HomeMy WebLinkAbout2013-00595 - expired permit ' ' j CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 3 - P1 5 9 5 *
DATE ISSUE : 07/Ol/2013
' ORONO, MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 3175 JAMESTOWN RD
PIN : 28-118-23-33-0014
LEGAL DESC : LIBERTY ACRES 2ND ADDN I
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER I
NOTE: WATERHEATER n �
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APPL CANT PLUMBING FIXTURE FEE(<$500) 15.00
CHAMPION PLUMBING LL�C STATE SURCHARGE PLBG(<$500) 5.00
3670 DODD ROAD- SUITE 100 'i
EAGAN,MN 55123- MAIL-IN FEE 2.00
�� TOTAL I 22.00
OWAIER
RILEY,NEIL&STEPHANIE I
3175 JAMESTOWN RD
LONG LAKE,MN 55356- I
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to ,
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is fQr only the work described and does
not grant permission for additional or telated work which requires separate I
permits. All provisions of laws and ohdinances goveming this type of work
shall be compied with whether or not Specified herein.This permit wi11 I
expire and become null and void if comstruction authorized is not
commenced within 180 days of the date of issuance,or if construction is I
suspended for a period of 180 days at�ny time aRer work has commenced.
The applicant is responsible for assuri{�g all required inspections aze
requested in conformance with the Sta�te Building Code.This permit may be
revoked at any time for due cause.
��c.��( ) ; � / � /3 � !
Applicant Permitee Sign re Date Issu y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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' �.EEt�iE�
�� ' �oty Ofr�COiz�JUN 2 8 2013 FOR C Y USE ONLY
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Date Receive� Pennit# ��3—
� ; 2750 Kelley���OF ORONO �Z�
a � 7 '�' Cn'stal Bay, � 3 Approved By, - Amount$:�
•�'t �;: , c� (952)249-4600—Main
`�k�so�%% (9�'_)?49-4616—Fax
C�'�'�' �I�t+' �'T��I�T�—�I�..�Tl@/���TG �`+��'L�`�'
` (All Commercial Permit �
s
1F�Letst be�.p�roved by�&�e�tate Prior to City Approval)
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GENERAL INFORMATION
1. You ma}�apply for plumbing permits by mail or in person at the City offices. Applications will be �
revie�ued and a permit wil]be issued within two working days.
2. Peipl�it cards will be sent by retum mail after a review is completed. PERMTTS ARE NOT
VA;LID UNTIL YOU RECEIVE A PERMIT. Vi'�RfiC 1��JST 1'd�T��GbFd UlV�'PL Ti'E1�L I
�E�21VEkT CQ,RFJ pS�Q�STEg3�N TFb�SOB SY'F�
3. Plumbing perni�ts may be issued ONLY to licensed plumbin�contractors and to property owners I
residi��g in t"e dwelling.
4. W�ien any new construction or remodeling is involved,a separate buiIding permit must be
obtained.
� 5. All worlc must be done in accordance with State Code requirements.
6. All work must be ins ected and air tested �
p before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT �
Check Al1 That A ly j
�Residential ❑Commercial(Approval Required) I
❑New ❑Additional
❑Repairs ❑ Replace �
❑ In Accessory Structure? �
rYou wilf need r�rior anprova[and may need CL�P.(Per Orono City Code,Chapter 78,Article IV) i
Job Site/Ow�ner Information: i
Site Address: `�'l ������ �(;, �I
Owner: � \, Mailing Address: S,�SL I
��ri� z�p: �3S�P
, Home Phone; ' �21Q Alternate Phone:
Contractor Information: '
` � I
Contractor: �r�/�ct Person: I
r1 L1
Address: D 1� State Bond#: b
City: Zi�,�� xpiration Date: 1 J�� II
� �
Phone: �Il � (� Alternate Phone:
�' ❑ Insurance-Current:
1
; I �j(�
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PLU1vIBING FIXTURES BEII�G II�tSTALLED; � ;'
FIX RE BSMT 1 2�` OTHER FIXTURE BSMT 1 2 OT ER
TZ'P� FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathti�b Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar '
Si]icocks • Miscellaneous
:� "PERMI'T�EE CALCU�,AT'ION(.S)
,,
BASED OFF-;2002 STATE ST�TUE.. ::
� Yes,this section applies
The replacement of on6y one Residential ftarture or a�pliance that meets all three of the followin,;
requiraments:
l. 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. (s improved,installed or replaced by the homeowner or licensed plumbin�contractor.
� Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00 '
7'otal Perntit 1�ee $��!
(Perrt�it�ees Cootti��ed�n I'�Iext P��e)
2
•
, _ PERMIT FEE�AL�UL�4TIE�N� -3Q$�OVER$�04.00 ,
If above doe5 not apply;follow guidelines below:
l. CON'b'Ft„�,C7f'Pk���� *is ].25%of contract price with a(l��neanuan�'ee of�50.06h)
x.0125$
, (contract price) (minimum�50.00)
2. STAT�S�JFLC'��S.F��E
x.0005 $
' (contract price) I
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4• �'l�I'T�,F�PE��T�'E�(Add Lines 1-3 Above) �
° * CONTRAC l PRiCE or JOB COST means the actual or estimated dollar amount charged for the
permitted worlc including materials, labor,profit,and other fixed costs. It is the amount to be charged
to the c�$tomer for the work done. If any material equipment,labor or installations are furnished by
the owner, tenant or any other party,the reasonable market value of such items must be added to the
estimated cost or conh•act price for permit fee purposes. In the event that there is a dispute on the
amount of the job cost,the City may request the submission of a signed copy of the actual contract.
° '"�The SfiATE SURCHARGE is.0005 of the contract price under$],000,000 or$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
� PLUIVIBI�TG PERIVIIT APPLICATiON AGREEII�ENT ..�' .
The undersigrred hereby app]ies 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 Sianature: � Date:
E���et �r c��a
� ,
3
DATE TIME ✓
CITY F ORONO CALLED IN
INSP CTION NOTICE HEDULED �
PER IT NO. � � COMPLEfED ��S
J����ADDF�ESS �I ?S �4w�.-a���. �CIZ_
1 OWN�R TELEPHONE NO.
CONTRACTOR �' ��d��nn ��
j DESQRIPTION �Q�e r' !/�ti ��
� ❑ FOOTING �LUMBING FINAL ❑ EXCAV/GRADING/FIWNG
Q ❑ POURED WALL ❑ MECHANICAL RI 0 LAKESHORE/WETIANDS
y p FRApAING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSI�ATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADpN SLAB O WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMfJ-SITE ❑ SEPTIC MAINT. FOLLOW-UP
_ ❑ DEMp-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER�CONTRACTOR TO MEET YOU:_YES_NO
� COMI�AENTS:
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� O WOF�KSATISFACTORY:PROCEED ❑PROJECT COMPLETE
� ❑COF�RECT WORK&PROCEED ❑ISSUE CERTiFICATE OF OCCUPANCY
O ❑CO ECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEF RECOVERING PERMANENT
❑CO RECT UNSAFE CONDITiON WITHIN HOURS. ❑pHOTO TAKEN
'INSPECTOR WILL REfURN
' ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
�NS�ECTION REQUIRED.CALL TO ARRANGE ACCESS.
�� �
Ca11 for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. ��--
White Copyllnspector's File Canary CopylSke Notiee