HomeMy WebLinkAbout2016-01548 - water heater 1
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CITY OF ORONO * Z 0 1 6 - PJ 1 5 4 8 *
2750 KELLEY PARKWAY DATE ISSUED: 12/19/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 70 FERNDALE GREEN
PIN : 36-118-23-44-0007
LEGAL DESC : ALLO-RAE TERRACE
: LOT 003 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER
NOTE: WATER HEATER REPLACEMENT
VALUATION OF PLUMBING 2000
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.00
CHAMPION PLUMBING LLC MAIL-IN FEE 2.00
3670 DODD ROAD-SUITE 100
EAGAN, MN 55123- TOTAL 53.00
�� Payment(s)
Minnesota State License#: plbg-PC000308,mech-MB005365 CHECK 33807 53.00
OWNER
BELLINI,CHRISTOPHER&KELLY
70 FERNDALE GREEN
WAYZATA, MN 55391-
AGREEMEIVT 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 oniy 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 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 Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued B S'gnawre Date
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' ;��p����� City of Oror�o.. . . �j (��
O �� P.o. Box 66 RECEIVE� Date Recei edR/���%�' Y
� 2750 Kelley Parkway
,,� , � � Crystal Bay, MN 55323 DEG 1 9 2016 Permit# o►��/l�-�l
�,4 ,�, �` (952)249-4600—Main A t'Oved B
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---` CITY OF ORONO Amount$:
CITY OF ORONO - PLUIVIBING PEF�MIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.qov/CCLD/PDF/pe plumbplanrevapp.pdf
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL TNE PERMIT CARD IS
POSTED ON THE JOB SiTi t.
3. P!�,�mbing permits may be issued ONLY to !icensed p!umbinc� cnntractors and to property owners
residing in the dwelling.
4. When any new construction or remodeling is involved, a separate building permit must be obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call (952) 249-4600.
(24-48 hour notice require�)
TYPE OF PERMIT(Check All That Apply) -�
�Residential ❑ Commercial (Approval Required) [Backflow Device: ❑ AVB ❑ PVB]
❑ New ❑ Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior aaarov�l and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information:
Site Address:_ "70 f����e, G•✓s,
Owner: Ucrtb�l�,�����,�,� _Mailing Address: 7� �`��Qe�.jc- Gtrn
city: �i�'o�� zip: ?'S34 � .
Home Phone: �SZ- �13- 00$D Alternate Phone:
Contractor Information: -�
Contractor: ����i�J�bf�g ..:
PC QOQ3�8
Address: �y��_��
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�7Q�dd RQa�f .
city: ��� ������� �
❑ Insurance - Current:
Page 1
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PLUM�ING FIXi.URES BEING 1NSTALLED '
FIXTUP,E BSMT 1sT 2ND OTHEP. FIXTURE BSMT 1S' ZND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet � Floor Drains
i
Lavatory Sewer Ejector
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Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater I
Disposal Water Softener
Dishwasher Wet Bar
I
Sillcocks Miscellaneous I
PEP.MIT FEE CALCULATION
1. CO���,��C i '�lC� * is 1.25% oi contract price with a {i�len3mu;:� �e� oi���.OJ)
x .0125 $ �D • DO
(contract price) (minimum $50.00)
2, S s�T� S��'��T,nG�'
x .0005 $ �' � �
(coniract price)
3. rflS i�G� � NA�1�Ll�li� (Only on Mail-In Applications) $ 2.00
4. TOTAL i�=R��117 F�� (Add Lines 1�3 Above) $ � �3 ' � �
* rp��i RArT PR�CE nr JOB CnST .m..ear,s thA �ct��al �r estimat�d dc�ll:r amount charged fcr the
permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to
the customer for ihe work done. If any material, equipment, labor or installations are furnished by the
owner, tenant or any other party, the reasonable market value oi such items must b`e added to the
estimated cost or contract price for permit fee purposes. In the event that there is � dispute on the
amouni of the job cost, the City may request the submission of a signed copy cf the-actaal 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 regulat.ir.�s of the State of Minnesota, and
cer�ifies that all statements made o 's applicatio are complete, true and c�rrect.
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Applicant's Signature; Date: IZ I�� �b
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Building Oiiicial/ Inspector: Da�e:
Page 2
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DATE TIMF
CITY OF ORONO CALLED IN
INSPECTION NOT/ICE c.f SCHEDULED t-�� •' �+-J
PERMIT PiO. �G' ��',t � / � /COMPLETED
ADDRESS ��L� ^-��n �� 1� �'�
OWNER �'� � � TELEPHONE NO. ` S�_��3-r�c�0
CONTRACTOR
� DESCRIPTION ��'� �1�4�'�l''�—
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
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 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERlCONTRACTOR TO MEET l^�U:_YES_NO
y COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED W ECT COMPLETE
� ❑CORRECT NfORK 3 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERINO PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOFi �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector: �I.�� �
White Copyllnspector's File C�nary CopylSits Notke