HomeMy WebLinkAbout2016-01483 (plumbing-fixtures) CITY OF ORONO * z 0 1 6 - 0 1 4 8�
2750 KELLEY PARKWAY DATE ISSUED: 1U28/2016
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2480 CASCO POINT RD
PIN : 20-117-23-21-0037
LEGAL DESC : TILLSONS VILLA CARMAN
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCT[ON TYPE : FIXTURES-MULTIPLE
NOTE: NEW:5 WATER CLOSETS,7 LAVATORY,2 BATHTUB,2 SHOWER,2 KITCHEN S[NK, 1 DISPOSAL, 1 DISHWASHER,3
SILLCOCKS,3 FLOOR DRA[NS,
1 SEWER EJECTOR, 1 WASHER,2 WATER HEATER 1 WATER SOFTNER, 1 WET BAR
VALUATION OF PLUMBING 64700
APPLICANT PLUMBING FIXTURE FEE 808.75
STATE SURCHARGE PLBG(VALUATION) 32.35
HOSS PLUMBING LLC TOTAL 841.10
3445 ERIK AVE SW Payment(s)
WAVERLY, MN 55390- CREDIT CARD 7157 841.10
(612)290-1368
Minnesota State License#:plbg-PC668034
OWNER
RUDOLPH, STEPHEN &SUSAN
2480 CASCO PT RD
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 type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if constraction 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 respgnsible for assuring all ired inspections are
requested in conf� with the State ild' g Code.This permit may be �/
revoked at a�� for due cause. (J��
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pplicant Permitee na ure Date Issued By 5ignature Date �
�p� City of Orono FOR CITY US ONLY
O P.O. Box 66 Date Received: �l �2 l�
2750 Kelley Parkway
� � Crystal Bay, MN 55323 Permit# � �t„ •— [�/�g
�F c,` (952)249-4600–Main � ��
• `qkfSHO�� (g52)249-4616–Fax Approved By:
Amount$: �%�i � u
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 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) [Backflow Device: ❑AVB ❑ PVB]
)�] New �Additional ❑ Repairs ❑ Replace
1/
❑ 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���� C'`���C� ���/1`� f�I��
Owner: � �5�.n � `�� ��-r!�" Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ��SS �/Ur�I JS���1 /�C Contact Person: J�`U/l�-S �� G'�O,�
Address:���� G�'K ��'�' S�� State Bond #: �� ���D��
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City:l,t�f�I�'e/'I J' �'"�/1� Zip:-5� -� � Expiration Date: �� --7'�-�7
Phone: (Dl,� -�/� '- 1��� Alternate Phone:
�f Insurance - Current:
Page 1
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT �sr 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
..
Water Closet ,� I Floor Drains �
Lavatory � v7 p� Sewer Ejector
Bathtub � Laundry Tray
Shower i � Washer `
Kitchen Sink � Water Heater �
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)
�vl% 7DD� ��
� x .0125 $
(contract price) (minimum $50.00)
2. STATE SURCHARGE
x .0005 $
(contract price)
3. POSTAGE 8� 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 ordina e of the City a the regulations of the State of Minnesota, and
certifies that all statements ma thisrapplicatio re complete, true and correct.
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Applicant's Signature� Date:
�������
Building Official/ Inspector: Date:
Page 2
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DATE TIME
CITY OF ORONO �N / _���
INSPECTION N TIC _D �g- scH�uLED -� �
PERMIT NO. � COMP ED
ADDRESS � � '-"' �
OWNER TELEPHONE NO. � G ^l3�'
CONTRACTOR
��' DESCRIPTION
❑ FOOTING ❑ DEMO F AL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
❑ 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
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNEAlCOKTAACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� KSATISFACTORY:PFiOCEED O PRWECTCOMPLETE
W ❑ RRECT WORK 6 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERIN(3 PERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDEH POSTED.CALL INSPECTOR �GTATION ISSUED
❑INSPECTiON REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspectfon 24 hours in advance. (952) 249-4600
OwnedContractw on site:
Inspector�C��L-�
WMts CopyRnspactor'a Flk C�nary CopylSib Nodes
�� �DATE TIME
CITY OF ORONO cnLLED IN �
INSPECTION OTICE u SCHEDULED � �
PERMIT NO. ��` — O � �" � COMPLETED
ADDRESS 2 �� C�S�C� �°� '`�.
�NNER TELEPHONE NO.�� �� ' ���'
CONTRACTOR ���� �� • ��
�, DESCRIPTION ^'��� � G•
4~j ❑ FOOTING ❑ DEM -FINAL ❑ SEPTIC FINAL
� ❑ 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 ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOL�OW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
� ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICOI�ITRACTOR TO MEET YWl:_YES_NO
� COMMENT'�
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� WORKSATISFACTORY`.PHOCEED ❑PROJECT COMPLETE
W CORRECT WORK d�PROCEED O ISSUE CERTIFICATE OF OCCUPIANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECdVERING PERMANENT
❑CORRECTUNSAFECONDtT10NWRHIN HOURS. p pF{OTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952) 249-4600
OwnerlCorrtractor on site:
Inspector: /'�Q•�� li.
YYhite CcPYMapscto�'S Ffl� C�nary CopylSib Nodee
DATE TIME
CITY OF ORONO CALLED IN !— 5
INSPECTION T/77__ SCHEDULED -�
PERMIT NO. ��� C 'LEI-ED
ADDRESS LQ.t)T P+
/I ' 90"/3�a
OWNER bit A � EPHONE NO.E .
CONTRACTOR P1 i ` / S
DESCRIPTION Pi b kt_at_
W ❑ FOOTING 0 DEMO-AL 0 SEPTIC FINAL
❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
Q ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL
❑ LATHE 0 MECHANICAL RI ❑ SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
is ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
❑ AS BUILT-SURVEY 0 SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
❑ DEMO-SITE 0 SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
LI COMMENTS: G 1/ ,p/ $
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LuWORK SATISFACTORY:PROCEED CIPROJECT COMPLETE
W ❑CORRECT WORK&PROCEED LI ISSUE CERTIFICATE OF OCCUPANCY
CI 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
O
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. v TjB'i he C
White Copy/Inspector's File Canary Copy/Site Notice