HomeMy WebLinkAbout2005-P09257 - plumbing .� PERMIT
CI"�"Y OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p09257
Crystal Bay, Minnesota 55323 Permit Type:
Fixtures
(952) 249-4600 Date Issued:
10/5/2005
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: $ 76.25 Valuation: $ 6,100.00
State Surcharge Fee: $ 3.05
Misc. Fee: $ 1.50
TOTAL FEE: $ $0.80
APPLICANT: Dauwalter Plumbing OWNER: Joseph&Deborah Norgaarden
15525 Green Meadows Cr 765 Ferndale Rd N
Carver,MN 55315 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPL[CANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, I-Assessing,(If Septic, 1-Septic) Page 1
� FOR CITY USE OVLY
O¢O�O City of Orono
P.O.Box 66 Date Received: Pernvt#
2750 Kelley Parkway
y� ��'"`� G` (52)azl 9a46M�N 55323 Approved By: Amount$:
t�'�tax���
CITY OF ORONO–PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
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 retum mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERM[T. 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 A 1
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑ Repairs ❑ Replace
❑ ln Accessory Structure?
*You will need prior approval and may need CUI'.(Per Orono City Code,Chapter 78,Article lV)
Job Site/Owner Information:
Site Address: �lp� F 1Li'1/1C�Q��, �C� (v
Owner��LR �01��I�L�r,�1�1 Mailing Address: �1 loS �.QaM��Q� �d i�7
City: llU(!l.i-i z�-d.— Zip: �5 3Q�
Home Phone: Alternate Phone: �5Z' �lP•��0(0
Contractor Information:
Contractor: j��y�����,�( �� Contact Person: lh}Q�•vi►1io i�A�vJa�E�r
Address: 155?S �DI(�.LL�1 IM10fl�G� State Bond#: _����
. � �v��.
City: Zip:�53�s Expiration Date: ('Z- 3 j-� �
Phone: �15Z �}�}-$•�}�I�� Alternate Phone:
❑ Insurance–Current: � � � ' �
1
Oct 04 05 10: z2a Dauwalter Plumbing 9524483509 p. 3
FI){TURE gSMT 1 2 Q'[i�A FDc7URE BSMT 1 2' OTF�R
TYPE �L FL TYPE FL FC,
Water Gosct , Floar Dreins
T.svacary a� Sewec Fjector
Bathroom Lnundry Tray �h
1�
Shower i Washer r ' �
1
Kitchcn Sink � WaterHeatcr
Disposal Water Softener
bishwasher W�B�
Siltcocks 1�isce��ffi►oo� �
,.�
❑ Yes,tfds section appiies
'It,e replaoemes�t of a RP,cidendal fixture or a�lience thac meEts eil three of the follewing requirecne�ts.
L. Daes noi require modifleation m etecaica!o�gas sen�ce,
2. Eias a total cacc,of$500,00 or less;�y�1p�che cost of the fixnuc or appliance:a,Ld
3. Is impro�ed,iruhalled or replaced by the homeowner ar licetued contracdar.
Skip n��a seetion,ifthis applies; Cost af Permiz $ I5.00
Sta�Suceharge S .SO
Maii-In Fee(If Applicable) � 1.50
Tata!Pennit Fa S
(permit Fees Couniaued Oo Nc;t Psee)
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PERMIT FEE CALCULATION S -JOBS OVER$500.00
lf above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
� �O, l ar, oo X.o�25$ �1 t� L�
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50)
�(� ,IOo, a� X.000s $ 3-c�
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �('; •�,1�
■ * 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 chazged
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 SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is
greater. For valuations over$1,000,000 call the Building Departrnent at(952)249-4600 for the price.
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 statements made on this application are complete, true and
correct.
/� � y�
Applicant's Signatu ,� Date: �(/ � C/��
Reset Form
�✓ `�� ��L. �" i �- .:� i � ��� - .
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3
✓
DATE TIME
CITY OF ORONO PD 92l.�� CALLED IN
INSPECTION OTICE SCHEDULED /Q' S�-o� �°: 3 v
PERMIT NO. �C�N�� COMPLETED
ADDRESS � 6S ��='�?'�NQ'4u"� �.6'� N
OWNER T�� I'�1�o�G�1'/L''k"� CONTR. ��c.vA-vl-ec Pt'13G
TELEPHONE NO. O g�Z " `�Yf�- `��b3 f� 6i L-221-�'7 t�6
� DESCRIPTION w�^-'r`¢�
l� 01 FOOTING 11 MEC ANICAL RI 18 EXCAV/GRADING/FI�LING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
_ �PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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d ORK SATISFACTORY:PROCEED '_' PROJECT COMPLETE
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� I� CORRECT WORK&PROCEED f- ISSUE CERTIFICATE OF OCCUPANCY
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O i_i CORRECT WORK,CALL FOR REWSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
C� CORRECT UNSAFE CONDITION WITHIN HOURS. ; PHOTOTAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
�7 STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. 249-460�
OwnerlCo or n ite:
Inspector.
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