HomeMy WebLinkAbout2014-00869 - water softner , CITYOFORONO * 2014 - 00869 *
r 2750 KELLF.Y PARKWAY DATE ISSUED: 08/11/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRF,SS : 1937 FAGERNESS POINT RD
PIN : 17-117-23-23-0012
LEGAL DESC : FAGERNESS
: LOT 020 BLOCK 000
PERMIT TYPE : PLUMBWG(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00
STATE SURCHARGE PLBG (<$500) 5.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345 TOTAL 22.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 22.00
OWNER
BOLDENOW, ELL(F.
1937 FAGERNESS PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
"l�he work for which this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and thc
State E3uilding Code. 'I�his permit is for only the work described and does
not grant permission for additional or related work which requires scparate
permits. All provisions of la�cs and ordinances governing this type of work
shall be compied with��fiether or not specitied herein."I'his permit will
expire and become null and void if construction authorized is not
commcnced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the Statc Building Code.This permit may bc
revoked at any time for due cau�se.
/ /
Applicant Permitee Signature Date Issued By S� ature Datc
08/11/2014 14:01 FAX 952933504� CULLIGAN �ZNTKA f�002
�
FOR CTTY USE ONLY
���L Cily Of Orono
P.O.Box 66 Datc Received� Pcrmic#
�4',;��,,, �` 2750 Kcllcy Parkway
`l� ��!�;' ��+ Crystal Day,MN 5�323 ApprpvCd p,y: Amoun;$:
�i.,w�.y��Es' (952)249�600
.��.
CITY OF ORO�TO—�LUM��NG PERMIT
(All Com�nercial per,ni�i musi bc oppro�cd hy thc BUliding Offici�l or Inspccior)
GEI�'ERAL XN�'ORMATION
1. You may apply for plumbing pernlits by mail or in person at the City offices. Applications will be
reviewcd and a permi[wiIl be issued within tu�o woCking days.
2. Permit cards wi11 be sent by retnm mai]after a review is complcted. AERMrTS ARE NOT
VALiD UNTIL YOU R�C�IV�A PERMIT. WORK MUST NOT BEGIN XINTIL THE
PERI�(YT CARD IS POSTEb OPi TI3L JOB SITE.
3- Plumbing pem�its may be issued ONLY to licensed plumbing contractors and to properry own�rs
residing in thc dwelling.
4. When ariy Rew construction oi remodeling is involve�a sep�r32e building pennit must be
obtained.
5. All work must be done in acoordance with State Code requiremen�5.
. 6. Ali work must be inspeCted and air testcd bcfore it is covered. Call(952)249-4600.
(24-48 houT notice required)
TYPE OF PERMIT
Check All That A 1
�Residentia] ❑Commcrcial(Approval Ttequired)
�New ❑Additional ❑Repairs 0 Replace
❑ In Accessory SCructure?
- *You will necd nrior annroval and may need CliP.(Aer Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address: 9 7 �a e r �SS r� I�X
Owner: y�b��Rr�O� Mailing Address:
City: ZiP� ���`�-�
Home Phone: 95� �''1$'( " a93� Afternate Phone:
Contractor Information:
Contractor: Concact T'erson:
Cu��iGAN WATER CpNdfTrp��NG
Address:603p�ULL�[�q(�,��v Stnte gond i#:
Mirvfv�'�arv�s,a, Mn� �5s4�
�City: (952) �33-72�� �ip: �xpiration Datc:
Phone: Alternate Phone: ��,�J I a,- 7,�1 7
❑ Insurancc—Current:
]
08/11/2014 14:01 FaX �J52�Jaa504�J CULLIGAN BZNTI�A �003
� . . �
e
, :�', ; P�,�'�z��,�.v��s:`B�n��:.r�sT�r::LED, ;,,.
l=1XTUR� BSMT 1' 2 OTHER FIXTURE BSMT 1 2 OT!-ILR
TYP� FL FL TYPE FL PL
Water Closet Floor l7r�ins
Lavatory Sewer Ejector
Bathrub Laundry Tray
ShoweC Washer
Kitchen Sink Water�-Ieater
Disposal Water Sofiener �
Dishw35her Wet Bar
Sillcocks Miscellaneous
�flM,�l„'d,Hi"f�7� r(1Y�:� ;P.�h!i�,d',i1d�YiP!..,9,�'�Ci.�e�!�4'ao:i.F.'Sy.y� ''i y�y �r '� � ��r����; � ,e�,.�
�,dlf?�I.,Ili�i', �;,Ilr ,�}r I ,.� �'r� � „'� iC'�{:7G'rt� �yvn I �,.j,,,,�,•���.�-�,
�}�'j�1',� �)�'�Ir�i,���{,�,, �.��'`R:';:4,i��J .�,�'�1r��l4n�h�"'��'�`i;t;EPF; ;'("�''�� "''t.".,Y'. �7;'�•(y •,q. r',,;,;I"„i�.� ti.���k;�.�bi`'v,�''�;�Ci�;..�;�a�'r� �n c���
, Il I.' f lr � M; hr . •��.� u�"� _�'��I��PV +3 1� ��. 1�Idl i1dY.I.�W11�"WSi) � t ;wPdMi�:�
dFI��CS�y iRh:'��ill��l.a�l�wi4��.?;�i�� ��� ti t�� 1[�L7� � Si V ' � � � �y I i f�� �Y � �4 p, c1 l i �' yC y
��k!n,.�o����cti���l�iy�G,1��lif�1jP�i:�� �{�r�fdlbd� r��, �e qi � 1 n ,�nry� �y. r��]��1 41�,.^� .� ��i�p�11� h•,.��I� r��hh
_ �f..�.�'�h�I+�Tl. ��,�i ��11,�7'ti7 1,�1'�L.,'�"U'Ci'�i� U 1 ir 7 l�tiN�� P tb�!��nV"�':
��i,�y tl ','��v,fic: ',fll�,)
❑ Yes,this section applies
The repl3cement of a Residenti�]fia-ture or appliance that meets all three of the folfowing requiremenTs:
1. boes not requiro modifieation to electrical or gas Service.
