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Home My WebLink About2014-00638 - plumbing . CITY OF ORONO * 2 0 1 4 - 0 0 6 3 8 * ; 2750 KF.LLEY PARKWAY UATE ISSUED: 06/23/2014 ORONO, MN _>5356- (952) 249-4600 FAX: (952) 249-4616 ADDRF.SS : 3350 FOX ST PIN : OS-117-23-44-0008 LEGAL DESC : PULLERTON ES"1'A"I'ES : LOT 004 BLOCK 001 PERMIT TYPE : PLUMBING (> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE NO"I'E: 1 WC, 1 LAV, 1 SHOWER, VALUATION OF PLUMBING 12500 APPLICANT PLUMBING F1X"IURE FEE 156.25 STATE SURCHARGE PLBG (VALUATION) 6.25 STEWAR"I� PLUMBING, INC MAIL-IN FEE 2.00 13025 GEORGE WEBER DR SUITE#I TOTAL 164.50 ROGERS, MN 55374 Payment(s) (763)428-1833 CHECK 12354 164.50 Minnesota State License#: pibg-PC000474,mech-MB003262 OWNER B[GOS, NANCY 3350 FOX ST LONG LAKE, MN 553�G AGREEMENT AND SWORN STATEMF.NT fhe work for which this permit is issucd shall be performcd xccording tu the approved plans and spccitications,applicable City approvals,and thc State l3uilding Code. �I�his permit is for only the work describcd and ducs nut grant pennissiun for additional or related ti�ork which roquires separatc permits. All provisions ot�la��s and ordinances goveming this type of work shall be compied with whether or not spccitied hcrein.This pemiit will expire and become null and void if construction authorized is not commenced��ithin 180 days of thc date of issuance,or if�construction is suspended for a period of 180 day�s at any time after work has commcnced. "I�he applicant is responsible for assuring all required inspections arc reques[ed in conformance N�ith the State Building Codc.This pertnit mav be revoked at any time for due cause. / l Applicant Permitee Signatw�e Date Issued Bv Sienature Date FOR CITY USE ONLY + ' O �' City of Orono P.O.Box 66 Date Received: Pertnit# /� �� 2750 Kelley Parkway Crystal Bay,MN 55323 ApProved By: Amount$: � (952)249-4600—Main 1�+ � � �- (952)249-4616—Fax � �� CITY OF ORONO-PLUMBING PERMIT ��ktsr+o��` (All Commercial Permits Must be Approved by the State Priorto City Approval) �- 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 THEJOB 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 reyuirements. 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 Structure? *You will need arior aaaroval and may need `.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: �ji�_� ' �' Site Address: ��.,� .�`� c�Q�� ,� � �^ ,� ;� -�- �1/ �- Owner: w �'' ` ' �_ Mailing Address: ;�"�� '1�: � �.., ,�. � �,, � City: r� �� Zip: �� Home Phone: Alternate Phone: Contractor Information: Contractor: , ��,,,�a;'�.C� �•'��" tactPerson: _\�'��lL1t � � Address: �� ' l�� State Bond#: '��1� �L�'� � , A a City: �`�'� � Zip��Expiration Date: � � �� , ' i � Phone: ��g��'�I� " ��1'� � Alternate Phone: ❑ Insurance-Current: 1 PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1S� 2N OTHER FIXTURE BSMT 1 T 2ND OTHER TYPE FL FL T'YPE FL FL Water Closet Floor Drains Lavatory t Sewer Ejector 1 Bathtub Laundry Tray Shower '� Washer r Kitchen Sink 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;excludin�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$50.00) �� K ��,�,�`,�_ '� .��`�l� X.ol2s$ �� .`�—; (contract price) (minimum$50.00) 2. STATE SURCHARGE �-� c�, � .-, � � �� •�� x.0005 $ ' �' (contract pnce) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ^ � �� y ■ * 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 a(1 statements made on this application are complete, true and correct. � Applicant's Signature: �/ Date: �� , � �. , !i' r 3 ��" AT TIME � CITY OF ORONO CALLED IN I�� INSPECTIO TI c� �,Q SCHEDULED � � �� PERMIT NO. `�- " COMPLETED ADDRESS �?� �X �� OWNER TELEPHONE NO.�� -�� CONTRACTOR S�r� �`�" �; DESCRIPTION �°�'�5�"^d �� W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL O MECHANICAL RI ❑ LAKESHORENVETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑ SITE INSPECTION Q O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTFiACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a ` J,,. j. j � O �. � O � W � Q � 2 W � W � j� W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � C RECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING 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 ��49-46�� OwnerlContractor on site: �� Inspector. ��y White Copyllnspector's Ffle Canary CopyfSfte Notice —_�---_..�- / �� 1 / DATE TIME V I CITY OF ORONO CALLED IN . ,,� INSPECTION NOTICE SCHEDULED � •�" PERMIT NO. ��/�rr�CCOMPLETED � � ADDRESS 1 � � ° r' OWNER TELEPHONE NO.��`�� CONTRACTOR �7 - � � �; DESCRIPTION � � � ly� ❑ FOOTiNG ❑ PLUMBING FINAL EXCAV/GRAD�NG/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI � ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIR LACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT "� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ qg� - ❑ SEPTIC I TALL ❑ HARD COVER REMOVAL PLUMBING RI ❑ SEPTI INAL � FOUNDATION/REMOVAL 2 O MEEf YOU: YES_NO � COMMENTS: � W C � _ � O � � •�� O � W � Q � � 2 � � � � � � � : � d W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑GORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION V�NTHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDEH POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 ho in adva .� 952) 249-4600 OwnerlContractor on site: spector. White Copyllnspector's File l.� Canary CopylSite Notice