HomeMy WebLinkAbout2016-01358 - plumbing . CITY OF ORONO * 2 0 1 6 - 0 1 3 5 8 *
2750 KELLEY PARKWAY DATE ISSUED; 10/24/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 25 BROWN RD S
PIIY : 03-117-23-21-0001
LEGAL DESC : LTNPLATTED 03 1 17 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: WATER HGATER REPLACEMENT
VALUATION OF PLUMBING 6500
APPLICANT PLUMBING F[XTURE FEE 81.25
STATE SURCHARGE PLBG(VALUATION) 3.25
PRONTO HEAT[NG&AC MAIL-IN FEE 2.00
7415 CAHILL RD
EDINA, MN 55439- TOTAL 86.50
(952)835-7777 Payment(s)
Minnesota State License#: mech-MB004828 CREDIT CARD 8852 86.50
OWNER
OTTO&JOLLY NANDA, MICHAEL
25 BROWN RD S
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for wfiich this permit is issued shall be performed according to
thc approved plans and specifications,applicable City approvals,and the
State E3uilding Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. Ali provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit�vill
expire and bccome 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 afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Bui(ding Code.This permit may be
revoked at any time for due cause.
C�l/(.—�t�(,�C�:;� % ��-�/ � �l� / /��
Applicant Permitee Signature " Date Issued Signature Date
FromPronto Heating and Air 952+767+9YY0 70/24/2076 06:50 #363 P.002/003
•
�N�� City of Orono FOR C1TY�15E ONLY
i O � P.O. Box 66 Date Received: /(J 'Z�/-�
� ') 2750 Keliey Parkway v
�. ,� �; Crystai Bay, MN 55323 Permit# ��/ � —�I�SQ
�F � (952)249-4600-Main
��'kt�����P` (952)249-4616-Fax Approved By:
Amount$: ���S U
CITY OF ORONO — PLUMBING PERMIT
(All Gommercia! Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.qov/CCLD/PDFIpe piumbplanrevapp pdf
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 wil! be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YQU RECEIVE A PEF2MIT. WORK MUST NOT BEGlN UNTlL THE PERM17 CARD IS
POSTED ON THE JOB SITE.
3. P(umbing 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 invofved, a separate building permit must be obtained. '
5. AI!work must be done in accordance with State Code requirements.
6. Al!work must be inspected and air tested before it is covered. Ca(I (952) 249-4600. '
(24-48 hour notice required)
TYPE 4F PERMIT(Check All That App1y)
�Residential ❑ Commercial (Approval Required) [Backflow Device: []AVB ❑PVB]
❑ New ❑Additional ❑ Repairs �-�place
❑ In Accessory Structure?
'You wiH need prior approva! and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site/ Owner Information:
Site Address: �� ��(��(�1'� �� �
�
Owner- Mailing Address:
City: 1� Z�p: .���
Home Phone: _t.4 I7 - Q ��- � Q� Alternate Phone: _ N��
Contractor Information:
Contractor�,( G � �- � Contact Person: � �Q
Address: � ! � State Bond #: �(��,0� ��q�Q �j
City: ����i Zip: '���Expiration Date: `t-Z� -1�
Phone: ������� ��� � Alternate Phone: _„__�
❑ Ensurance—Current:
Page 1
From:Pronto Heating and Air 952+767+91�0 �O/24/2076 06:b1 #363 P.003/003
� .
PLUMBING FIXTURES �EING iNSTALLED .
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1S� 2"D OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Baihtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater �/
Disp�sai Water Softener
Dishwasher Wet Bar
Silicocks Miscellaneous
' PERMIT'FEE CALCULATION
9. CONTRACT PRICE �` is 1.25% of contract price with a (Minimum Fee of$50.00)
��� , C�� x .0125 $ � Z J
(contract price) (minimum $50.00)
2. STATE SURCHARGE
� Q�� � � x .d005 $_. �)r Z�
(contract price)
3. ROSTAGE � HANDLING (Only on Mail-in Applications) $ 2.00
4. TQTAL PERMIT FEE (Add Lines 1-3 Above) $ � , ��
` COIVTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materiafs, labor, profit, and other fixed costs. It is the amount to be charged to
the customer for the work done. If any materiai, 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 AGR�EMENT
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 a!! statements made on this application are complete, true and correct.
Appiicant's Signature: Date: �L�-��L/-� �D
Building OfFicial/ Inspector. Date:
Page 2
� � �%l�� � DATE V TIME
�ITY OF ORONO CALLED IN
INSPECTION NOTICE ��Q' SCHEDULED � �� �r�
PERMR NO.�-���� � ',� COMPLETED
ADDRESS ��- � �!�C-L f'1 �,�rl S -
OWNER TELEPHONE NO.C�`�� � �� � �� �
CONTRACTOR �n� �� ��c L.�� ,
� DESCRIPTION ��-' t �lGl` ����a�,�P `1 �- �-� C`�C \
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN(3
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
� ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 dWNERI�CONITRACTOR TO MEET YOU:�,;rE8_NO
X
� COMMENTS: ---� �
� ` /�G/J�� ,P/w�n-� INa��P� �`°�TC%� /S O� /�0 r%m,��
0 Gti rr O' Pcrt, �' �i.rvi/��� 0�r�7.
).
�
° ' �l/ [if ����lr,S Go.-►����i�ric�
W
�
Q
�
W
�
W
�
�
�
W WORK SATISFACTORY:PFiOCEED PROJECT COMPLETE
O
� CORRECT YMORK a PROCEED ISSUE CERTIFlCATE OF OCCUPANC�
W
O ❑CORRECT VMORK,CALL FOR REINSPECTION TEMPOFiARY
V BEFORECONERINf3 PERMANENT
❑OORRECT UNSAFE OONDITION WRHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED
❑INSPECTION REOUIRED.CALL TO ARRAN(3E ACCESS.
Csfl forthe next inspectfon 24 hours in advance. (952) 249-4800
OwnerlContractor on site:
inspector: �"'-/� L.•
Whlts CopyAnspscto►'s FIN C�nary Cop�dBM�Notfa