HomeMy WebLinkAbout2016-00918 - plumbing . CITY OF ORONO * z 0 1 6 - PJ PJ 9 1 8 *
. 2750 KELLEY PARKWAY DATE ISSUED: 08/03/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (9_52) 249-4616
ADDRESS : 425 FERNDALE RD N
PIN : 36-1 18-23-14-0014
LECAL DESC : HAUSER LAUER WCC ADDN
: LOT 003 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: WATER HEATER
VALUATION OF PLUMBING 2582
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.29
CITY VIEW PLUMBING& HEATING TOTAL S1.29
1880-B WAYZATA BLVD W
P.O. BOX 150 Payment(s)
LONG LAKE, MN 55356 CHECK 36406 51.29
(952)473-8793
Minnesota State License#: plbg-MB005208
OWNER
HAUSER, HELEN
425 FERNDALE RD N
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 Cor only the work described and does
not grant permission for additional or related work N hich requires separate
permits. All provisions of IaN°s and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
eapire 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 I 80 days at any time afier H�ork has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance��°ith the State Building Code.This permit may be
revoked n'v'time for due cause.
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pplicant Permitee Signature Date Issued B, ignature Date
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' � NO�`, P.O. Box 66 Date Received:
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CITY OF ORONO — PLUMBING PERMIT
(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 completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. 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 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) [Backflow Device: ❑ AVB ❑ PVB]
❑ New ❑ Additionai ❑ Repairs ❑ Replace
❑ In Accessory Structure?
'`You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information: � r
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Site Address: ✓f�� `��� G �� � � G v�
Owner: � ��� ���e� _l��n5 �'� Mailing Address: `��� � �� �������- ��� °�
c�ty: ''� (��`�C���-- zfp:SS� �'l
Home Phone: Alternate Phone:
Contractor Information:
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Contractor. � �"�7 (�����1 �'���h Contact Person: �� ���i��
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Address: /�,�J '� fil/e5� �:'ct�(������� L��S�t te Bond #: � �
City: �-��9 �G�� Zip:��� �J� Expiration Date:
Phone: ������������ ��� � Alternate Phone:
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� Insurance — Current: �` 5
Page 1
P�UMBING FIXTURES BEING INSTALLED"
FIXTURE BSMT 1sr 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. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
� x .0125 $
(contract price) (minimum $50.00)
2. STATE SURCHARGE
� � x .0005 $
—� (contract price)
3. POSTAGE 8 HANDLING (Only on Mail-In Applications) $ 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
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 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 statement de on th�� application are complete, true and correct.
��- - �� ���
ApplicanYs Signature: Date: �
Building Official/ Inspector: Date:
Page 2
`J 5 �- � �/
DATE TIME
CITY OF ORONO CALLED IN �-3—��
INSPECTION NOTICE SCHEDULED $-S -f�.b L/.'.3
PERMIT NO. ad�h-lb�'I�� COMPLETEq
ADDRESS � t:
OWNER � • �PHO O�a`—a'�'�Z
CONTRACTO � �J � �
� DESCRIPTION
�a�-er e�e.r � `
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEP FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ 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
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SI ❑ SEPTIC INSTALL
2 OW ET YOU:�ES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
W ❑CORRECT WOflK 8 PROCEED ❑ I E CERT�FICATE OF OCCUPANCY
O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALLINSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advan 2 9-46Q�
OwnerfContractor on site:
Inspector.
White Copyllnspector's File Cenary CopylSite No ce