HomeMy WebLinkAbout2016-00315 - plumbing MHEEZIfflum
CITY OF ORONO * 2 0 1 5 - 0 0 3 1 5 *
2750 KELLEY PARKWAY DATE ISSUED: 03/18/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS 4440 FOREST LAKE LANDING
PIN 07-117-23-24-0017
LEGAL DESC TONKAVIEW GARDENS
: LOT 012 BLOCK 000
PERMIT TYPE PLUMBING(>$500)
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE FIXTURES- MULTIPLE
NOTE: 1 WATER CLOSET, 1 LAVATORY, 1 BATHTUB, 1 SHOWER, 1 FLOOR DRAIN, I WET BAR, 1 WASHER BOX
VALUATION OF PLUMBING 7000
APPLICANT PLUMBING FIXTURE FEE 87.50
STATE SURCHARGE PLBG(VALUATION) 3.50
TJK PLUMBING INCORPORATED MAIL-IN FEE 2.00
13570 GROVE DR#284
MAPLE GROVE, MN 55311- TOTAL 93.00
(651)216-1318 Payment(s)
CREDIT CARD 1782 93.00
OWNER
CHURCH,JOSEPH
6175 STONE COURT
INDEPENDENCE,MN 55359-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applic nt Perruitee Signature Date Issued By Signature Date
` . City of Orono FOR CITY USE ONLY
&D�T
VO P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:
(952)249-4600—Main
y (952)249-4616—Fax
CITY OF ORONO—PLUMBING PERMIT
l�KESHO (All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.iiiii.gov/CCLD/PDF/pe plumbplanrevapp.edf
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 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 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 approval and ma eed CUP. (Per Orono City Code, Chapter 78,Article IV)
Job Site/Owner Information: /
Site Address:
Owner: -:50 C�f'JJC- Mailing Address:
City: 0 /jG Zip:
Home Phone: l �` G 7l�Ulternate Phone:
Contractor Information: �/
3 VJ�Abia , 1 .�
Contractor: �►�l`ti J �� Contact Person: �<
Address: �J�7� � �� Drt- 2 PC �q*q
State Bond #:
City: �� �� t-%l�%✓� Zip: 3i1 Expiration Date: 2- l—
Phone: �Z �! " Alternate Phone:
❑ Insurance—Current: '�l '� fz� Q -64
1
FIXTURE BSMT IST 2 No OTHER FIXTURE BSMT 1 2 ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub / Laundry Tray
Shower / Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous /
div,z5ke r n
❑ 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
• � r
PERMIT FEE CALCULATION(S)L JOBS OVER$500.00
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract rice with ajMinimum Fee of$50.00)
&112W x .0125 $
(contragt price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(contract price)
3. POSTAGE&HANDLING (Only on Mail-In Applications) $ 2.00
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 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.
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:
3
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� TIME
CITY OF ORONO CALLED IN �! ��
INSPECTION NOTIC SCHEDULED 9— — '
PERMIT NO. �b -�� OMPLEfED
ADDRESS
OWNER C�2�' EPHONE NO���- �� �"
CONTRA �
� DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
�4 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ -SITE ❑ S PTIC INSTALL
Q OWN FiACTOR TO MEET YOU:�YES_NO
c�., COMMENTS:
a�
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RKSATISFACTORY:PROCEED p,i PROJECT COMPLETE
W ❑CORRECT WORK�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 O CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORE CONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContract�j site:
Inspector.�����
Whits Copyllnspector's File Canary CopyfSite Notice
( � C� DATE TIME j�'
CITY OF ORONO CALLED iN
INSPECTION NOTICE SCHEDULED
PERMIT NO. �9_0 5-d0��S COMPLETED
ADDRESS 0
OWNER TELEPHONE NO.
CONTRACTOR
DESCRIPTION
tL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ 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
v ❑ DEMO-SITE PTIC INSTALL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU: YES_NO
COMMENTS:
W
a
J
O
O
LL ZZW
ccQ
2
W
z
W
cc
j
GW L WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
cc ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection hours in advance. -4600
Owner/Contractor on site:
Inspector.
White Copy/Inspector's File Canary;0py1SIte Notice
BUILDING REVIEW CHECK LIST
UBC: 3 CONSTRUCTION TYPE: \114
_ Sq Footage $Per Sq Ftg
Basement x
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 5,00022
Inspections Required: Work Requiring Separate Permits:
Site x Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
___4 Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
—�Final Grading/Filling _ Electrical(State Permit)
Other
REMARKS(IN HOUSE):
------- ------------------ -- ----------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
-------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT):
8
CUM
4440 Forest Lake Landing
Orono 55364
1. Re-frame; wo bedroom door entrances (non-structural changes)
2. Add one French door off living room (non-structural change)
3. Replace closet area with 1/2 bath (non-structural change)
4. Remove deck above garage completely (replace with an
ornamental iron guard rail)
4. Repair front concrete steps
5. Cosmetic improvements inside to include new carpet, paint,
and hardwood floors.
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