HomeMy WebLinkAbout2017-00089 - plumbing CITY OF ORONO * z 0 1 7 - 0 0 0 s 9 *
2750 KELLEY PARKWAY DATE ISSUED: OU3U2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 761 BR[DGEWATER DR
PIN : 33-118-23-12-0092
LEGAL DESC : STONEBAY SEVENTH ADD[TION
: LOT 5 BLOCK 1
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: WATER SOFTENER
VALUATION OF PLUMBING 2030
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.02
TRI COUNTY WATER CONDITIONERS MAIL-[N FEE 2.00
325 3RD AVE NW
P O BOX 65 TOTAL 53.02
HUTCH[NSON,MN 55350- Payment(s)
(320)587-2950 � CHECK 21202 53.02
OWNER
FRAYNE,GORDON&ELLEN
761 BRIDGEWATER DR
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMEIVT
The work for which this permit is issued shall be performed according ro
Ihe approved plans and specifications,applicable Ciry 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 construction authorized is not
commenced within 1 AO 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 responsible for assuring all required inspections are
requested in conformance with State Buil ' g Code.This permit may be
revoked at any time for du ause.
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Applicant Permitee Signature Date Issued y Signature Date
f p � City of Orono FOR CITY USE ONLY
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� NO��� P.O. Box 66 Date Received: � �3 ! �f ��
' 1 '' 2750 Keliey Parkway
�`, � �.;� Crystal Bay, MN 55323 Permit# � / 7 -- (�U��
%�� ;, / (952)249-4600—Main
'�'Kf�F{�f� (952)249-4616—Fax Approved By: _
Amount$: • ��
CITY OF ORONO - PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to Ciry Approval)
I�ttp://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
❑ 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: -� � �
,
Fr����Z
Owner. � Maili g ddress: �7C�1 k�l''��1�',r'Lc� �2�'' ��. 2,
City: �(���17C� Zip: ��5�(c1
Home Phone: `1� - �y- //���Alternate Phone: N/�'
Contractor Information:
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Contractor: ��i �L�L����i �G��� �13��� Contact Person: J��n
��c� ��x
Address: �� 3'����� /6�h/ Lp S State Bond #: �� � � ��c //���
City: �(_�( ��/l/ 1��� Zip: ��--�J�� Expiration Date: �� 3/ /7
Phone: ��-� - �,� '�'
���J� Alternate Phone:
(� Insurance — Current: �z�( 1 11 Z�r'1S �Y1SCl►'Z��'k�'� /��l'�C'�I ��(�-��- � �:��
Page 1
.
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Cioset Floor Drains
� Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower 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)
����/� �
�XJ , C�� x .0125 $ �� �
(contract price) (minimum $50.00)
2. STATE SURCHARGE
,���1 CX;
X .0005 $ � , ��
(contract price)
3. POSTAGE � HANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ � � �o(,
" 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 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: _ � � Date: � � 7
Building Official/ Inspector: Date:
Page 2
i � ���
TIME �
CITY OF ORONO CALLED IN �� �
INSPECTION TIC ,� SCHEDULED — -' � �
PERMIT NO. MP�ED � �
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�� ELE�� o a- a� - ��
CONTRACTOR �� �
� DESCRIPTiON � �
1y ❑ FOOTING ❑ DEMO-FINAL SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAVlGRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OMINERICONTRRCTOR TO MEET YW:_1168_NO
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� O YMORK SATISFACTORY:PROCEED �JECT COMPLETE
W ❑ppRRECT YNORK 3 PROCEED ❑ISSUE CEFiTIFlCATE OF OCCUPANCY
OD ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORE CdVERIN(3 PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER P08TED.CALL INSPECTOR �pTAT10N ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
caM ror n�e next tnspe�tion 2a no��s�n�►a�e. (952) 249-4600
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