HomeMy WebLinkAbout2016-01496 (plumbing-fixtures) � CITY OF ORONO * 2 0 1 6 - P1 1 4 9 6 *
2750 KELLEY PARKWAY DATE ISSUED: 11/30/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2413 CARMAN ST
PIN : 20-117-23-12-0011
LEGAL DESC : NAVARRE
: LOT 000 BLOCK 002
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NO'I'E: (2)WATER CLOSETS,(3)LAVATORIES,(1)BATHTUB,(1)SHOWER,(1)WATER HEATER
VALUATION OF PLUMBING 6500
APPLICANT PLUMBING FIXTURE FEE 81.25
STATE SURCHARGE PLBG(VALUATION) 3.25
LEGEND SERVICES, INC TOTAL 84.50
201 N MEDINA ST Payment(s)
P O BOX 382 CHECK 8190 84.50
LORETTO, MN 55357-
(763)479-5002
Minnesota State License#: mech-MB005090
OWNER
BLUTH, PETER
2413 CARMAN ST
WAYZATA, MN 55391-
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 rype of work
shall be eompied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within I RO 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 appiicant 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.
.
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Applica rmi e Signature Date 'Issued Signature Date
,,��pN� City of Orono FOR CITY USE ONLY
O� P.o. Box ss Date Received: // - �J� - 1-b
� 2750 Kelley Parkway Permit# o�� L S,� —O i �t � �
�,,.,�' � ; Crystal Bay, MN 55323
\�i ��� (952)249-4600—Main A roved B
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Amount$: � S�
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http:!/www.dli.mn.qov/CCLD/PDF/pe plumbplanrevapp.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 finro 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) [Backflow Device: �AVB ❑PVB]
❑ New �Additional •�Pr��d�T�r�� ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information:
Site Address: � `��3 C��n^�ti 5 T
Owner: t"��� �����'` Mailing Address: s� � A�"�-
City: '�✓r� ,�-s �-b��,,ti Zip:
Home Phone: `s�'3��'� �`1 Q� Alternate Phone:
Contractor Information:
Contractor: ����� ����`�s, ��-- Contact Person: �1 i��
Address: ►��' l��x 3��� State Bond #: (���yy5o I
City: L��'� '� Zip: �f 35 7 Expiration Date: 1� �i 17
Phone: ��j -'����y�� Altemate Phone:
[Q Insurance — Current: ����u i�c�+'�
���
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1sr 2No OTHER FIXTURE BSMT 1sr 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet I + Floor Drains
Lavatory ,�( I Sewer�jector
Bathtub � Laundry Tray
Shower � Washer
;�.�.,�
Kitchen Sink Water Heater Gze�
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION
1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
.�.S_
� 5��� x .0125 $ �f�
(contract price) (minimum $50.00)
2. STATE SURCHARGE
�
�= y `'�' x .0005 $ 3 � �5
(contract price)
3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00
��� 5'U
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 fumished 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 actuat 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: u� � Date: � 1 - Z � � l�
�.
Building Official/ Inspector: Date:
Pege 2
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� DATE TIME `/
CITY OF ORONO CALLED IN ��
INSPECTION NOTICEI SCHEDULED ��" �
PERMIT NO. =��-'� Y -'C l�����` COMPLETED
ADDRESS � � I � C�Ct 4'��� �� �� _
OWNER TELEPHONE 1�0.
CONTRACTOR � ��Ct ��c� �r' �c;�C�-_J
� � �l�/ . �!
� DESCRIPTION � `=�
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FI AL
Q ❑ POURED WALL �MBING RI ❑ EXCAV/GRADING/FILLING
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
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
� ❑ DEMO-SITE ❑ SEPTIC INSTALL
? dWNENCONTRACTOR TO MEET YiOIl:_YES_NO
� COMMENTS: �
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W
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERIN(i PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p p�{OTO TAKEN
INSPECTOR WILL RETURN
❑5TOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED
INSPEC710N REWIRED.CALL TO ARRANGE ACCESS.
Cafl for the next inspection 24 hours in edvance. (952) 249-4600
OwnedContractor on site:
Inspector: � ��
White CoDYAnspector's FlI� C�nary Copy1SIM Notia
��--� � � � > � � �
��� " �� DATE TIME �
CITY OF ORONO cnLLED IN T.—.
INSPECTION NOTICE SCMEDULED ��. �(, '. `''�
PERMIT NO.L�"�� �' ���� � COMPLEfED
ADDRESS 2- `-f ( >> �-�' �� r��--� � �'� `� #- _
�IyNEq TELEPHONE NO. � �' �� � ���'-z�`�
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CONTRACTOR I�� ��� �� �� � _ �'-�_� �i �_c��
� DESCRIPTION I l ' i'Y� �'� ���
4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ' PLUMBING RI ❑ EXCAV/GRADING/FILLING
"j ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
� ❑ DEMO-SITE ❑ TIC INSTALL
? OMINEq�CONTRACTOR TO MEET YW:�YES_NO
� COMMENTS:
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W �VMORK SATISFACTOAY`.P�CEED � � . O PROJECT COMpLETE
� �CORRECT WORK 8 PROCEED �7 � «��~ �s ❑ISSUE CERTIFlCATE OF OCCUPANCY
O p CpqRECT VYORK,CALL FOR REINSPECTIOEi/�?/p,.� � TEMPORARY
V BEFORE CONERIN(i ��� �j��)�vl Lf� "� �pERMANENT
❑CORRECTUNSAFECONDITIONWRHIN HOURS. p PHOTOTAKEN
INSPEC•TOR WILL RETURN �G f c+ 7I, Y'oS� pCITAjIO�ISS�ED
❑STOP ORDER POSTED.CALL INSPECTOR-��•�`CL//id ✓n '
�INSPECTION REWIRED.CALL TO ARRANGE/�CCESS. r �
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Call fo�the next inspectfon 24 hours in advance. (952) 249-4600
pwr�IContractor on sRe:
Inspector. ,.
L Canary CoDYISIM Notkx
1AThib CcDY���tor's FlI�
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DATE TIME
CITY OF ORONO LED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.2f�I(Q ('�I�� ? —
COMPLETED
ADDRESS 2� (.� � �v��V1''Y.'.e_G'� S4—
01NNER TELEPHONE NO. ��3����2
CONTRACTOR � -�� ��� °
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� DESCRIPTION ���� �� �- �
4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINO
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
W 0 AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
r � DEMO-SITE ❑ S IC INSTALL
Z O�WNBYCOKTMCTOR TO MEET 1fOU: _NO
� COMMENT�
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� ❑WiOFiK SATISFACTORY:PROCEED �JECT COMPLETE
�QOf�iECT YMOFtlC a PROCEED ❑ISSUE CERTIFICATE OF OCCURANC�
0��0 CORRECT WOPoC.CALL FOR REINSPECTION TEMPORARY
V BEFORE COVEi�NO PERMANENT
❑(�pqREC'T UNSAFE CONDI'TION WITHIN ��. O PHOTO TAKEN
INSPEG'TOR WIL.L RER/RN
❑STOP OROER P08TED.CALL INSPECTOR ❑pTATION ISSUED
❑IN3PECTION REQUIRED.CALL TO ARRAN(iE ACCESS.
csN wor u�e�ext h�spection 2�nours M�►anoe- (952) 249-4600
on site:
�nspector: � � �^�' ��
Mlhib CoP1►11nsp�Cta's FlM Can�ry Cop�dSi1�No11e