HomeMy WebLinkAbout2016-00945 (plumbing) t 1,
CITY OF ORONO * z 0 1 6 - 0 PJ 9 4 5 *
2750 KELLEY PARKWAY DATE ISSUED: 08/10/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 525 KEENE AVE
PIN : 02-117-23-31-0027
LEGAL DESC : MINNETONKA BLUFFS
: LOT 000 BLOCK O15
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (5)WATER CLOSETS,(7)LAVATORIES,(2)BATHTUBS,(3)SHOWERS,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISPOSAL,(3)
SILLCOCKS,(1)FLOOR DRAIN,(1)LAUNDRY TRAY,(1)WASHER,(1)WATER HEATER,(1)WATER SOFTENER,(1)WET BAR
VALUATION OF PLUMBII�TG 12000
APPLICANT PLUMBING FIXTURE FEE 150.00
STATE SURCHARGE PLBG(VALUATION) 6.00
LARSON PLUMBING INC. TOTAL 156.00
3095 162ND LANE NW
ANDOVER, MN 55304 Payment(s)
(763)427-7680 CHECK 30902 156.00
Minnesota State License#: plbg-0841699
OWNER
H&J Development Prtnrshp
DETTLOFF,HB&JC
1001 TWELVE OAKS CENTER DR#10
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 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 ate Building Code.This permit may be
revoked at any tim�.fqp � a •
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plicant Permitee Signature Date Issued ignature Date
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%'�p����� City of Orono FOR CITY SE NLY
4 �°, P.O. Box 66 Date Received: � i a /b
-�i ; 2750 Kelley Parkway _�i (��
1, Crystal Bay, MN 55323 Permit# /� � T f
`•'�,\,.� �� (952)249-4600-Main A roved B :
`.-�kt'sr��"`� (952)249-4616-Fax PP Y � ,.�
Amount$: /Jr�Oi
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CITY OF ORONO - PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http:/lwww.dli.mn.aov/CCLD/PDF/pe plumbplanrevapp.pdf
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 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)
V�11Residential ❑ Commercial (Approval Required) [Backflow De�;ce: ❑AVB ❑ PVB]
�,�
�New ❑ Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information:
Site Address: �o��� .1�� C��,YLSO rl �
Owner: z�h►'�C�-�r Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �--�YSOn t'�U�Mb; rG �r�C Contact Person:
Address: ���� ��9�'� ��'1 �(11�i State Bond #: �����Y �
City: ���(`�,Y� Zip: 1nr��'1 Expiration Date:
Phone:�l�3-�') �1'��9g0 �- � Alternate Phone:
� Insurance - Current:
Page 1
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FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OT ER
TYPE Floor Floor TYPE Floor Floor
Water Closet � �� � `�j Floor Drains �
Lavatory � i � Sewer Ejector �
Bathtub � Cj � 2, Laundry Tray ((� I
Shower � I 2: Washer � �
Kitchen Sink C� � Water Heater �
Disposal � Water Softener �
Dishwasher � � Wet Bar �
Sillcocks Miscellaneous
, °::'; �?"�t��IT:��� ' ��°1"�E�N ,�
1. CONTRACT F�RICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
�ar�°�' x .0125 $
(contract price) (minimum $50.00)
2. STATE SURC�HARGE
x .0005 $
(contract price)
3. POSTAGE 8� ANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PER IT FEE (Add Lines 1-3 Above) $
* CONTRACT PRICE r JOB COST means the actual or estimated dollar amount charged fo the
permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charg d to
the customer for the wo k done. If any material, equipment, labor or installations are furnished b the
owner, tenant or any o er party, the reasonable market value of such items must be added t the
estimated cost or contr ct price for permit fee purposes. In the event that there is a dispute o the
amount of the job cost, the City may request the submission of a signed copy of the actual co tract.
x�.:.R . �f.�:. � l_�11�B��Gi PEF���'�"����° .. �° �.:'���:�T
The undersigned hereb applies to the City for issuance of a Plumbing Permit, agrees to do all w rk in
strict accordance with t e ordinances of the City and the regulations of the State of Minnesota, and
certifies that all stateme ts made on this application are complete, true and correct.
Applicant's Signature: �'(' � Date:
Building Official/ Inspect r: Date:
Page 2
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DAT TIME
CITY OF ORONO C ED IN �
INSPECTION E SCHEDULED
PERMIT NO. cOMPLETED
ADDRESS ��o� 'rJ ��P D f���
OWNER TELEPH NE NO.�Q �a-,����
CONTRACTOR
� DESCRIPTION l
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tL ❑ 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 ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SE IC INSTALL
2 OWNERICONTRACTOR TO MEET YpU:�ES_NO
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION FiEQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspecto��'�W" �
White Copyllnspector's Ffle Cenary CopylSfte Notiee
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DATE TI
CITY OF ORONO LLED IN /�� �
INSPECTION NO�, E �HEDULED l
PERMR NO. �U(� �9 COMPLETED
ADDRESS t�-'
OMINER TELEPHONE NO. � ' a��' (o�
CONTRACTOR �
� DESCRIPTION �l '
1y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC INAL
Q ❑ POURED WALL O PLUMBING RI ❑ EXCAV RADIN(i/FILLINO
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL � TAEE R MOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE IN PECTION
Q � FRAMING ❑ MECHANICAL FINAL ❑ RATED ALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑COMP INT
� � FINAL ❑ WATER HOOK-UP ❑ FOLLO -UP
W 0 AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUND IOWREMOVAL
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g O�N611COKTRACT�OR T�MEET YOU:�_NO
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W ❑OORRECT WOFMC a PROCEED ❑18SUE CERTIFICA OF OOCl1RANCY
0 ❑COFiRECT WOFtl(.CALL FOR HEINSPECTION TBA
V BEFORE CdNEA1N0 PERAAA BiT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑PHOTOTAKEN
INSPEC7�OR YVILL RETURN ❑CITATiON ISSUED
O STOP ORDER POSTED.C/1LL INSPECTOR
O INSPEC110N REOUtRED.C/1LL TO ARFiANl3E ACCESS.
CaN tor the next tnspection 24 hours M sdvsnoe. (952) 49-4600
on site:
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1NMt� �FlI� Gn�ry Cop�f81M
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TE TIME
CITY OF ORONO �d�l�J' CALLED IN � — �
INSPECTION NOTIC ��E�����HEDULED l — — �
PERMIT NO. COMPLETED
ADDRESS �O7J� �'-e�
�N� T E HONE NO. Z7 7 g�
CONTRACTOR
� DESCRIPTION �`F% ry ��� �D
41 ❑ FOOTING ❑ D -FINAL ❑ SEPTIC FINAL
� ❑ 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 ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATEFi HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
? 01MNERICONTRACTOR TO MEET YWJ:_YES_Np
� COMMENTS:
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O OORRECT WORK a PROCEED
4r O ISSUE CERTiFlCATE OF OC;CUPY►NCY
o }�CORRECT WORK,CALL FOR REtNSPECTlON �Mp���
� �BEFORECONERINf3 pEqINANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. p p�pTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOH �GTATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cafl for the next inspection 24 hours in advanoe. (952) 249-46�0
OwneHContractor�site•
Inspector:
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