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Home My WebLink About2015-00534 - plumbing , CITY OF ORONO * Z 0 1 5 - 0 0 5 3 4 * ,, 2750 KELLEY PARKWAY DATE ISSUED: OS/04/2015 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 335 HOLLANDER RD PIN : 25-118-23-43-0009 LEGAL DESC : REG. LAND SURVEY NO. 1429 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 STATE SURCHARGE PLBG(<$500) 5.00 APPLIANCE CONNECTIONS, INC. MAIL-IN FEE 2.00 12850 CHESTNUT BLVD SHAKOPEE,MN 55379- TOTAL 22.00 (952)445-4803 Payment(s) Minnesota State License#: mech-MB004165 CHECK 6459 22.00 OWNER ERICKSON,WALTER&NANCY 335 HOLLANDER RD WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if cons[ruction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance wi[h the State Building Code.This permit may be revoked at any time for due cause. /r,!n /Uy ' , � � ��t ( ��'Y�C..��`� � � ��/ � � �, Applicant Permitee S' nat re Date Issued By Signature Date FOR CTTY USE ONLY � A� City of Orono �7 �,j/ ¢O`r P.O.Bor 66 Date Received: � �I��Permit# L (�� aj `�,., � 275U Kelley Parkw�ay I � (,� a�� ',' x� � Crystal Bay,MN 5532; � Appro��ed By: _j�'�' Amount$:_� '"t '• o` (952)249-4600—Main �4�,a�aof�.. � (95_)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval : .� '1 , . .. �r €� T ;..� i ' .. 5 ;a�� 3 HC (�:' 1\�:ii.� �vaat.;�iit �� r €_ '}�� : ' i 6tiX',3rg3E:H - �1.� )J. )�'�{ 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 RECEIV�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 piumbing coniractors and to property owners residing in the dwelling. 4. �n%hen any new cuns�ruction ar re��o�leiing is invoiveu,n separate buiiding 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 ❑ Tn Aceessory Structure? *You will need prior approval and may need,(;t't'.(Per Orono City Code,Chapter 78,Article I� Job Site/Owner Information: Site Address: �J � �('� /1� �/�� ' Owner:( G?/y�/i�� YI C K.-c�G� Mailing Address: J �� fy�Ol IG✓� `�� ,: �� c� _ Z�p: � 5�3�_l Home Phone: 7 5 a � 7 � �O I�� Alternate Phone: �Q j d� �J 9 � c� �a� Contractor Information: Contractor: ��S ��Contact Person: �� Zs�o cn�st�,uc Bn�d. ,. Address: __��379 State Bond#: �� g Ciry: r . ' 952-4.45��8,03 Expiration Date: Phone: Alternate Phone: ❑ Insurance—Current: . 1 • . 9 . <�' PLUMBING FIXTURES BEiNG INSTALLED ,' FIXTURE BSMT 1 2 OTHER FIXTURE BSMT ls 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 . PERMIT FEE CALCULATION(S) ." � BASED OFF -2p02 STATE STATUE [� Yes,this section 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;excludine 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 Pemrit� $ 15.00 State Surcharge $ ''S.00 Mai1-In Fee(If Applicable) $ 2.00 Total Permit Fee $�, c")� :r , (Permit Fees Continued OnNext Page) , 2 , , , . If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of conttact price with a(Minimum Fee of$50.OQ) . x.0125$ (conVact price) . (muiimum 550.00) i � 2. STATE SURCHARGE •*Add the State Bldg Code Div.Surcharge(Minimum Fee of 55.00) ' � x.0005 $ � (contract price) ' (minimum S s.00) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PER1bITT FEE(Add t.inss 1-3 Above) $ V • * CONTRACf PRICE or JOB COST means the actual or estimated dollar amount charg,ed for the permitted yvork including materials,labor,profit,and omer 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 owner,tenazrt or any other party,tlie reasonable market value of such items must be added to the estimated cost or conttact 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 55.00—whichever is greater. For valaations over 51,000,000 call the Building Department at(952)249-4600 for the price. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do a11 work in strict accordance with the ordinances of the City and the regulations of the Staxe of Minnesota, and certifies that all statements made on this application are complete, true and correct. ' C Applicant's Signature: Date: � � �� - ` . � , � � � "� , - �.., , , � , ' • . , . _ 3 DATE TIME\f CITY OF ORONO CALLED IN �' INSPECTION NOTICE SCHEDULED PERMR NO. �� ' Do,��?Sr COMPLETED �.�5 /a• 'o� ADDRESS 3 33 /ti�of/�•�r�e•� �. OWNER TELEPHONE NO. CONTRACTOR _�•�/��tt.�� L'Ort�2�.s�� DESCRIPTION �iv��r 6Fc.e��.� ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS ILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YiOI�L�ES_NO v�i COMMENTS: � G � �iU�er /ie�fiG✓ /'e,plAGet�ls•rfi `' j � " Q�,�I��irt c �OS ,��c � �Xt S� /�I4 /��•r.L��d�'�J� �rt?saKoc, `__ �O Q /it�vr K �'o•+�t/J/�t� — � �2 � .�ct/�Q ' �c�� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE W ❑CORRECT VYORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOMERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTiON REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 OMmerlContractor on site: Inspector: � i �'�- White Copyllnapector's File Canary CopylSffe Notice