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Home My WebLink About2016-00770 - water heater CITY OF ORONO �0 1 6 - 0 0 7 7 0 * 2750 KELLEY PARKWAY DATE ISSUED: 07/OU2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2515 COUNTRYSIDE DR PIN : 04-]17-23-]1-0007 LEGAL DESC : COUNTRYSIDE MANOR : LOT 003 BLOCK 002 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER NOTE: REPLACEMENT OF WATER HEATER VALUATION OF PLUMBING 950 APPLICAIVT PLUMBING F[XTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 1.00 CHAMPION PLUMBING LLC MAIL-IN FEE 2.00 3670 DODD ROAD-SU[TE 100 EAGAN, MN 55123- TOTAL 53.00 �� Payment(s) Minnesota State License#:plbg-PC000308,mech-MB005365 CHECK 33022 53.00 OWNER DELANGE, LEON&CONSTANCE 2515 COUNTRYSIDE DR LONG LAKE, MN 55356- 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 perniission 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 construction authorized is noc commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time aRer 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 revoked at any time for due cause. �l 4� � � � � � Applicant Permitee Signature Date Is ue B Signature Date .. � �� '�� City of Orono FOR Cl SE Y T � ��b � �'O `, P.O. Box 6o RECEN�D Date Received: b � 2750 Kelley Parkway �y� ,� , � `; Crystal Bay, MN 55323 Permit# oCv�� ' �77� �,�� ,� � �gs2�24s-4600—Ma�n �UL � 1 2'016 Approved By: _ _ (952)249-4616—Fax Y Amount$: /� C�TY OF ORONO CITY O� ORONO — PLUMBING PEF�IVIIT (All Commercial Permits Must be Approved by the State Prior to City Approval) http://www.dli.mn.qov/CCLD/PDF/pe plumbplanrevapp.pdf 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 compleied. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTfL THE PERMIT 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. Ail 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-�8 haur notice required) TYPE OF PERMIT(Check All That Apply) Residential ❑ Commercial (Approvaf P.equired) [Backflow Device: ❑AVB ❑ PVB] ❑ New ❑ Additional ❑ Repairs �Replace ❑ In Accessory Structure? *You will need prior aparov�l and may need CUP. (Per Orono City Code, Chapter 78, Article IV) Job Site / Owner Information: � Site Address: �J� S C..�G�rnf'/� �5�� '� ��' Owner:/�Oh� ��'- �,c% h � Mailing Address: `� � �� _ � City: Zip: Home Phone: �� " �3(��U ' UU��Alternate Phone: Contractor Information: Contractor: aGh�itptOtl Plun'Ib�f1Q PC 000308 Ad d ress: 651-365_�34� � 3670 D�dd�iu�d �gan,MN 55123 Phone: Alternate Phone: ; ❑ Insurance — Current: �, f Page 1 • . . PLUMBWG FIXTURESBEIN�G. INSTAU..EI?- FIXTURE BSMT 1s-r 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER TYPE Floor Floor TYPE Floor Floor Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous �-- PERMIT FEE CALCULATION 1. C��RAC i P?!CE * is 1.25% of contract price with a (Mir�i►:�� Fe� of$5��0) / � x .0125 $ sV' (contract price) (minimum $50.00) 2. STAT� S�lRrHARG� 0� x .0005 $ ' (contract price) 3. POSTAGE � NANDLING (Only on IVlail-In Applications) $ 2.00 S � v� 4. TOTAL P�R�il1� F�E (Add Lines 1�3 Above) $ — � * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work includir�g 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 th� actual contract. PLUMBING PERMIT 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: �/a�� -l', Building Oificial/ Inspector: Date: Page 2 � �� DATE TIME CITY OF ORONO CALLED IN �-�,-L=- INSPECTION T C . CHEDULED ��/-/,C� lD ' PERMIT NO � 7 � MPLETED � ADDRESS Sl-5 OWNER � ELEPH O.��a 3S� �� CONTRACTO � DESCRIPTION ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF �LUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a ►•f/,�c v e4�. ,r r�i3O�� O _ GJC �St'��t� l��iKs ��S �trlr — >. � O � Q � �va''!� �'o r,.c.ol`��^9' �//�� C�� 2 W � W � � J W ❑WORKSATISFACTORY:PROCEED L��OMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WFLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-460� OwnerlContractor on site: � ie d� Inspector. iv-.- � White Copyllnspector's File Canary CopylSite Notice