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Home My WebLink About2011-01143 - plumbing . CITY OF ORONO PERMIT NO.: 2011-01143 f 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 09/29/2011 952 249-4600 FAX: 952 249-4616 ADDR�SS : 4195 HIGHWOOD RD PIN : 07-117-23-44-0022 LEGAL DESC : HIGHWOOD LAKE MTKA : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: FIXTURES: (2)WATER CLOSETS,(2)LAVATORIES,(2)BATHTUBS,AND(1)SHOWER VALUATION OF PLUMBING 8000 APPLICANT PLUMBING FIXTURE FEE 100.00 GRABOW PLUMBING,INC. STATE SURCHARGE PLBG(VALUATION) 4.00 8420 REDWOOD STREET TOTAL 104.00 COON RAPIDS,MN 55433 �) Minnesota State License#: 038623PM OWNER SMITH,DOUGLAS&ROBAN 4195 HIGHWOOD RD. MOLJND,MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate permits. Al(provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. ��/., cv G� . �- p i .�r i �r g ,�Z.�,L .Applicant Permitee Signature Date Issu y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � ^ #� �� p City of Orono �� ", l/ / �'¢' �� P.O.Box 66 �'.Data Re�t��d� . � � Ferrnt�� - 2750 Kelley Parkway - ' � y� Crystal Bay,MN 55323 Appr��ed By Arraeltnt$ �� (952)249-4600—Main �� ea�4 (952)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://www.dli.mn. ov/CCLD/PDF/ e lumb lanreva . df �C��;1�1�.T.,��T�3��'��T �� ` �.�� 1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Pernut 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) � -; , TYP�Q�`�'�R�3T E� � 3`�h�c��.�iat A'= 1 ) � � Residential ❑ Commercial(Approval Required) ❑ New ❑Additional ❑Repairs ❑Replace ❑ In Accessory Structure? *You will need nrior anproval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) .�o� ��e r I 3Gh�ier�£�iati Ori �� Site Address: �/9� iy:��aeo•� ,�/ Owner: .Si�i'� Mailing Address: ..r•r"� City: Zip: Home Phone: Alternate Phone: :�cr�t��ctc�r�orm�tian - Contractor: Gi�.,�w �/�� Contact Person: /��-i�a Address: gN� Re�('wooa/ t� State Bond#: /��'' /H� City: �•+� . -r ZiP',fSy�? Expiration Date: /� / 3 i � �� Phone: �3• 7 ff6 3Sf� Alternate Phone: � Insurance—Current: 1 " � ♦ 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 ❑ Yes,this secrion applies . , The replacement of only one 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;excludin¢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 $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Nezt Page) �� 2 1� If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) ��d x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE 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 fiunished 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 pernut 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 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: //'/� s✓ �• � Date: ? / R� �i� 3 S`�'�' DATE TIME ✓ CITY OF ORONO CALLED IN �'z, INSPECTION NOT CE SCHEDULED �'� � l0� � PERMIT NO.��-'�ll 5�.3 COMP�ETED ��C�"� ADDRESS OWNER TE EPHONE NO.(O� Z �� D�3Z� CONTRACTOR ��'� � >; DESCRIPTION � � � Ll! ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � o � �c� � U� � 0 � W � Q � z W � W � � � �RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED _r, ISSUE CERTIFICATE OF OCCUPANCY � ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PEAMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETl1RN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on sit : Inspector. U �� White Copyllnspector's File Canary CopylSite Notice ..J�`� / DATE TIME CITY OF ORONO CALLED IN <O `� ' INSPECTION NOTICE /(.�� SCHEDULED O-/ � �/ �3 :oD PERMIT NO.��— D�` [J COMPLETED ADDRESS `C l � �-�� /--L� OWNER TELEPHONE NO. �l�' �� CONTRACTOR �/��OZl� �� ; DESCRIPTION v �'� � � � ❑ FOOTING ❑ PLUMBING FINA ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATtON ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � '�� ' T� �I�PeJ�' f-lC�� 0 � ��t `-( 1Z. s, o K. 0 � W � Q � Z W � W � � d ,,/ W fC7`V+LQBK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on sit Inspector. White Copyllnspector's File Canary CopylSite Notice \r � � / { � � ' / ��`�.' �/ DATE , � TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED I =Lt�,S� --, PERMIT NO.'_�Ll � � C�� r� —1 COMPLETED �. -1 ADDRESS `"� I `( `"� �-" I I `1 Vl U�Y;�`�� , Tirr OWNER TELEPHONE NO.�� C�� 3� CONTRACTOR ��i"��4"�"t�"' f�Lt,�fYl�rj � I_ � �; DESCRIPTION �1�.�-��"J �� N� � � � FOOTING �MBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARO COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:�YES_NO � COMMENTS: -� � W a � � V ��/� v ��_'}-��0� .S >. o �-cJ t� � � C Ces S �S w � Q � z w � w � � a �/ W� ❑WORK SATISFACTORY:PROCEED •�PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on site: Inspector. ._ White Copyllnspector's File Canary CopylSite Notice