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Home My WebLink About2011-00017 - plumbing � . CITY OF ORONO PERMIT NO.: 2011-00017 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: OU05/2011 952 249-4600 FAX: 952 249-4616 ADURESS : 1985 FAGERNESS POINT RD PIN : 18-117-23-14-0004 LEGAL DGSC : FAGERNESS : LOT 003 BLOCK 000 NERMIT TYPE ; PLUMBING (> $500) YROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTl7RES- MULTIPLE NO"I�G: PLUMBING FIX"IURGS-(4)WAl�1;R CLOSETS,(�)LAVA'CORIBS,(2)13A"I'll"fUQS,(1)KITCIII�N SINK, (1)DISHWnS11GR, (2)SILLCOCKS,(1 GACH)PLOOR DRAIN, LAUNDRY TRAY, WASI IER, WATER F11?ATGR, WATER SOFTLNER VALUATION OF PLUMBING 12000 APPLICANT PLUMBING FIXTURE FEE 150.00 BEN SCHORER PLUME3ING& HVAC INC. STATE SURCHARGE PLBG(VALUATION) 6.00 4520 85TH STREET SE DELANO, MN 55328- TOTAL 156.00 (763)972-8137 OWNER BRIGGS, MATTHEW& ALISSA 1985 FAGEKNESS PT RD WAYZA"fA, MN 55391- AGREEMENT AND SWORN STATEMENT 7�he work for which this permit is issued shall be perfonned accordin�to thc approved plans and specitications,applicable City approvals,and the State Building Code. "I'his pennit is for onh�the�cork describcd and does � not grant permission lar additional or rellted work�vhich requires separate pernuts. All provisions of la�vs and ordinanccs govcrning this typc of work shall be compicd with��hether or not speci�ied hcrcin.This permit will expire and becomc null and void if construction authorized is not commenced��ithin 180 days of the date of issuance,or if construction is suspended 1or a period of I RO days at any time after��ork has commenced. fhe applicant is responsible for assurine all required inspections are requcsted in conlorn�ance with the State Buildin�Code.This permit may bc revoked at any time lor due cause. `� �-� / � �'� �.p lJ �y��- /� �� /� Applicant Permitee Signature ��a�� Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1� � � FOR CI Y USE ONLY � ��,�`� City of Orono //� 4 `yO� P.O.Box 66 Date Receivedl � �� Permil# ��d� b�� .;„ 2750 Kelley Parkway �f y �)��'�;;-�. � Crystal Bay,MN 55323 Approved By: Amount$:��JI�/� ��q�?��tj��jl��o` (952)249-4600 � �"��EBH04 CITY OF ORONO -PLUMBING PERMIT (All Commercial permits must be approved by the Building Officiai or]nspector) GENERAL INFORMATION l. You may apply far 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. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN L'NTIL 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. 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 Apply) �Residential ❑ Commercial(Approval Required) �New ❑ Additional ❑ Repairs ❑ Replace ❑ In Accessary Structure? *You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Arricle IV) Job Site / Owner Infornlation: c. -- � Site Address: � �a'b�� -��`=S S l -f- ' �� Owner: Mailing Address: City: ��>>�� Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �`� S�-d"�`r^ �¢�� Contact Person: �"`'` �`-� r`�� Address: ��S=-� :%'��'��Str-�.-� �� State Bond#: �' ��`�' ��-�� f�•� .� City: ^�� Zip: �� Expiration Date: �'��3�- �v�Z Phone: �� " ��- `�.� i�� Alternate Phone: ❑ Insurance- Current: 1 • �/ , � PLUMBING FIXTURES BEING 1NSTALLED FI�TUItE BSMT 1' 2 OTH�R FIXTURE BSMT 1' 2� OTHER TYPE FL FL TYPE FL FL Water Closet � j � Floor Drains � ! Lavatory � � � Sewer Ejector Bathtub / Laundry Tray � Shower � Washer / Kitcl�en Sink Water Heater � Disposal Water Softener Dishwasher / Wet Bar Sillcocks � Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes, this section applies The replacement of onl��one Residential fixture or appliance that meets all three of the foilowing requirements: 1. Does not requit�e modification to electrical ar gas service. 2. Has a total cost of$500.00 or less; excludin� the cost of the fixture ar appliance: and 3. Is improved, installed or replaced by the homeowner or licensed plumbing contractor. Skip next section, if this applies; Cost of Pernut $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 ,` � PERMIT FEE CALCULATION(S) —JOBS OVER��00.00 lf abo��e does not apply; follow guidelines below: L CONTRACT PRICE * is 1.2�%of contract price with a(Minimum Fee of��0.00) 1�i�� x .0125 $ (contract price) (mi n i mu m$50.00) 2. STATE SLJRCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�5.00) x .0005 $ (conrract pricc) (minimum$ 5.00) 3. POSTAGE&HAI��DLING(Only on Mail-In Applicarions) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the pernlitted 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 puiposes. 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. ■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$5.00—whichever is greater. For valuations over�1,000,000 call the Building Department aT(952) 249-4600 for the price. PLUMBING PERMIT APPLICAT]ON AGREEMENT The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accardance 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: �]�jV� ��`�'``� Date: �'-S�C� 3 ��l��/Q l 7 DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED � � PERMIT N . COMPLETED ADDRESS � �� OWNER TE�L�EP�/�ON NO.�(J!Z z�Z `�,/ CONTRACTOR s��%7l1�`f. /��;,wi'wU T >; DESCRIPTION �C ��P /`-�`— � ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ti 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 ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTHACTOH TO MEET YOU:_YES_NO � COMMENTS: � W a � � .::� '� � ,� �/ �c�! �,�. ` 'i"� ✓ 0 a � ° � ' ;,� .�..� c"5,.�- �-` �° W � Q � z W � W � � GW�T�WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION RE�UIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-460� OwnerlContractor on site: Inspector. b,�,�,T�� White Copyllnspector's File Canary CopylSite Notice