HomeMy WebLinkAbout2005-P08612 (plumbing) PERMIT
C I TY 'O F O RO N O Permit Number:
275� Kelley Parkway - PO Box 66 P08612
Crystal Bay, Minnesota 55323 Permit Type: FiX�ures
(952) 249-4600 Date Issued: 4iisi2oos
SITE ADDRESS: 1070 Ferndale Rd W
Wayzata,MI�T 55391
P I D: 02-117-23-43-0002
DESCRIPTION:
Proposed Use: Kesidenhal
Pernut Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 450.00 Valuation: $ 36,000.00
State Surcharge Fee: $ 18.00
Misc. Fee: $ 1.50
TOTAL FEE: $ 469.50
APPLICANT: Lakeside Plumbing OWNER: Timothy&Rosie P Owens
12469 Zinran Ave. 1070 Ferndale Rd W
Savage,MN 55378 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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APPLICANT PERMITEE SIGNATURE I SUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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� FOR CITY L;SE ONLI'
;��� City of Orono
P_O.Box 66 Date Received: Permit#
� � ��" 2750 Kellcy Park�va}�
�+ ; p• ��� Cn�stal Qay,MN 5�323 Approved[3y: Amount$�.
��t� '-� '.� i�� (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commcrcial permits must bc approved h��the Building Official or Inspxtor)
GrNERAL INFORMA7'ION
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 warking days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECENE A PERMIT. 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 Apply)
�Residential ❑Commercial(Approval Required)
[�]New ❑ Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior apnroval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner [nformation:
Site Address: �e`1Q ��rn��-l� �.c�
Owner:��o�.,� �ome.S Mailing Address: yul �. ����� Si
City: 1�t1 �=�c�. Zip:
Home Phone: Alternate Phone:
Contractor Information: �,
Contractor: �o��_ 5:�� P��rnb:,� Contact Person: �ve_
Address: �cl�y1�`i 2=��c.. �v� State Bond #:
City: �a��� Zip:SS3�� Expiration Date:
Phone: �Sa- ��`I- 11��� Alternate Phone:
❑ Insurance—Current:
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PLUMBING FIXTURES BETNG INSTALLED
FIX"I'URE BSMT I�� ?�D OTHGR FIXTURG BSM"I� I�� 2��° OTHER
TYPE FL FL TYPE FL FL
Water Closet ' r� `� Floor Drains �
v� c �e
Lavatory + � �I Sewer Ejector
1
Bathree�wksb ` Laundry Tray i
I
Shower 1 , � Washer �
Kitchen Sink � Water Heater �
Disposal i Water Softener
Dishwasher , Wet Bar ' I
Sillcocks � Miscellaneous
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` PCRMIT FEE CALCULATION(S)
BASED OF,F -2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or a�pliance that meets all three of the following requirements:
I. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appliance: and
3. Is improved, instalied or replaced by the homeowner or iicensed contracior.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee([f Applicable) $ 1.50
Total Permit Fee �
(Permit P'ees Continued On Next Page)
2
� ' .
� PEIZMIT FEE CALCULATION(S)-JOBS OVER$500.00 ;
If above does not apply; follo�v guidclines belo�v:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
��.f�= r.0125 $ �•�C�
(contract price) (miniininn$»00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(��1inimum Fce ofS.�ll)
���D�� x .0005 $ ��
(contract price) (minimum$ .�0)
3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 1.50
4. TOTAL PF,RMIT FEF:(Add Lines 1-3 Ab�ve1 � ��p�.�p
■ * 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. [t 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 pennit 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 Department 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 i❑ strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, ai�d certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: �� �W1e..e-� Date: '/-I:i- oS
Reset Form
3
�� E TIME �
CITY OF ORONO CALLED IN
INSPECTION N T SCHEDULED I� Iv,'jC7
PERMIT N0. � COMPLETED
ADDRESS �
OWNER CONTR. ��p/1!�(�/�,�
TELEPHONE NO. SZ—�! `f' �� C�
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPUACE 34 TREE REMOVAL
Z 04 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:
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W� WORKSATISFACTORY:PROCEED I�'PROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED !- ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,� pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
� INSPECTION REQUIRED.C LL TO ARRANGE ACCESS.
Call for inspection 24 hours in advance. (952) 249-46�0
OwnerlC tra n s te:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
� � DA TIME �
�� 6 �
CITY OF ORONO CALLED IN
INSPECTION N TI SCHEDULEDI _�� �
PERMIT NO. o�-� COMPLETEDIi
ADDRESS D7D �
OWNER CONTR.
TELEPHONE NO. 9s2 ��� ���
� DESCRIPTION L�� ���'Q � v
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADI ILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED r�ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING ' pERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑'PHOTOTAKEN
INSPECTOR WILL RETURN � CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next"nspection 24 hours in advance. �952� 249-46QQ
OwnerlContr s t :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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<%— , DATE TIME
CITY OF ORONO CALLED IN ', l �
INSPECTION TI E SCHEDULED �-Z -�b Q��
PERMIT NO. � � � COMPLETED
ADDRESS �D 7D ���'��lda�-- ,L��L Lv �
OWNER CONTR. ���''
TELEPHONE NO. 9�2 O 97� 7�OB0
� DESCRIPTION �`Q'� �
� 01 FOOTING 11 MECHANICAL RI � 18 EXCAV ADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL i 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAWT
� 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:
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� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W�ORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL flETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (952� 249-46��
OwnerlContracto s te:
Inspector.
White Copyllnspector's Fi e Canary CopylSite Notice