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Home My WebLink About2015-00458 - plumbing CITY OF ORONO * Z 0 1 5 - 0 0 4 5 8 * 2750 KELLEY PARKWAY DATE ISSUED: 04/2U2015 ' � ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 4174 HIGHWOOD RD PIN : 07-117-23-44-0026 LEGAL DESC : HIGHWOOD LAKE MTKA : LOT 032 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: (3)WATER CLOSETS,(4)LAVATORIES,(2)BATHTUBS,(1)SHOWER,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER,(2) SILLCOCKS,(1)FLOOR DRAIN,(1)LAUNDRY TRAY,(1)WASHER AND(1)WATER HEATER VALUATION OF PLUMBING 10000 APPLICANT PLUMBING FIXTURE FEE 125.00 STATE SURCHARGE PLBG(VALUATION) 5.00 KAB PLUMBING LLC TOTAL 130.00 20725 196TH AVE NW Payment(s) B[G LAKE, MN 55309- CREDIT CARD 6396 130.00 Minnesota State License#: plbg-690863 OWNER LUNDE, DAVE P O BOX 4551 ST PAUL,MN 55104- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of I SO days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections are request d in conformance with the S[ate Building Code.This permit may be re y time f e . � �' 7 � " � � - - �Z� � �.� Applicant Permitee Signature Date Issued y Signature Date FOR CTI'Y USE ONLY � City of Orono � �O� P.O.Box 66 Date Received: Permit# � � 0 2750 Kelley Pazkway Crystal Bay,MN 55323 Approved By: Amount$: (952)249-4600—Main y � (952)249-4616—Fax �' �` CITY OF ORONO —PLUMBING PERMIT `�K�SHO��' (All Commercial Permits Must be Approved by the State Prior to City Approval) (P�j�'f� htt ://w��ve.dli.mn. o��/CCLD/PDF/ e lumb lanreva . df' GENERAL 1NFORMATION L 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) ❑ New ❑Additional ❑ Repairs ❑ Replace ❑ In Accessory Structure? *You will need arior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site / Owner Information: � Site Address: � � �� I�(� �1l'C�C�CJ� �r� Owner: l�L�l"� Cr 1 L U. ��r��Mailing Address: � "1G '�J� City: � �G�c� 1 Zip: G;� y Z y Home Phone: �(o� `7 7� 7 �J �b Alternate Phone: Contractox Information: Contractor: � l�/��/`f� Contact Person: �✓� V ' Address: pZ(�7�� rG'��(/�,�I�(-l.J State Bond#: �� City: Zip:��Expiration Date: ( � � 2� ,� Phone: /r�j Z �°�' � �j �/� Alternate Phone: ❑ Insurance—Current: 1 . •. � � . `°�'.�:I�SB�'G F��CUIt�S��INCr�'1�T'1�L��i�. `_. � FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet � � Floor Drains � Lavatory ` Sewer Ejector Bathtub Laundry Tray � Shower , . Washer ` � Kitchen Sink ' � Water Heater Disposal , � Water Softener Dishwasher � � Wet Bar Sillcocks � Miscellaneous � ,§ ;� `� � � , � � � � �� " � � �:�;� �u , � _ �� ,; �.v, ��. a ,,,�� .��, .r� :�t� �,r ,� w� a€rt rvx z '�� ' y �1 -.^s$+ f Y Sr`�'" M ;tk yM..; '+` . i� �io`•� '' •bh,'i`-4.� rwa'7 h "�4�~ * 5 iir.., � �. ❑ Yes,this section applies ' � . The replacement of only one Residential fixture or a�pliance that meets all three of the following requirements: 1. Does not reyuire modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next section, if this applies; Cost of Permit $ I5.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 + � � PERMIT FEE CALCULATION S —JOBS OVER$500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) /�,�� x.0125 $ (c tract price) (minimum 550.00) 2. STATESURCHARGE x.0005 $ (contract price) 3. POSTAGE&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 ordinances of the City and the regulations of the State of Minnesota, and certifies t at all statements made on this application are complete, true and correct. Applicant's Signature: Date: � `Z� � 3 �� / -- DATE TIME�, / �� CITY OF ORONO CALLED IN ' 7-� � INSPECTION N.QII.�, �,/�QSCHEDULED �'� PERMIT NO.od�Y 7" U MPL D -��S ADDRESS �� OWNER LEPHONE NO. � �✓ lq -3555 CONTRACTOR � � DESCRIPTION � �� ly ❑ FOOTING ❑ DEM I AL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ P MBI RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF LUMBING FINAL ❑ TREE REMOVAL � RADON SLAB CHANICAL RI Z ❑ ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERfCONTiiACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � J d W ❑ RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � O ECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PEf1MANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDEH POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours advance. 4 4600 OwnerlContractor on site: Inspector. w White Copyflnspector's File Canary CopylSite Notiee � � � � � � OATE TIME V CITY OF ORONO CALLED IN � INSPECTION NOTICE r_S� SCHEDULED � �ERMIT NO. "` `� {� COM�LETED ADDRESS � I � �'�`�-�'�� ►� OWNER TELEPHO� NO. �� '� J-1 j CONTRACTOR c� l m- -, �' 1 � DESCRIPTION � 11�I ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINA Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ 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 kJ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE EPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YO�YES_NO � v�i COMMENTS: —� � Y�6n� - /s l�l�Ys • o � ��l c S.0 Sc.� /•�t� -��c�4 �� . / � sG�4 l •S4•.c!J �S�C l� Cs� !Jc ✓ O � � 1r¢!.�'t v�e �d�� e�¢il fi G�,OS Q � �Jt � � � �l� . �..t4L W � J d W� ❑WORK SATISFACTORY:PROCEED �BOJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS_ ❑ pHOTOTAKEN INSPECTOR WFLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (g52) 249-460� OwnerlContractor on site: Inspector. White Copy/lnspector's File Canary CopylSite Notke