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Home My WebLink About2016-00551 (plumbing-water heater) CITY OF ORONO * Z 0 1 6 - 0 PJ 5 5 1 * • 2750 KELLEY PARKWAY DATE ISSUED: OS/19/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3703 CASCO AVE P[N : 20-117-23-31-0004 LEGAL DESC : CASCO HEIGHTS : LOT 000 BLOCK 004 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER NOTE: REPLACE WATER HEATER VALUATION OF PLUMBING 0 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 1.00 CHAMPION PLUMB[NG LLC MAIL-IN FEE 2.00 3670 DODD ROAD-SUITE 100 EAGAN,MN 55123- TOTAL 53.00 �� Payment(s) Minnesota State License#: plbg-PC000308,mech-MB005365 CHECK 32814 53.00 OWNER KLICK,JOHN&CYNTHIA 3703 CASCO AVE WAYZATA, MN 55391- AGREEMEfYT 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 type of work shall be compied with whether or not specified herein.This permit will expire and become nuli 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 State Building Code.This permit may be �j ,� revoked at any time for due cause. '/� � �� L � I \•�� Applicant Permitee Signature �Date Issued By Si atare Date � FOR CITY USE ONLY � City of Orono �j,A (n Za� � � P.O.Box 66 Date Received: �>�L 1��"Permit# �U'� S 0 � 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: ___�_�_ Amount$:y�_ (9�2)249-4600—Main � � (952)249-4616—Fax F �` CITY OF ORONO—PLUMBIlVG PERMIT f�KFSHO�`� (All Commercial Permits 1Vlust be Approved by the State Prior to City Approval) ht# ://rv�vw.dli.mn.Qov/CCLD/PDF/ e lumb lanreva . df 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 YOU RECEIVE A PERMIT. WORK NIUST NOT BEGIN UNTIL THE PERi'�IIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits 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 A 1 �f Residential ❑ Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs [�Replace ❑ In Accessory Structure? *You will need arior apvroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: �i7Q� GUScv Av� Owner: ,�c�v�n j Gi�c1�I kl�Ck Mailing Address: City: �rcn� Zip: 5`��91 Home Phone: �;,I,�.�y(s,I -5'-��S 7 Alternate Phone: Contractor Information: �. Contractor: i I ��:��(!'', �� '��1C� Contact Person: i c�r TLCc�c. �y' J Address: �� IiCICY �`C� State Bond #: City: ��'�� Zip:�t�1z-�' Expiration Date: Phone: Yi��``�L��i ��1 �� Alternate Phone: ❑ Insurance—Current: 1 PLUMBING FIXTURES BEING INSTALLED FIXTiJRE BSMT ls 2ND OT�IER FIXTURE BS1�IT 1 r 2YD OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink a er Heater � Disposal Water Softener Dishwasher Wet Bar Sillcocks l�iiscellaneous PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three of the following requirements: 1. Does no?require modification to electrical or gas service. 2. Has a total cost of$500.00 or less; excludin�the cost of the fiYture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed plumbing contractor. Skip nert section,if this applies, Cost of Permit $ 15.00 � Jv�l�� State Surcharge $ .e�I 00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee � •� �j�j_G 0 � (Permit Fees Continued On Next Page) 2 � z• PERNIIT FEE CALCULATION S -JOBS OVER$500.00 If above does not apply;follow guidelines below: 1. CONTR�CT PRICE * is 1.25%of contract price with a(Nlinimum Fee of$50.00) x.0125$ (contract price) (minimum�50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 d. TOTAL PEI'utiIIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE 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 the job cost, the City may request the submission of a signed copy of the actual contract. PLUMBING PERMIT APPLICATION AGREEMENT The undersi;ned 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: �f ��„ � � �� . : r3 �� '� v aa �� ,..�,; . .. ,,,,,,,,,,; , ,3^.�, �.......v�_ _�..'.v i _,�.�.. ..�, ..,., s�'. ` �� .._ ...! � ,,,. ,„ '�' .,. ..�. �. _.r� _, , ,„� i � �. . �: ....� � , �� : .. , �y� ,�*� �E. - ,.-,,, ;i: .,: � � A �.�. � - � ' ,., ,.� ,.- - . 4✓Y T�� . ��"$w R �15�� k 2 �.�_ �<, : '� � � � �„ 3� ��_ «� . �� ,, � ,� � � � � ' :�� ;, � �,� �`�` � �� , �� i ��aa�'�`-' � ,�'a j; y � � � ` �'�� a��` �a ,� a`�� . a �. .. . �.. . _ , ..- �' ��.,` �a w.�'�:#� ��.��. , . . „- �� R A� � q 7 z . . ,. '�•a��' � ��"�� r �`��S'�'"�'�� f`e��tl,��l�"JO� �J�+D��1��p j��1C3��t .a�t�'sl��r��a,�.�ra�� c��s�s�a�p ;P��¢gi4 �S.E .�`:yydx�t 'g 4Ko��"3�9 ��"'°L��.l��',. 4Rti.�ftA� •� �ii63�7�.t� .4 ..,4q'". 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