HomeMy WebLinkAbout2015-01081 - water softner � CITY OF ORONO * 2 0 1 5 - 0 1 0 B 1 *
2750 KELLEY PARKWAY DATE ISSUED: 08/25/2015
• ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 85 FERNDALE GREEN
PIN : 36-118-23-44-0024
LEGAL DESC : ALLO-RAE TERRACE
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: REPLACING EXISTING WATER SOFTNER
VALUAT[ON OF PLUMBING 2400
APPLICANT PLUMBING F[XTURE FEE 50.00
STATE SURCHARGE PLBG(VALUAT[ON) 1.20
BENJAMIN FRANKLIN PLUMBING MAIL-IN FEE 2.00
5718 INTERNATIONAL PKWY
(612)238-9709 TOTAL 53.20
Minnesota State License#: plbg-PC643703 Payment(s)
CHECK 23624 53.20
OWNER
POWERS,JOHN& ROXANNE
85 FERNDALE GREEN
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 rela[ed work which requires separate
permits. All provisions of laws and ordinances governing[his typc of work
shali be compied with whether or not specified herein.This permit will
expire and become null and void if construction au[horized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of l80 days a[any time after 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. �� �
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1� t�� c�� �� r:� ;�v� � ���� � , ���,, ;�,
Applicant Permitee ignature Date Issued By Signat re Date
ck$53,20 JOB334955 FOR ci�v usE o:vLv
� City of Orono
� ��� P.O.f3ox 66 Date Received: � �J ��� Permit# �C9��—"(� (���
27�0 Kelley Parkway � 1
' Crystal Bay,MN 55323 Approved By: _�_ Amount$: SJ- �
(952)249-4600—Main
� (952)249-4616—Fax
yF� c`� CITY OF ORONO—PLUMI3ING PEI2MIT '�U.� � lj �-�(��-
�k�sti��� (All Commercial Permits Must be Approved by the State Prior to City Approval)
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GENERAL INFORMATION
l. 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 JOI3 SITF:.
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 Accessory Structure?
*You will need prior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
s�te aaaress: 85 Ferndale Green
oWner: Roxanne Powers Mailing Address: Slte
„ „
City: Zip:
Home Phone: 952-473-� 39� Alternate Phone:
Contractor Information:
Benjamin Franklin PLumbing Jennie Wood
Contractor: Contact Person:
5718 International Pkwy PC643703
Address: State Bond #:
New Hope 55428
City: Zip: Expiration Date:
Phone: 6� Z-Z38-9709 Alternate Phone:
❑ Insurance—Current: Owner'S InSuranCe
1
, PLUMBING FIXTCIRCS BCING INSTALLED
FIXTURE f3SMT I'� 2�D OTHER FIX"I'URE BSMT 1`T 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washcr
Kitchen Sink Water Heater
Disposal Water Softener 1
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE C.ALCULATION(S) :
BASED OFF' - 2002 S'TATF STA'1�li C
❑ Yes,this section lies
The replacement of only one Resi tial fixture or a liance that s all three of the following
requirements:
�
1. Does not require modification to e �cal or gas service.
2. Has a total cost of$500.00 or I ;exc �n the cost of the fixture or appliance: and
3. Is improved,installed o� aced by the ho wner or licensed plumbing contractor.
%
Skip next sectio this applies; Cost of Permi $ I5.00
State Surcharge $ 5.00
,� Mail-In Fee(If Applic e) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
,� �= � PERMIT�FEE CALCULATION(S)��—JOBS OVER $SQQ.QQ .,.. ;��
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fce of$50.00)
2400 X .o�2s $ 50
(contract price) (minimum$50.00)
2. STATE SURCHARGE
2400 X .000s $ � �2
(contract price)
3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $53.20
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, labcr, profit, and other fixed costs. It is the amount te be charged
to the customer for the work done. If any material, equipment, labor or installations are furnished by
the owner, tenant or any other party, the reasonable market value of such items must be added to thc
estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
`�, � ' �L;LJMB TN'G PER.MIT'A1'PI,ICATIQ A+��2.EEM� .`T'�. :.`�.� ;� 'L� ` '
The undersigned hereby applies to the City far issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all tements made on this application are complete, true and
correct. � ��� �
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f, ; ,� ';"��' / ,:
Applicant's Signature: �,� Date: 7�30/�5
.- �/� 3
DATE TIME �
CITY OF ORONO c.�►��n�H
INSpECTiON NOTICE SCHEDULED
PERMIT NO.,�6/S -o!O Y/ COMPLETED y-/e •/?
A��E$� �5� ��.�K�4�e cyr2B.G
pWNEp TELEPHONE NO.
COI�fTRACTOR �
� DESCRIPTiON Gl/a 6e v i�����ite.� ��s�� �
ty ❑ FOOTINCa ❑ DEMO-FINAL ❑ SEPTIC FINAL
d ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADINGlFILLING
�Q ❑ FOUNDATION WATEHPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
i ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSUUITION ❑WOOD BURNERlFIREPLACE ❑ CAMPLAINT
v ❑WATER HOOK-UP �FOLLOW-UP
W AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_ ❑ DEMO-SITE ❑ SEPTIC INSTALL
v
? OMfNENCONTRACTOR TO MEEi Y�U:_YEs._NO
� coMM�r�
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j Permit has expired per MN Building Code Sec. 1300.120 subp. 11
� Expiration, no record of a Final inspection.
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W ❑WORK SATISFACTORY:PROCEED ❑PFiOJECT COMPLETE
� ❑CpqRECT WOpK�PROGEED O ISSUE CERTIFICATE OF OCCUPANCY
W
00 ❑CORNECT WORK,CALL FOR REINSPECTION TEMPORARY
(� g���NQ PERMANENT
D CORRECTUNSAFEOONOITIONWfTHIN HOURS. ❑PHOTOTAKEN
INSPECTOR MfILL RETURN ❑CITATION ISSUED
❑STOP OROER P08TED-G1LL INSPECTOR
O INSPECTION REGIUIRED.CALL TO ARRAN(iE ACCESS.
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