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Home My WebLink About2012-00928 - replace water heater „ • CITY OF ORONO * Z 0 1 2 - 0 0 9 2 8 * 2750 KELLEY PARKWAY DATE ISSUED: 09/14/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1465 FOX ST PIN : 02-117-23-33-0002 LEGAL DESC : UNPLATTED 02 1 17 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING (> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NOTG: REPLACE WATER I IEATER VALUATION OF PLUMBING 1791 APPLICANT PLUMBING FIXTURE FEE 50.00 SODERLIN PLUMBING STATE SURCHARGE PLBG (VALUATION) 0.90 3612 CEDAR AVE S MINNEAPOLIS, MN 55407- MAIL-IN FEE 2.00 (612)721-4080 TOTAL 52.90 OWNER FIELDS, STEPHEN 1465 FOX ST WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performcd according to the approved plans and specifications,applicable City approvals,and the State[3uilding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separatc permits. All provisions of laws and ordinances governing this type of work shal!be compied with whether or no[specitied herein."Chis 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 lor assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. C VIi�-G(-L� -�j l ��l / Y � � l 1 �fl / a-- Applicant Permrtee Signature Date lssued I3y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , \ __. POR CI"PY CSG O\Ll' �� Cit�•of Orono N.O.l30.�66 I)alc Rcccivcd: Perntit�� i � 27�0 hcllcy Park�ca�� --— — - ----- .� � �'� � Cl}�stal Bay.:19N 553?; Approvcd By: 4mount 5: �� ►, � � �� (95�)2�9-4C00--Main f��Ft''reaXON (952)249-4G 16- fa.r �`y `�� NO CITY OF ORONO - PLUMBING PCRMIT S �Q� (All Commcrcial Perii�its Must be Appro��ed by the State Prior to City Approval) �� O G� GENERAL INFORMATION L You mny apply for plumbing permits by mail or in person at the City offices. Applications will bc reviewcd and a permit�vill be issued�vithin two working days. 2. Permit cards will be sent by rcturn mail aftcr a rcvic�v is complcted. PLRMI"I�S ARE NOT � VALID UNTIL 1'OU RECL'IVE A PERMIT. ��"ORK NIUST NO"['13CGIN U�''I'I1,'1'FII? � PL:R111"C CtV2D IS POSTEU O� TH1�;J013 SI"1'P:. -��-� 3. Nlumbing permits may be issucd ONLY to licensed plumbing contractors and to property owncrs "` residing in the dwciling. � a. When any new cons�ructio�or remodeling is involved,a separate building perinil must be _;�,� obtained. --�-- 5. All �vork must be done in accordancc�vith Sta�e Codc reqliirements. �—� G. All�vork must be iilspected aild air testcd before it is co��ered. Call O52)249-4600. �� (24-=18 hoin•noticc rcquired) TYPC OF PERMIT (Check All T11at Apply) �Residential ❑ Commercial (Approval Required) ❑ Ne�v ❑ Addi[ional ❑ Repairs ❑ Replace ❑ lu Accessory Structure'? *You��ill necd prior approval and m�ry need CUP. (Pcr Orono City Code,Chapter 78,Article IV) Job Site / Owner 1�lformation: Site Address: ��f�"'J �"L �-� S l� . ` /Gf�S Fo� S'i �- O�vner: J/�� l�Z� �j Mailin� Address: ��;:� City: �/�/✓U Zip: J� �� •. Home Phone: (p�� - �[(o - �QU � Alternate Pho�le: _.. Contractor Information: Contractor: ��-L/�✓ Contact Person: �C��(..� Address: �(Cr�� /�"/�- •�I� `J Statc Bond #: ��G ��Dol�f � City: ��/�.�� Zip: 55�"07Cxpiration Date: %� -��v1��3 Pllone: �' ��-7c��-��(� Alternate Phoi�e: ❑ Insw�ance-Current: I PLUMBING FIXTURES BEING INSTALLED �J PIXTURE BSMT 1ST Z1D OTHER FIXTURE BSMT 1'� 2�D OTHER ---- TYPE FL PL TYPE TL PL '_ Water Closet Floor Drains Lavatory Scwcr Ejcctor Bathtub Laundry Tray Showcr Washer Kitchen Sink Watcr Heater l Dis�osal Watcr Softencr Dishwasher Wct Bar Sillcocks Miscellancous PERMIT FEE CALCULATION(S) BASCD OFF - 2002 STATE STATUE ❑ Yes',this scction applics The replacement of only one Residential fiixWre or ap�liance that meets all three of the followin� requircments: 1. Docs not requirc modification to electrical or gas servicc. 2 Has a total cost of$500.00 or less;excludin�,�he cost of the fixture or appliance: and 3. ]s improved, installed or rcpl�ced by thc homeowaer or licensed plumbing conU�actor. Sl:ip next section, if this applies, Cost of Permit � I�.00 State Surchar�c S �.00 Mail-In Pcc(If Applic.�blc) $ 2.00 '1'otal Yermit I�ee � (Perrnit Fees Continucd On Next Page) �--�- 2 . . � . PERMIT FEE CALCULATION(S) -JOBS OVER $500.00 If above does not apply; iollow guidelines bclow: L CON"I�RAC'1� PRICE * is 1.25'%oi'contract price�vith a(Niinimum l�ce of�50.00) ��7� x .01?� S JCi �Q U (contract price) (minimum�$0.00) Z. STATI?SURCHARCF ��G( ( x .0005 $ �(� (contract price) 3. POSTAGE& HANDLING (Only on Mail-[n Applications) S 2.00 ;_� d. TOTAL VGRMIT FEG(Add Lines I-3 Above) � S� .��(� �� ■ * CONTRACT PRICE or .TOL� COST me:ins the actual or e�timakc�i dollar amount charged lor thc ---� permitted work including materials, labor, profiC, and other fixed cosls. It is lhe amount to be charged ��'"� to thc customer for the work donc. If any material, equipment, labor or installations arc furnished by the owner, tenant or any other party, the reasonable markct valuc oi�such items must be adde� to thc estimated cost or contract pricc for permit fee purE�oses. In the event that there is a dispute on thc amount of thc job cost, thc City may request the submission of❑ signcd copy of the aclual conU�act. PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hei-eby applies to the City for issuance o1'a Plumbin� Permit, agrees to do �ill �vork 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: '��7,�� Date: �— �� ... Reset Form 3 :�/ " D E TIME CITY OF ORONO ��CALLED IN �/o� INSPECTION NOTICE u SCHEDULED -----� PERMIT NO. � ' �� COMPLETED ADDRESS � �J �L�'� �i ` OWNER TELEPHONE NO.L�'�v� -d��-�'�� CONTRACTOR �� ` � - � DESCRIPTION v�C�- W�— �p�� -'� �yl � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q � RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTI FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � � ❑WORK SATISFACTORY:PROCEED s�2aOJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 Owner/Contractor on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice