HomeMy WebLinkAbout2015-00052 - plumbing " t' CITY OF ORONO
* 20 15 - 00PJ52 *
2750 KELLEY PARKWAY DATE ISSUED: O1/20/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1510 GREEN TREES RD
PIN : 11-117-23-23-0015
LEGAL DESC : GREEN TREES ON TANAGER LAKE
: LOT 005 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOI�T TYPE : FIXTURE
NOTE: WATER SOFTENER REPLACEMENT
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG (<$500) 5.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345- TOTAL 22.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 22.00
OWNER
STEVENSON, SCOTT
1510 GREEN TREES 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 separa[e
permits. All provisions of Iaws 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 a[any time afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with[he Sta[e Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issue y Signature Date
U1/19'2015 13:21 FA� 9529aa5049 CULLIGAN MNTKA �002
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FOR C1TY USE ONT.Y
CiCy of Orono
O¢Q�� P.O.Box 66 pnte Rcccived: Pcrmit#
'+. 2750 Kellay Parkway
��� > A oved B Amount 5:
1� � t.!'��r�y� Crystnl Boy,MN 55323 PPr Y=
��'��, (952)2�9�600
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CITX Ok'ORON"O—PLUMBING PERMYT
(All CornmErcial permits must be epproved by[he Building Official nr Inapector)
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications wiil be
reviewed and a germit will be issuod within two working days.
2, Permit cards will be sent by rtl.vrn mail after a review is completed. PERTvIITS AR�NOT
VALID UNTIL YOU RECBIVE A PER'�11'f. 'WORK M[JST NOT BEGXN UNT'TT�TAE
PER'VIIT CARD I5 POSTED ON T�TE�OB SITE.
3. Plumbing permits may be issued ONLY to liCensed plumbing Contractors and to property ovmers
residing in thc dwelling.
4. Whcn any new conscruction or remodeling zs involved,a separ�tc building permit must be
obtained.
5. All work must be done in acoordanCe with State Code requirements_
6. All work must be inspeGied and ai�tested before it is covered. CaII(952)249�600.
(2448 Ixour notice required)
TYPE OF PERMZT
Gheck All That A 1
�Residential ❑ Commercial(Approval Required)
�]New ❑Addi1'ionsl ❑ Repairs ❑ReploCe
`
❑ Tn Accessory Structure?
#You will need priOr ApbtOWAI Sqd m0.Y tteed C�.(Per Orono City Code,Chapcer 78,Article 3v)
Job Site/Owner X���or��aation:
Site Address: 1 reA
Owner: �c.�� 5���� �'1 Mailing Address:
Ciry: Zip: .��`� �
I-�ome Phone: 15d- `I 7 I - ���5 Alternate Phone:
Contractor Information:
Cantractor: Contact Person:
CULL1GAiV WA ER C�IVDiT10NING
Addr��U �tJL�iGAI� VV',qY State Sond#:
N1! P��TO , 55945
, ���,: (952� ��3-72p0 zip: Expiration Date:
Phone: Alternate Phone: 950 �`� �a�— ����
❑ Insurance—Curr�nt:
1
01/19 2015 1a:21 FAX 9529a�5049 CULLIG9N MNTKA �003
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i �i:ici,.u ���i � "� i;� � �.a `M` ,;v .�j.��
FIXTURE BSMT 1' 2' OTFIER FIXTURE BSMT 1 2 OTI-iER
TYPE PL PL TYPE FI. FL
Watcr Closet Floor Drains
Lavatory 5ewcr EjecSor
Sathtub Laundry Tray
Shower W ashcr
Kitchen Sink Water Heatet
l�isposal Water Softener �
I,
Dishwasher Wct Bar
Sillcocks Miseellaneous
��I,.�rM1pl�"w����l�Vt�li�ih'�-.'�(�I"!r',r,!"i�r. �i°l�i"��:'1 : 4� - ,n;:'t`;:'nvn':y�.���'r•:y',,�"�'j�'�I��a�,,iH,na�m��n',1" "�'Ic��i
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❑ Yes,this section applies
The 1'eplacement of e Residrntial fixture or a�pliance that meets a11 tliree of the following requi�ements:
1_ Does not require modification to electricaf or gas serviee.
