � State Bond#: ���C����
City: ���Q � ✓Wv Zip;Fj'3'��Z� Expiration Date: �r {� b 9
Phone: �(��-�75�'�z�-(� Alternate Phone: ���--2 Z�v �5 � 2 G
❑ Insurance— Current: r���[�,..��
1
.
PLUMBING FIXTURES BEING INSTALLED '�
FI7�TURE � BSMT � 1' ' 2� �� OTHER FIXTURE � BSMT 1'' 2'� OTHER
TYPE FL FL TYPE FL FL
Water Closet ' i � Floar Drains
1
Lavatory � � �y Sewer Ejector
_�
Bathtub / Laundry Tray �
Shower ` Washer i
6
Kitchen Sirilc Water Heater
i
Disposal Water Softener
Dishwasher ' Wet Bar �
Sillcocks Miscellaneous
� PERMIT FEE CALCULATION(S) � �
� � BASED OFF - 2002 STATE STATUE� j
❑ Yes,this section applies
The replacement of a 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; excludin�the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ ,Sp
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
�
�
. �
PERMIT FEE C1��T:G[JLATION(S —JOBS OVER $500.00
If above does not apply; foilow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of�50.00)
D. °� a .oi?s �
contract price) (minimum�50.00)
2. STATE SURCHARGE **Add the State B1dR Code Div. Surcharge(Minimum Fee of$.50)
a .000� $
(contract price) (minimum� .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) � 2.00
4. TOTAL PERMTT FEE(Add Lines 1-3 Above) �
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
perniitted 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 fumished 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 tbere 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
ereater. For�°aluations over$1,000,000 call the Building Department at(952)249-4600 for theprice.
PLUMBING PERMTT 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 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: �'- 2Y"-�
3
� ^� �� D TIME
CITY OF ORONO CALLED IN `��� G l'
INSPECTION ThIC /�f SCHEDULED dJ�'�/ -�
PERMIT NO. v -v� COMPLETED
ADDRESS G���GL-� - '�
OWNER CONTR� .
TELEPHONE NO. J- - 7 3 ��S �
� DESCRIPTION I'J •
� ❑ FOOTING ❑ MECHANICAL ❑ 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
J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J LUMBING FINAL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
�
W
a
� i�� U - � Q A���s s ,�; � �7-�.�
° �
� � � ._ . ; IP t j S+ ��c� �
� %� �1 f �
W
�
Q
�
Z
W
�
W
�
�
d
W ❑WORK SATISFACTORY:PROCEED f l PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
W
0 I�CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V�� �FORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ,_, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cal1 forthe next inspection 24 hours in advance. (952� 249-46��
OwnerlContractor on site:
Inspector. � A / /� � � � S
White Copyllnspector's File Canary Copy/Site Notice
� � �� TIME
CITY OF ORONO CALLED IN /��/�
INSPECTION NOTI E SCHEDULED � �� •�Q�
PERMIT NO —�5�� COMPLETED << . G`
ADDRESS �O4�d �i�'� �i��—
OWNER CONTR. P�
TELEPHONE NO. �l� — S�7 �
� DESCRIPTION /
� ❑ FOOTING ❑ MEC ICAL RI ❑ EXCAV/GRADING/FILLING
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ IAKESHORENVETLANDS
Q ❑ 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 �LUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
j
d
ORK SATISFACTORY:PROCEED �ROJ ECT COM PLEf E
W ❑ CORRECT WORK 8 PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContract
Inspector
White Copyllnspector's File Canary CopylSite Notice