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Home My WebLink About2012-00032 - plumbing ' CITY OF ORONO PERMIT NO.: 2012-00032 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: OU13/2012 952 249-4600 FAX: 952 249-4616 ADDRESS : 2905 FOX ST PIN : 04-117-23-34-0007 LEGAL DESC : AUDITOR'S SUBD.NO.230 : LOT 035 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RES[DENTIAL COIVSTRUCTION TYPE : FIXTURES-MULTIPLE NOIE: E3ASEMEN"1': I WC, 1 LAV. 1 DISPOSAL, 1 F3AR S[NK, 1 WET BAR FINISH I,L BAR&BATH-RI 2 YEARS AGO VALUATION OF PLUMBING 2100 APPLICANT PLUMBING FIXTURE FEE 50.00 FREEDOM MECHANICAL STATE SURCHARGE PLBG(VALUATION) 1.05 1 1 135 HWY. 7 WATERTOWN, MN 55388 TOTAL 51.05 (612)363-6198 PAID WITH CC# 4420 Minnesota State License#: 004042PM OWNER FRANCIS, MICHAEL& BERIT 2905 FOX ST LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT I'he�vork for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State Build�ng Code. This pennit is for only the work described and does not grant permission for additional or rclated work which requires separa[e permits. All provisions of laws and ordinances goveming this type of work shall be compied��-ith whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced wi[hin 180 days of the date of issuance,or if construction is suspended f'or a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requeste i conformance with[he State Building Code.This permit may be revo� d a ny { e T�r e cau l �--��i�� l l3 � /� � �� Applicant Permitee Signature Date Issued By Sig a re Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . 4 I � FOR CITY USE ONLY City of Orono (�40�0 P.O.Box 66 Date Received: Permit# �;t 2750 Kelley Parkway �� ?�� Crystal Bay,MN 55323 Approved By: Amount$: \t-',I��N"�'.G` (952)249-4600—Main '+@°gRHA$� (952)249-46]6—Fax CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Priar to City Approval) htt ://ww�v.dli.�nn.�ov/CCLD/PDF/�e lumb lanreva . df GENERAL 1NF'ORMATION 1. You may apply far plumbing permits by mail or in person at the City offices. Applications will be reviewed and a perniit 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 LINTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMI7'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) 0 Residential ❑ Commercial(Approval Required) �New ❑ Additional ❑ Repairs ❑Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/ O�mer Information: Site Address: vZ ��}J f��k S T r' Owner: _��yvc_/S� Mailing Address: City: ��_..a�.��-L;� Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: l-2�e��•� r��G� Contact Person: G�� /��c,� Address: �,�� / �'�� S� State Bond#: City: �lL�'/? Zip:�,Qvf; Expiration Date: %� -3/ - /� Phone: �� ..3v� 3 �f%E1 Alternate Phone: 2r f� �'G�7 ��'�� C�`� (Y�� -� �l�V �r�� Insurance- Current: 1 � • ' ' PLUMBING FTXTURES BEING INSTALLED' FIXTURE BSMT 1 2' OTHER FIXTURE BSMT 1 2` OTHER TYPE FL FL TYPE FL FL Water Closet / Flo or Drains l Lavatory � Sewer Ejector Bathtub Laundry Tray Shower Washer K�chen Sink � Water Heater �� Disposal � / Water Softener ( Dishwasher Wet Bar � Sillcocks Miscellaneous F.�r�� ,,� � �,��- �-'� �Y��S .�-�� ' � �� PERMIT FEE CALCULATION(S) '�� BASED QFF -2002 STATE STATUE I ❑ 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 f r , ' ' PERMIT FEE CALCULATIQN S `-70BS O�:ER$��Q'Ofl , . If above does not apply; follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) ��l�C"�. ��L x.0125 $ (contractprice) (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 pernut 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 coniract. � �.�. ��.� ��?LL:��r�"�?�R�I�I��y .� �.?LIC�1"��AGREEM:E F ��.E �ra � ..M <: .�,.��. ,.��. � � � �_ . �. � f . �. ... . . � � �; The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all wark 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. j� � Applicant's Signature: _�j� C�' �',�� -Cr Date: ��/��1� 3 / � 5 CJ �� r DATE TIME CITY OF ORONO �' CALLED IN 8�/�/�' INSPECTION NOTICE SCHEDULED �l- (a �6 .` � PERMIT NO. �/� - ud G 3� COMPLETED ADDRESS �9�� `X �-� OWNER �'/1 %-►�-�� TELEPHONE NO. CONTRACTOR ��tie'�_�� G��L.-e,� >: DESCRIPTION ��'c' � � ❑ FOOTING �PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ 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 FI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTORTOMEETYOU:�CYES_NO � COMMENTS: � W C � � O �. � O � W � Q � Z W � W � 1 � GW ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORREC7UNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN 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. �952� 249-46QQ OwnerlContractor on site: � Inspector. White Copyllnspector's File Canary CopylSite Notice � � �� DATE TIME V CITY OF ORONO CALLED IN � INSPECTION NOTIC SCHEDULED � Z ,/O.'d� PERMIT N0. �� OGYJ.3� c PLETED ADDRESS a�'I D S s�/�� OWNER TELEPHONENO. f��3-��d" CONTRACTOR��-��yYc �L ��.1� >: DESCRIPTION D � � � ❑ FOOTING ❑ PLU I G FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W � o � � � � ti� � a � 0 � W � Q � Z W � W � j d ��JORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-4600 OwnerlContractor on s'te: Inspector. . White Copyllnspector's File Canary CopylSite Notice