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Home My WebLink About2015-00576 - plumbing • CITY OF ORONO * Z 0 1 5 — 0 0 5 7 6 * � 2750 KELLEY PARKWAY DATE ISSUED: OS/1 U2415 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 375 FERNDALE RD N PIN : 36-118-23-41-0003 LEGAL DESC : iJNPLATTED 36 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 STATE SURCHARGE PLBG(<$500) 5.00 CHAMPION PLUMBING LLC MAIL-IN FEE 2.00 3670 DODD ROAD- SU[TE 100 TOTAL 22.00 EAGAN, MN 55123- Payment(s) �� CHECK 30945 22.00 OWNER CARLSON,MATTHEW& KALEENA 375 FERNDALE RD N WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within l80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. �'� � ��"1'Y�Cs`L'� � � 1 � � �S � '1cu, � �t- �-�-'�-- Applicant Permitee Signature Date Issued By Signature Date � �� . FOR CITl'USE Ol!'L]' r �� City of Orono 5_((—�� Z�tS �j� �Q P.O.Box 66 Date Received: ermit# i � �� 2750 Kelley Parkway � Crystal Bay,MN 55323 Approved By: � Amount$: �iZ� � (952)249-4600—Main �� (952)249-46]6—F� � 1„�� F ��j CITY O�' OROl�O—PLIrTMBIl�'G PERl'vIIT � �� . �k�SH�� (All Commercial Permits Must be Approved by the State Prior to Cih�Approval) az�ir;://L��si��v.t?�i.�a�t�.�oti�/CCL:�/��5d�/�e s>ldasa�l»I�t�ar'ev�e�r�.�nd? GENERAL INFORMATION 1_. Yt�u 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 NOZ' VALID LINTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL TNE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbin�contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved,a separate buildinQ permit must be � obtained. 5. All work rnust be done in accordance with State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952j 249-4600. (24-48 hour notice required) TYPE OF PERMIT ------------ (Check Al(That APPIY) — — --- - �Residential ❑ Coirimercial(Approval Req�.�ired) ❑ New ❑ Additional ❑Repairs �Replace ❑ ln Accessory Structure? *You will need prior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Ownez��Information: __ 2 . � ^I � S ite Address: �)� � b�� 1; �lL t �� Owner: �(�-��,�1) ( /pI,V �� Mailine Address: c�r�: �,U��,��l , M� �i��/z�p: , � Home Phone: �� Alternate Phone: � Q�� J�� Coniractor�i��formaiion: �� . ; Contractor: � �ia�� "��.:��.� "` '� `I' ��`";�'� "!��%� Contact Person: Address: � `�' � `t,�` ��%��' '��' �`i} State Bond#: City: 'y�-��-��'�� Zip:`�=�^'E�- ' E�piration Date: Phone: '�4�-�` �``�%�'`�; ��, ��' Alternate Phone: ❑ Insurance—Current: 1 �� I ' ' 1 , / �.y �, PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1sT 2'�v OTHER FIXTURE BSMT 1sT 2ND OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains iavaiory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink ter Heater � � Disposal Water ener Dishwasher Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE � Yes,this section applies The replacement of only one Residential fixture or appliance 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;excludin�the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner or licensed plumbin;contractor. Skip next section,if this applies; Cost of Permit $_ 15.00 State Surchar�e $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $�� (Permit Fees Continued On Next Page) 2 r . , ' � � ! • � �, ' - PERNIIT FEE CALCULATION(S)-JOBS OVER$500.00 If above does not apply;follow guidelines below: 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 5 (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMTT 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 wark 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 fc�r 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 statements made on this application are complete, true and correct. � J �� Applicant's Signature: , �C�=�`� Date: � � '� � � �� DATE TIME � CITY OF ORONO CALLED IN i� INSPECTION NOTICE SCHEDULED �I t5/I� `3 _3e,c�;.r� PERMITNO.=��'�� -�'� �7G= COMPLETED ADDRESS -�rr'� �c-_r't�c,o-.-�. ?c-1 N OWNER �'�� 'C�--s"�5z''� TELEPHONE NO. ��-�� - �ct�1� CONTRACTOR � , �: DESCRIPTION ��'�--��' ��-� ��- ��-� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 4! ❑ AS BUILT-SURVEY ❑ S WER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ PTIC INSTALL ❑ FOUNDATION/REMOVAL 2 O�ONTRACTOR TO MEET YOU: YES_NO v, COMMENTS: � W a � � O �. � O � W � Q � 2 W � W � J d W ❑WORK SATISFACTORY:PROCEED OJECT COMPLEfE � ❑CORRECT WORK&PROCEED SUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 ho in advance. (95 249-4600 OwnerlContractor on site: inspector. White Copyllnspector's File Canary Copyl te Notiee