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Home My WebLink About2015-01286 - plumbing CITY OF ORONO * 2 0 1 5 - 0 1 2 8 6 * � 2750 KELLEY PARKWAY DATE ISSUED: 10/05/2015 * ' ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 965 EDGEWOOD HILLS RD PIN : 02-117-23-14-0001 LEGAL DESC : REG. LAND SURVEY NO. 1098 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NOTE: REPLACE 1 K[TCHEN SINK,I D[SPOSAL& 1 DISHWASHER VALUATION OF PLUMBING 1250 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 0.63 GLACIER PLUMBING INC MAIL-1N EEE 2.00 680 VALHALLA DR NE CEDAR, MN 55011- TOTAL 52.63 (763)413-1883 Payment(s) Minnesota State License#: plbg-PC643630 CHECK 7554 52.63 OWNER BJORK, ROBERT&BETH 965 EDGEWOOD HILLS RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applican[is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. f�� f % �� -� �.�,L_ � F �(�_� � � (_\ � � � _ � �_� � � �' (,� / / Applicant Permitee Signature Date Issued By Signature Date , � � � t��oK c�rrv usF:<m�_,v �,_.____� Cit of Orono /��-�� P.O Qox 66 Date Received; �� Permit# �� l��- �� (�.,1 �ti 2750 Kelleti Parkway � /,� i � Crysr31 C3ay,MN 55323 Appro��ed By �� Amuum$: ��"�� (9�2)249-4600—Main �� :� . (952)249-4616—Pax ��F� �`�'� CITY OF ORONO-PLUMBING PERMIT �K�s�i��`% (All Commercial Peri��its Must be Approved by the State Prior to City Approval) � het��:I1`�+�r��r�.dli.Ba�i�.�ovlC'f"L,[)/f'�7Ft ae lernab >laEu-era �. ��lf 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 PERNIIT. 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 a�ld 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-�8 hour notice required) TYPE OF PERM[T (Check All That Apply) �Residential ❑Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs [�] Replace ❑ In Accessory Structure? *You will need prior approval ancl may need CLIP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner [nformation: SiteAddress: ! �oJ� �. Clq�. (.e�DO� ��1 �(S I�e� Owner: dJ�`� � ;�7f�-, Mai(ing Address: �l(�.S��,�,�,c�c� ��. v' c�ty: �,B,�n� z�p: .55��1 Home Phone: Alternate Phone: Contractor Information: Contractor: �r l,Qcc.e,`v ��Lrnb��ontact Person: S�_ Address: (�l��hG.�U.L /(�� State Bond #: �C�`�3�i.3(' City: C-e�o�R.�- Zip;j�U�( E�piration Date: ��3��5 Phone: �� '�� '�8�3 Alternate Phone: �l Z- ��'o '�7L'� [� Insurance-Current: �� /!,�/1.�J�/Z_ 1 �-- PLIJMBING FIXTURES BE[NG INSTALLED FIXTURE aSM'i' 1' 2 OTHER FIX"1-URE BSN1"I' l� 2�� OT'HER TYPE FL FL TYPE FL FL Water Closet �loor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink � Water Heater Disposal � Water Softener Dishwasher i Wet Bar � Sillcocks Miscellaneous � � � � PERMIT FEE C"��1�CtJLATION(S} � � � � �� BASED�FF -2002 STATE STATUE � � � ❑ l'es,this section applies The replacement of only one Residential fixture or 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 plumbing contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 1.00 Mail-ln Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 ( ♦ ` , . �'ERMIT�'EE CALCULATION S -JC?BS OVER$540.a0 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25°%of contract price with a(Nlinimum Fee of$50.00) � �.o�.�(� ' x .0125 $ �Q Q� (contract price) (minimum$SO.UO) 2. STA7'E SIiRCHARGE � r �� X.000s $ ��3 (contract prica) 3. POS`I'AC,E& HANDLING(Only on Mail-In Applications) $ 2.00 4. TOT.AL PERMIT FEE(Add Lines 1-3 Above) � .�a.� ■ * 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 char�ed to the customer for the work done. If any material, equipment, labor or installations are furnished by the owner, tenant or any other parry, the reasonable market value of such items must be added to the estimated cost or contract price for pern�it 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. [� PLUMBII�IG PERMIT AP�'LT�ATTON AGREEMENT The undersigned hereby applies to the City for issuance of� Plumbing Permit, agrees to do ali work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certities that all statements made on this application are complete, true and correct. Applicant's Signature: ��,e, �� Date:__)0�_1�J� 3 � \� DATE TIME v CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED � PERMIT NO. ��-��OCOMPLETED � �L� � c �. ADDRESS � OWNER TELEPHONE . � � CONTRACTOR � � DESCRIPTION l `� I � �R"�� l� ❑ FOOTING - ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING R� ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF PLUMBING 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 W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � J ❑ DEMO-SITE ❑ TIC INSTALL 2 OWNERICONTFiACTOR TO MEET YOU:�YES_NO y COMMENTS. (�C�C I (�l�' ��'-��`� � � Lla ' a � " 8�T j � 4 o , _ � � 6 f x��G�B•�, O • � — rc<oca�c ��.c.�•, �• s�N e -�- �s�.s�� W Q �' f�i�qC 4�t ts��✓ �i�'l�S Z a (�/d - �f/C Sc l+. �td �i s� o� W �x�� , �,�� !/� ��i � � �K � Ga�c✓ a S�TORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca e nex i ion24 hou in advance. (952� 249-4600 Ow tractor on sit • �� "`' Inspector. � '""'' White Copyllnspector's File Cenary CopylSfte Notice V DATE TIME CITY OF ORONO CALLED IN INSPECTION NQT�C� SCHEDULED —�–�� / PERMIT NO. �� '� ��a�OMPLETED J� �3��,(� ADDRESS �165 ��'� lY! i�� • OWNER TELEPHONE NO. CONTRACTOR r�G�•e� P��- Z nc. � DESCRIPTION �ls` �� l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF �RLL1vL161NG FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEEi YOU:_YES_NO c�.� COMMENTS: � W C '� � 1//� u�v�. � 0 � � � �+�GIIC L�Vvt��o-L�2 W � Q � 2 W � � � � ,�•r`►K� -�i�.�l s� J � O WORKSATISFACTORY:PROCEED �AQJECT COMPLEfE W ❑CORRECT WORK 8 PflOCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOYERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector: ` White Copyllnspector's Flie Cenary CopylSNe Notice