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Home My WebLink About2015-00012 - plumbing � CITY OF ORONO * z 0 1 5 - 0 0 0 1 z * f 2750 KELLEY PARKWAY DATE ISSUED: 01105/2015 ORONO, MN 55356- 952 249-4600 FAX: (952 249-4616 ADDRESS : 1165 FERNDALE RD W PIN : 02-117-23-43-0026 LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE : LOT 000 BLOCK 000 PERM[T TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NOTE: 2 KITCHEN SINKS,2 DISPOSALS,2 D[SHWASHERS VALUATION OF PLUMBING 8500 APPLICANT PLUMB[NG FIXTURE FEE 106.25 STATE SURCHARGE PLBG (VALUATION) 4.25 SELECT MECHANICAL SERVICES INC. TOTAL 110.50 6219 CAMBRIDGE ST Payment(s) ST. LOUIS PARK, MN 55416- CHECK 3814 110.50 (952)926-4488 OWNER BROOK, ROBERT 1165 FERNDALE RD W WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and speciYications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permi[s. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time Yor d cause. � � , � /.� (�. f� 1 5 � � � 1�-�-� �� S Applicant Perm' ee Signature �Date� Issued By S gnature Date . � � I�- Z�� f FOR CITY USE ONLY O City of Orono ,� ` �'S.� � 7i P.O.Box 66 Date Received: �/�/�5 Permit# (� � ( � �0 2750 Kelley Pazkway �1 ��l.� Crystal Bay,MN 55323 Approved By: � Amount$:_�_ �� (952)249-4600—Main � a (952)249-4616—Fax yF c.` CITY OF ORONO—PLUMBING PERMIT ��fSH�� (All Commercial Pernuts Must be Approved by the State Priar to City Approval) htt ://www.dli.mn. ov/CCLD/PDF/ e lumb lanreva . df GENERAL INFORMATION 1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Pemut cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE 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 pernut 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 ❑ In Accessory Shucture? *You will need prior apuroval and may need CUP.(Per Orono City Code,Chapter 78,Article I� Job Site/Owner Information: Site Address: I` �s I �Rl��l'�i ��J4� W Owner: �iOQ �(�60}�.l S�-JA�O� QU 11�/�Mailing Address: S'� '�`� � c�Ty: l� A��TA z�p: �`s3�/ Home Phone: Alternate Phone: Contractor Information: Contractor: .S�G�"CT /�,F'C{�/A�Il�� Contact Person: C'�/l�l� ��✓gL�'�- �f,C3Do33 90 Address: �21� ��4�`'�BR 1�C��?I�F�/'State Bond#: PC f��1 Z�7� .�5 S2�ZoZ City: .�LOI/LS PA� Zip:S��`�c Expiration Date: � 1! /� � /��(v Phone: 9S2- 9 2�. ��L� Alternate Phone: ❑ Insurance—Current: 1 . t PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Z Water Heater Disposal � Water Softener 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;excludine the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 . , �. PERMIT 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$50.00) � n �,��, x.0125$ �!/��, 2S (contract price) (minimum$50.00) 2. STATE SURCHARGE �,�OO�� /� Z,S' x.0005 $ !. (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ � / �O 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 including 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 pariy, 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 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. Applicant's Signature: Date: ` S ��f� 3 �/ DATE TIME � �If CITY OF ORONO CALLED IN INSPECTION N9TI �.Z SCHEDULED '� � � __�� PERMIT NO. /�� COMPLETED ADDRESS � � `� � � OWNER TELEPHO NO. � � ��2 CONTRACTOR 'e �� =�" ' � DESCRIPTION � � ' �� l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL �i ..J� ❑ EXCAV/GRADING/FILLING � ❑ FOUNDATION WATERPRO NG FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATfON ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ S ER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ PTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMEN : � W a � f O � � O � � W � � - Q � 2 W � W � j d W RK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � CO RECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J 2� 2 -46�� OwnerlContractor on site: ; Inspector. , White Copyllnspector's File � � Canary Copy/Site Notice /�� DATE TIME� �TY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED �z��J � PERMIT NO. �f�-�� COMPLETED ADDRESS < < �S �"�J"nG�c� �e � W OWNER TELEPHONE NO.��2 Cog��0 4Z CONTRACTOR ��'E'[`+" I�Yl�'1 � DESCRIPTION ��►'1!'� � �`✓��-1 ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF �'�UMBING F�NAL ❑ TREE REMOVAL Z ❑ RADON SIAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑�PTIC INSTALL ❑ FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU: YES_NO c�.� COMMENTS: �� s � � 1�SVti u �� a � �/15u i4G ' 0 � FI�Cfif.�✓GS Seti � SG+e�G� �- � � r 1 K•sk RL�kc�ac /i/1 �n� /L•,]�t4r�5�a✓ Q ^ �''GS� Q� rJ ♦/ �C -�a..�c.sl�e�� d- d� � � �_r�,.1�� -,crtl� W ' � j / W ❑WORKSATISFACTORY:PROCEED �-?RCJECTEOMPLEfE ��CT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY O�O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR W{LL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for " s ion 2a hours in advance. (952� 249-4600 Ow o ctor on site: • � Inspecto . White Copyllnspector's File Canary CopylSite Notice