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Home My WebLink About2006-P09943 - vacuum breaker PERMIT GITY�OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: po9943 Crystal Bay, Minnesota 55323 Permit Type: Vacuum Breaker (952) 249-4600 Date Issued: 6/5/2006 SITE ADDRESS: 1485 Green Trees Rd Unit# Wayzata, MN 55391 PID: 11-117-23-23-0011 DESCRIPTION: Proposed Use: Residential Permit Class: Plumbing Permit Type: Vacuum Breaker Permit Sub-type(s): Vacuum Breaker DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: RPZ valve for lawn irrigation FEE SUMMARY: Pernut Fee: $ 15.00 vaivation: $ 0.00 State Surcharge Fee: $ 0.50 Misc. Fee: $ 1.50 TOTAL FEE: $ 17.00 APPLICANT: Weld&Sons Plumbing Company,Inc. OWNER: Patricia Clouser Revocable Trust 3410 Kilmer Lane N 1485 Green Trees Rd Plymouth,MN 55441 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � �,��t--�t.� �. �9rn---Q—� APPL[CANT PERMITEE SIGNATURE UED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 s � FOR CITY USE ONLY �� City of Orono � P.O.Box 66 Date Received: Pe�mit# � �� a'!� 2750 Kelley Pazkway �� '>i�: �� Crystal Bay,MN 55323 Approved By: Amount$: �,�:y,�.� (952)249-4600 CITY OF ORONO-PLUMBING PERMIT (All Commercial permits must be approved by the Building Official or Inspector) 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 maii 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 A 1 �Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs �Replace '�;.�1,; � �' ❑ In Accessory Structure? *You will need arior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: ��(�� =� �'�� +�{C� Owner. �"�� C ��'�-S�� lYlailing Ad�ress: ,! �C.' -� (�-r�L�, 9�°,'r,� f�c,��c� c�ry: (�r��v z�p: �,�5- ��-� �, /� '� a� �i L %�_ � Home Phone: `",�'� ' ! �-�� "� �� a � Alternate Phone: �� - '�'7c' `��7�0 Contractor Information: Contractor: �"�CML� ��-^S I'�i�"'t�'•�^y Contact Person: I �r+-. S�'f 0� , > J � `I Address: ��1 U �-�(��^�r- L�e-�l/• State Bond#: �—�f� '-�� , � City: j �Nl��t''� Zip.-�i�(�(� Expiration Date: R =--�> t �� Phone: �(� '�-�� `�G Alternate Phone: �� -��-��7�� Insurance-Cunent: ��'�w'� ,�n5. 1 ��c �„ �' ,��, �� l 'c a �..-�� : , : -_' . �• . �r ,d .. : , . .�:��. .., ;. . , ,., .. _. .e _ ��s a��.��, , ,.�•��,..,,- FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathroom Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous I f�('� � PERMIT FEE CALGULATICIN(S) � BASED OFF-2002 STATE 5TAT"C,TE ;';` . �`- �� f Yes,this section applies / The replacement of a 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;excludins the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ I5.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 1.50 Total Permit Fee $ � 7,�v (Permit Fees Continued On Next Page) 2 , � � �...�.- ULATIUN S � . : .' . .Ob ` .��,.�.��.... If above dces not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25°/a of contract price with a(Minimum Fee of$35.00) x.0125$ (contract price) (minimum$35.00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surchatge(Minimum Fee of$.50) x.0005 $ (contract price) (mioimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 __ 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 owoer,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. ■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is geater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. ,sx �� ''� ';� 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 conect. Applica.-�t's Sign�ture: �^ �N�ic-(/', Date: �l�r�� , �� µi �oe ,��{� 'µ::- A,r�'..', .. �.� ld � ... . . . 3 � �'� /�l US� Date WELD & SONS PLUMBING CO. 3410 Kilmer Lane North Plymouth, MN 55441 (763) 475-0296 Fax (763)475-2566 AP,PUGATION FOR�BACKFLOW PREVENTOR TEST REPORT .108 Ai�DFESS:(BLDCi�) (STREET NAME) (AVE�ST�BLVD�PKWY�ETC) (DIHECTiON N E.S.w,N.E S.E; ,9lOG NAME) ! '' , ( � � - ,- � .;, � ,,i . ; � ± ;r,;,, 1'`'1 v� , `7 i`"'( I OWNER/OCCUPAHT: DESCHIPTION OF WO K: � _ �1 ' -�! � „ �=� � i' � � `, ;�>''� �. �;J'-��'��' �INSTALL u ALTER fiEPAIR u HEPtACE CONTACT P RSON: S V W F `��htl`�'-Z- L,_t;tu�.�;/� i f� ;� `�^. - '{�✓t DEVICE L ATION: ��1�C�d�'i��"� KE: i • MOOEL: SIZE: SERIAL NUMBER: v\1!.�.- t"`. { ; �'� . .._ E jc �!C) ��;.•,...vt; � :� r t.i�`:�-w��r ALl A , 6 MAUT ATE(AAONTH,OAY 8 Y A ): MONTM,DAY 6 VEAR�: ` •" 11 d �• I �� -! � .i � �� ._ �`../ 'v . .T.. ✓"1 ! l.l CHECK VALVE CHECK VALVE PRES.DIF.ACROSS PRES.Dlf.WMEN STqAINER NUMBER 1 NUMBER 2 NUMBER 1 CMECK RELIEF OPENS TEST BEFORE ❑ �EAKED ❑ �AKED n NONE REPAIRS � CLOSED ❑ CLOSED PS� ps� J �; CLNO FINAL TEST �-� CLOSEO - � CLOSED - PSI � y PSI ��/�-�� -,� � .� �,� h.. ^ � DESCRIBEREPAIH: �� h;��'� � � � �� ,�(�� '� .;t,�- :,,�,r� Y, -.t-f} � �� , � �ti`� �:�^, ��r`� �� <�;,`e{-'c� �'-��f ;-« � �-rCs."✓\ ( Cf ��' _' _�.___ f ESTIMATED COMPLET�ON TO AL ALU � p , M� ! � � L/ � t, � L ' s��L' �-' S s S ��a M A A � � �� LI A I N. 1,i `-�t 1.�i� a�✓�`> ','("G(.�-��;�n;. _' r1 C. , AUTH.SK3NATURE � 'i �� li :.i MPANY STREET ADDRESS: , _ � -v��- � � � .- �/ '� i / i l'C-� �l, r{k^n.��- �:v��' �j�i � '.�-1,:. ( i �YLtiLi 1�1�a'_ arv `�`� ' , �' '('•''-� � �A:} �v� `�' `�C� l(�-� � ?C,`' '_� ;�-� c ��, � �-�i i ` �f ?��f�;1 r ��Y � DATE TIME � CITY OF ORONO ' �A��E�iN 6-Z/ INSPECTION N TIC SCHEDULED �� PERMIT NO. �g 3 COMPLETED ADDRESS �`�n 5 (�1-P��,'`. �P_PS /-�� OWNER_/.�,��C4 �� CONTR. IUP�LO� '� ��1N-O TELEPHONE NO. 952- q �5 9��9 � DESCRIPTION �� V�� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAI 14 SEWER HOOK-UP 06 PROGRESS � 07 OEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP Q = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � J O a � O � W � Q � Z W � W � j d W WORK SATISFACTORY:PROCEED �; PROJECT COMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ^7 CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR � INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (J52� 249-46�� OwnedContra�teren i e: Inspector. - � White Copyllnspector's File Canary CopylSite Notice r �` �,�=