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Home My WebLink About2012-01074 - plumbing ,`, - CITY OF ORONO * Z 0 1 2 — fd 1 0 7 4 * 2750 KELLEY PARKWAY DATE ISSUED: 10/24/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 75 FERNDALE RD N PIN : 36-118-23-44-0006 LEGAL DESC : ALLO-RAE TERRACE : LOT 002 BLOCK 001 PERMIT TYPE : PLUMBING (<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER SOFTNER NO"1'E: REPLACE WA"CF,R SOF"I�F,NF,R APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 5.00 6030 CULLIGAN WAY MINNETONKA, MN 55345 MAIL-IN FEE 2.00 (952)912-7379 TOTAL 22.00 PAID WITH CC# 0597 OWNER BRINKMAN, MR. & MRS. 75 FERNDALE RD. N WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The ti�ork for which this permit is issued shall be performed according to the approved plans and specifications,appGcable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type oY work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance wi[h the State Building Code.This permit may be revoked at any time for due c se. l� �a�/� l� i� �� a� Applicant Permitee Si re Date �s By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. l0/23/2012 13:12 FAX 9529335049 CULLIGAN MNTKA C�002 FO CIT USE ONLY ,�s'� City of Orono /!>� D 7 /O�"�� P.�,Box b6 Date Received: � ertnit# a0l a" � �.Fr,� 2750 Kelley Parkway � y1 t�''�� Crystal Bay,MN 55323 Approved By: Amount$: �a• '' (952)249-4600 �+ae� CITY OF ORONO-PLUMBING PERMIT (All Commercial permits must be approved by[he Building Oflicisl or Tnspector) 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 witl be sent by return mail after a review is completed. PERMITS ARE 1VOT VALID UNTIL YOU RECEIVE A PE22M1T. WORK MUST NOT BEGTN 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 scparate building permit must be obtainad. 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 A 1 �Residential ❑Commercial(Approval Required) �New ❑Additional ❑Repairs ❑Replace / ♦ ❑ In Accessory Structure? � *Yov will need nrior annroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address. �.5 �-�e,rn c�� f�cX Jv Owner: �o.�r�v� ,�c�Y�� Mailing Address: c��y: z�p: 55 3� � Home Phone: ��' `�� v -�( 5U Alternate Phone: Contractor Information: CULI��'Gd�TER CONDITIONING Contact Person: i�►�( 6030 CULUGAN WAY �04t�P�EsTC�NKA, MIV 55345 State Bond#: � (952� 533-7200 City: Zip: Expiration Date: Phone: Alternate Phone: 9'Sa-9 �o� - �3�7 ❑ Insurance-Current: ] 10/23/2012 13:12 FAX 9529335049 CULLIGAN MNTKA C�003 . , z�•;�.4:' �.'�.. ... . "'=h;lr.�i�,�.t.''.:.r�..rt..!*,1�.':'f��:��:f �"��:"},�r� 1 �y,�^ �%��j!�+�r !p�,i�t .�a:� �:;.,_:,F:�.<<;,;,.�: � '.i:.. .�}.,ntv.� �}� p•.Hi4'.:...ti�' .i t.. r,):� ,�+! 7-� .�.t',�;.i'.'�i.':,...'�' rA�7+.`]�:.;��.`�"'Si:�� !�5c.":k�f-:�{.:.,r,'•,I,_w"`:;u_.ui.'` .:{:.>Trc.°�+�,1Y'Il�l�'}��1'`Shc'SG`LT'��li�ilY.K3o��-1',,�.��t"��3J-;;;��.,; _ FIXTURE BSMT 1 2 OTHER FtXTiJRE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector I', Bathtub Laundry Tray Shower Washer ' Kitchen Sink Water Heater _ Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous �� i✓H y + ��n '�xt,L"�}��"�� Y �l��i.��H1.�O1.V��,7}� ��4 �;�g�y' �'��,� ��•'�i f� � mar�k } JI'u :Y ��F �-�j �5 � �' -.f.k ta � -a � �' i iaalt � ��,��;��; ` , ,�� 4�''l�t ��, �OQ2 5TA`I'E STATU�' ' �;� r=�„��r; E��"�� ❑ Yes,tt►is section applies The replacement of a Residential fixture or ap�liance 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;excludine the cost of the fixture or appliance;and 3. [s improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State 5urchazge $_ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Rage) 2 10/23/2012 13:13 FAX 9529335049 CULLIGAN MNTKA f�004 I „�,. . r (�,��'_1 , ,(�►x�.['! ( �`1 /'� 7�{} .. r.S�.. •!i' ��I �'�+1r+°,f�,r.i..l 6' : }�i .i.:��1. .�, , ,�'�.G�rll::J11,��WLry,'i'� fihr�?'i�,J;l'1��.V��, 2��-N ..�...M` ".{ If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract ptice with a(Minimum Fee of$50.00) x.0125 $ (conaact price) (minimum$50.00) 2. STATE SURCHARGE **Add t6e State Bldg Code Div. Surcharge(Minimum Fee oFS5.00) x .0005 $ (contrac[price) (minimum S 5.00) ! 3. POSTAGE&HANDLING(Only on Mail-in Applications) $ 2.00 � 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ao�•d U ■ * 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. 1t is the amount to be charged to the customer for the work done, if any material, equipment, labor or installations are fumished 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, ■ '�* 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 Deparhnent at(952)249-4600 for the price. � - u �' � u r �; s. 7 y :t 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 �tate of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicant's Signature: �� Date: � - ,3- � �k., •is, . „�;;k:� 3 � DATE Z TIME � CITY OF ORONO CAL�ED IN //-/S � INSPECTION NOTICE SCHEDULED /,i�1�� PERMIT NO�v�oZ�/�7 COMPLETED ADDRESS I OWNER �%�� LEPHO NO.�I�-9`� '�'1�✓�"� CONTRACTOR �� >; DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL Q � TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � NER NTRACTOR TO MEET YOU:.�YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � � d � ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952� 249-46�0 OwnerlContractor on site: Inspector. �' / i,f`�J� � White Copyllnspector's File Canary CopylSite Notice