2 Has a total cost of$SOO.QO or less;exc�g the cost of the fixture or applianee: and
3. Is improved,installed or rcplaced by the homeowncr pr liecnsed conTraetor_
$k!p next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5_00
Mail-In Fee(Tf Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
7
'
I
08/11/2014 14:01 FA1 �52�a�5049 CULLIGAN MNTKA �004
! '
,, . , ",,. , ., �" �
,.�'.. , ..r.,, .. � �'����� �'Y-1
"'`� ,�: ,P�' 1�iL�U� ''TION S'"'`JO$S"C4 ,,�,; ,;� „•. ;
�.��`i$��0.0':0"0`� �.,,;'��';
1f ebove does not appl�;follow guidclines below;
1. C N�'RACT P CE *is 1?5%of contract�rice wish a(Minimum Fee of$50,00)
x.0125$
(contract pncc) (minimum$50.00}
?. STATE Sl7RCHARG� 'y*Add the State Bldg Code Gliv.Surcharge(Mioimum P'ec of$5.U0)
x .00DS $
(canQacl UfIC2) (minimullt$ SAO)
3. POSTAGE&�ANDLING{Only on Mail-�q Applicalions) $ 2.OQ
4. TOTAI,PERMIT F��(Add Lines 1-3 Above) �_ �a, Q�
■ � COI�'T}7ACT PRICE or JOB COST meens the actual or estimated do(lor amount charged for the
permitCed work including ma2erials,labor,profit, and otf�er fixed costs. It is the amount to be charged
to the customer for the work done. lf any material, equipment, labor or installations are fiimished by
thc owner,tenant or any other party,Uie reasonable market valuc of such items must be added to the
estimated cost or contract price for permit fee purposes. 1n the event that there is a dispute on the
amount of the job cost, tho Ciry may request the submission of a signed copy of the actual connac�.
■ **The STAT�SURCHA}tG�is.0005 of the contract price undcr$1,000,000 or$5.00—wkliGhevcr is
greatcr. �'or valuations over$I,OOO,ODp call the Buildin�Department at(952)249-4600 for the priec.
��,�i�1�lq'1. S�il�;ill�pl''�a�'1,���'.T�4�J6F�'.C'i� ',���::,�'1l' "a:C,� � .1.. r�F'�r�l•l1'��.'����. �r �V,4Ai^�VL'�' �,1�"r�';�I��u�4�{.{, 1 �`J�k'iY�� j+�}�f�Nt,,Py✓�}�{I��1,
���iM I4NI4�ri i1.^IIY,1
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do al]
work in strict accordanee with the ordinances of the City and the regulations of the State of
Minnesota, and ceriifics that 111 statements made on this application are complete, true and
Correct.
AppIicant's Signature: Date: - �
�, ,�
� �`� �¢ ap,(+ �If vn��m{�:
,'�S ��sOI'i�'��T
E11,nr�iSf��+��;�;�i,M[��'llf4;rv„nt�
I
I
3
DATE TIME ,
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO...�r{ -C� �! COMPLETED -!6-/
ADDRESS 193? /c��u-•r ess f�� ���
OWNER TELEPHONE NO. .
CONTRACTOR ����f �t�cr .�v/Ge
.
j: DESCRIPTION W4��v .��vter� 6rtS�re l,
�
tL ❑ FOOTtNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVEfLANDS
�
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
�� FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J�O DEMO-SITE ❑ SEPTIC MAINT. �OLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL LJ RARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL
2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
y ��i'rrtr� RO�vds� �4deF� �—L`!C/� �d✓ �
O 7 !'!�✓' CG� ,
'� �16 n� � 6�
�
�
° ��S� G4� a�d�(o c r,z �o�P' G��,:, /�sc��s
W � � / /� /� •
� � SC-X Pd4�� rJ t l�E� / �1 S,,d�G�.F�r
Q
�
2
W
�
W
�
�
W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
�PECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. �!^� ��
White Copyllnspector's File Canary CopylSite Notice