HomeMy WebLinkAbout2005-P08985 - plumbing PERMIT
CITti' OF ORONO
2.':i0 Kelley Parkway - PO Box 66 Permit Number: po8985
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued:
7/20/2005
SITE ADDRESS: 765 Ferndale Rd N Unit#
Wayzata,MN 55391
PID: 36-118-23-11-0014
DESCRIPTION:
Proposed Use: Residential �
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 42.50 Valuation: $ 3,400.00
State Surcharge Fee: $ 1.70
TOTAL FEE: $ 44.20
APPLICANT: Owner/Self OWNER: Joseph&Deborah Norgaarden
�' 765 Ferndale Rd N
Wayzata, MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECfFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICA P[? �E.S161 `TURE ISSUED BY SIGNATURE
Copies: 1-File(Srgnatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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� FOR CITY CSE ONLI�
City of Orono
� �- �'������` P O-Bo�66 Date Received: Permit k
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;� p"R• �j� Cq�stal Bay,MN�5323 Approved B��: Amount$�.
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CITY OF ORONO- PLUMBING PERMIT
(All Commercial permits must be approved b}�the Buildin�r Offieial or Inspector)
GENERAL 1NFORMATION
l. You may apply for plumbing permits by mail or in person at the City ot�ices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERM[TS ARE NOT
VALID UN"I'1[, YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POST'ED ON THE JOB SITE.
3. Plumbing perniits may be issued ONI,Y 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 A 1 )
�Residential ❑Comi�ercial (Approval Required)
❑ New ❑ Additional ❑Repairs �Replace
� �
❑ In Accessory Structure?
*You will need nrior annroval and may need C'l`P. (Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address: ,7�G�� F� �tZ�1D:=�� rZ_ ►�\j ��
Owner: �G�E i�rt J,�.� �- �cr-s F��.,z,��•�c.� �� �l,
� /�lGhf�i3i-�RDr'�� Mailing Address: �,;,��z�a�ra �:��v
City: ���ND ��.'Hyz�%� /Yiia�r.a,��,�rs�ip: 55.3�j1
Homc Phone: i'S�- `�%� -���'�:�C� Alternate Phone: (c�%� -���C.� `�'�/(�
Contractor Information:
Contractor: ���i'IU��= ,�S �ec��r,t�Contact Person: ��f.J �%�������c�� -f�c��iE- �Y�'nl���
Address: State Bond#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ [nsurance-Current:
1
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PLUMB[NU FIX'I�URES B}'ING 1NSTAI.L,}��[�
FIXTURE BSM�I' l� 2" O'CH�R FIX'I'URE QSM'I� 1� 2� ' O'1'HER
TYPE FL FL TYPE FL FL
Water Closet � � Floor Drains
Lavatory �,�,�t�� � Sewer Ejector
�, c`�
Bathroom � Laundry Tray � �N t E ���
Shower � Washer _I �Nq,y ;c. ��;
Kitchen Sink ��er+ �- Water Heater
L�
Uisposal Water Softener
Dishwasher Wet Bar
Sillcocks A4iscel�►eetts 1
�az�-1�s�3
PERMIT FEE CALCULATION(S)
I3ASFD OFF -2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to electncal or gas service.
2. Has a total cost of$500.00 or less;excludina the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ 50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee �
(Permit Fees Continued On Next Nage)
2
FERMIT FEE CALCULATION(S)—lOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CON'fFtACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
����{-C:C�-� X .ot2s $
�� s �
(contract price) (minimum$35.00)
2. S'I'ATE SURCHARGE ** Add the State Bldg Code Div. Surcharge('�tin�mum Fee of$.50)
� io
-- .3►�� _X.000s $-- 1,
(contract pnce) (mimmum$ _�0)
3. POSTAGE&HANDLWG(Only on Mail-In Applications) $ 1.50
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 induding 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.
■ ** The STATE SURCHARGF, is .0005 of the contract price under$1,000,000 or$.50— whichever is
greater. For valuations over$1,000.000 call the[3uilding Department at(952)249-4600 for the price.
PLUMBING PERM[T 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 certities that all statements made on this application are complete, true and
correct.
Applicant's SigrlattEr�;__ , c' 7 -��� Date:
�_ _�
Reset Form
3
L � `��� DATE TIME
CITY OF ORONO CALLED IN �G l`��L%j
INSPECTION NO;�jC�� �_ SCHEDULED �� ,C���.
PERMIT NO. f C l � COMPLETED
ADDRESS `��'� -���_�`c�---��z_� �G1� /I���
OWNER � CONTR. � (,L l_��;r I�r""
TELEPHONE NO.���� ����� ��3�1��-j'✓t����',
� DESCRIPTION ����'�-m� ��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS: � dZ �
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W WORKSATISFACTORY:PROCEED C� PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED �r ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑COARECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETl1RN
'_7 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REOUIRED.CALI TO ARRANGE ACCESS.
Call forthe ext inspection 24 hours in advance. (952� 249-460�
Owner/Contract n site:
Inspector.
White Copyllnspector' File Canary CopylSite Notice