2. Has a total cost of$500.00 or less;excludin�the eost of the fixture or applianee:and
3. Is improved,installed or replaced by the�iomeowner or licensed contraetor.
5kip next seCtion,if this applies; Cost of Permit $ 15.Op
State 5urchargc $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit�'ee $
(Pcrmft I'ees Continucd On Next Page)
2
O1/19/2015 1a:22 FAT 9529a35049 CULLIGAN MNTKA 1�004
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w��q y � ,�C.���F{� ,�;�4Y,Ir������1'1��i��tix4W;� �� i.�+��S�� Y . r'���47.,��},�, .�����.�.��Y�{�'Il�,���s��;ir��.��I.^'h
lf above does not apply;follow guidelines below�
�. CONT_RA,C'X'�'AZXC� "'is I.25%of contract price wizh a(Minimum Fee of$50.00)
x.O]25$
(concracc price} (minimum$50.00)
Z. STATE SURCHARGE �*Add the State Bldg Code 177iv.Surcharge(Nlinimum�ee of55.00)
x.0005 $
{contrnct price) (minimum S 5.60)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.0�
4� TOTAL PERMIT FEE(Add Lincs 1-3 Above) $ �a. ��
■ x CONTRACT PWCE or ]OB COST means the actual or estimatcd doilar amount charged for the
pernllt[ed work including materiaIs,Iabor,profit,and other fixed costs. It is the amount to be charged
to the customer for the work done. [f any matcrial, equipment, fabor or installations are fvrnishcd by
the owner,tenant or any other party,the reasonable markct value of such items must be added to the
estim3ted cost or conttact price for permit �ee purposes. In Chc cvcnt that there is a dispute on [he
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
� *�The STATE$URCHARCrE is.0005 of the contract pricc under$1,OOQU00 or$5.00—whichevtr is
groatcr. For valuations over$1,000,000 call the Building Deparhncnt at(952)249-4600 for the priec.
a�i.�..*.y'��9 .�,���� �'.a ��ri IS4�M� �F w i � y���,�y � T Y�c�r 4�,��1�.y� �� �. .��n .q.,,,�aj���.���)i�i��1�,'J,.wa:r'�r�
i:`+'4'�.VL4 u d.1.�-a��'�in�..x.n..�1�����J1r;l.�?��`��,�`��_�.LL,l�+7?'ll,.��. ?��)l� ���iJ.;ti'��a ,t�� ��. ;i"���';� �
The undersigned hereb� applies to the CIty for issuance of a Plumbing Permit, agrees to do all
work in st�-iet aeeordance with the ordinances of the Ciry and the regulations of the State of
Minnesot� and certifies that all statements made on this application are eomplete, true and
correct.
Applicant's Signature: Date: �._�
d,,, �;i���i7�nPrzt�;;� �
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CITY OF ORONO C1ILLED IN ____.�L—
INBpECT10N NOTICE SCMEDULED
PERMIT NO.��S'60C��a._ coMa.ereo -!(�
pppp�g /b�O G re�.c, Te�s 2a��
p�WNEp TELEPHONE NO.
CONTRACTOR �sc•� �7� l���r Sm�vrc� L'�.
'' DESCRIPTION l�/�'� So�c.�t� ,•i s��"
4�j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV!(iRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Zi ❑ RADON SLAB ❑ MECHANICAI RI ❑ SITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP LON1-UP
_ ❑AS BUILT-SURVEY ❑ SEWER HOOIC-UP ❑ FOUNDATION/REMOVAL
r ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 dIMN6UCCNTAACTOR TO MEET YWJ:_YES_NO
� COMMENTSc
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� Permit has expired per MN Building Code Sec. 1300.120 subp. 11
� Expiration, no record of a Final inspection.
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W ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPIETE
� ❑�CT WOi�C 8 PROCEED ❑ISSUE CEHTIFICATE OF OC(XIPANCY
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00 ❑�CTyYDRK,CALL FOR REINSPECTION TEMPOFiARV
V BEFORE CdVERINO PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN ��• O�iOTO TAKEN
INSPEG?OR 1AfILL FETURN
❑CITATION ISSUED
❑gTpp OqOEq pOSTED.CALL INSPECTOR
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
ceN�«a�.���u n�s h�►�,o�. (952) 249-4600
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