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Home My WebLink About2012-01194 - plumbing I � CITY OF ORONO * z 0 1 z - 0 1 1 9 * , 2750 KELLEY PARKWAY DATE ISSUED: 1U2U201�2 ` ORONO,MN 55356- (952) 249-4600 FAX: .(952)249-4616 � ADDRESS : 3155 JAMESTOWN RD PIN : 28-11!8-23-33-0012 LEGAL DESC : CAMELOT : LOTi 001 BLOCK 001 PERMIT TYPE : PLLIMBING(>$500) I PROPERTY TYPE : RE3IDENTIAL CONSTRUCTION TYPE : FIJ�TURES-MULTIPLE NOTE: KITCHEN SINK-(2) DISPOSAL-(1) DISHWASHER-(1) VALUATION OF PLUMBING 2500 ' i i � � i APPL CANT PLUMBING FIXTURE FEE 50.00 FREEDOM MECHANICAL STATE SURCHARGE PLBG(VALUATION) 1.25 8382 172ND AVE SE BECKER,MN 55308- TOTAL i 51.25 (612)363-6190 Minnesota State License#: (�04042PM i NER � DECUBELLIS,KENNET &JENNIFER � 3155 JAMESTOWN RD i LONG LAKE,MN 55356+ i i AGREEMENT A�TD SWORN STATEMENT The work for which this perm�t is issued shall be performed according to � the approved plans and speci�ations,applicable City approvals,and the State Building Code. This pe it is for only the work described and does not grant permission for addi ional or related work which requires separate permits. All provisions of la�s and ordinances governing this type of work � shall be compied with whet r or not specified herein.This permit will � expire and become null and�oid if construction authorized is not commenced within 180 day$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 responsiblt for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at an e f due,c�ause/ i�i'i��%�C� // l 7/l !-2 /� l 2/ l/ Z.- Applicant Permitee Signature Date Is u By Signature Date SEPARATE PERMITS RFQUIRED FOR WORK OTHER THAN DESCRIBED ABO E. FOR 'ITY SE ONLY O¢D�O City of Orono �� -: ao�a- ��'� P.O.Box 66 Date Receive : ermrt# 2750 Kelley Parkway .� � u� �. Crystal Bay,MN SS323 Approved By: Amount$: �� s� '' `c` (952)249-4600—Main �axo� (952)249-4616—Fax � CITY OF ORONO-PLUMBING PERMIT �J� �" �o� (All Commercial Permits Must be Approved by the State Prior to City Approval) Iii( , �:��s3.l.fl��l.t11t7.�'sr�,��? iY.i13i� '�,d�Df;. � GENERAL INFORMATION I. 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 UNT1L YOU RECEIVE A PERMIT. WORK MUST NOT BEG1N UNTIL THE PERMIT CARD IS POSTED ON THE JOB S1TE. 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 invoived,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 A 1 ,,�Residential ❑Commercial(Approval Required) ❑ New �Additional ❑Repairs ❑Replace ❑ In Accessory Structure? *You will need arior anproval and may need��_P.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: ��5 �/ar`C S �C�«''� �C'X Owner: ��C_:-�.b C.�( i S 1Vlailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �recQe.�� (��e�-.�c�� Contact Person: 1 C'��-- Address: �3�f� /�,��P .�t.IG S� State Bond#: City: �e�� Zip:,S-S7�.g Expiration Date: Phone: �,��- -�� 1- ��1�� Alternate Phone: ❑ Insurance-Current: 1 . i '� II�. �� .,�i..,�,aa'� Tt n.,t��. .'. � F XTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTI-IER E FL FL TYPE FL FL er Closet Floor Drains Lavatory Sewer Ejector Ba�thtub Laundry Tray Sh wer Washer Ki chen Sink n Water Heater d Di�posal I Water Softener II Di�hwasher � Wet Bar Sill ocks Miscellaneous I I � *r_. ,.�� ._�� ;�;, ❑ I Yes,this section applies I The teplacement of only one Residential fixture or annliance that meets all three of the following I requ�rements: I 1. Does not require modification to electrical or gas service. �I I2. Has a total cost of$500.00 or less;excludine the cost of tlie fixture or appliance:and I 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractar. Skip next section,if this applies; Cost of Permit $ 15. I State Surcharge $ 5.0 Mail-In Fee(If Applicable) $ Total Permit Fee $� (Pern�it Fees Continued On Negt Page) � 2 I �I . • � gt�..J�(C�� . If above dces not apply;follow guide(ines below: 1. �ONTRACT PRICE *is 1.25%of contract price with a(Minimum Fe.e of$50.011) oa o'��cSbC7 x.0125$ �� (contract price) (mioimem sso.00) I 2. STATE SURCHARGE I x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 ' --�— 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S . *i CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged $'or the �ermitted work including materials,labor,profit,and other fix�costs. It is the amount to be c�arged tb the customer for the work done. If any material, equipment,labor or installations are furnis ed by �he owner,tenant or any other party,the reasonable market value of such items must be add to the ¢stimated cost or contract price for permit fee purposes. In the event that there is a dispute�on the pmount of the job cost, the City may request the submission of a signed copy of the actual c ntract. Tt�e undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees � do all wqrk in strict accordance with the ordinances of the City and the regulations of the�State of Mnnnesota, and certifies that all statements made on this application aze complete, �rue and cqnect. � Applicant's Signature: Date: ��'�� a a ,� �y._ v}$ � � - :�- �� ' . , I .�,��` ��:� .�::,�_ � i I I � I I i I � � � �I 3 r� DATE TIM I � V'I � CITY OF ORONO C'�� CALIED IN ` INSPECTION OTIC SCHEDULED '�/� PERMIT NO l —d��g LETED - ADDRESS �� OWNER � LEPH NE NO � - - 'O CONTRACTOR ��-� � DESCRIPTION � � � � 'I � � ❑ FOOTING ❑ PLUMBING I AL ❑ EXCAV/GRADIN�FILLING Q ❑ POURED WALL ❑ MECHANIC RI ❑ LAKESHOREM/ LANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL' Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTIO Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT I � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER MOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOW EMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO I v�, COMMENTS: I � I' j 0 a � 0 � W x Q � z W � W � � 1 Q��ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEf W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE F OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION - TEMPOR RY V BEFORE C�/ERING PERMAN NT ❑CORRECTUNSAFECANDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPEG70R � ❑INSPECTION REQUIRED.CALITOARRANGE ACCESS. ; Ca�1 for the next inspection 24 hours in ac�vance. (952)I249-4600 Owner/Contractor on site: Inspector. S � White Copyllnspector's Fiie Canary Copy/Site tice � �_ � . ;� / <� DATE TIME W CITY OF ORONO �iN a- i3 WSPECTION NOTICE �y' scHE�u�Eo a' '� �'�3�� PERMIT NO. �� ' I COMPLETED ADDRESS � S� �� OWNER TE EPHONE NO. CONTRACTOR � � � �: DESCRIPTION �C � � � ly ❑ FOOTING ❑ PLUMBING NA ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANIC ❑ LAKESHORE/WETLANDS � O ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAI. � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COM ENTS: � W 4 L�'C_ C'e� � � f��e � �A ✓�-,o�' � � � o �� ' l�-�r' �r-,�� . 0 � � t C v vv�,c� �� ' O t�. Q � � G �4- c � crJ I��J t'� v ti1�P W � � d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � CORRECT WORK&PROCEED r! ISSUE CERTIFICATE OF OCCUPANCY W � ❑ ORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR W4LL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice