HomeMy WebLinkAbout2012-00574 - plumbing ; � � '' CITY OF ORONO
* 201z 00574 *
2750 KELLEY PARKWAY DATE ISS ED: 06/20/2012
� ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 2670 KELLEY PKWY #� �d�
PIN : 33-118-23-12-0037
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500) I
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TY E : FIXTURES-MULTIPLE
NOTE: 2 WC,3 LAV, 1 T�[JB, 1 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER
VALUATION OF PLUII�IBING 4000
PPLICANT PLUMBING FIXTURE FEE 50.00
AMERICAN MECHA ICAL CO,INC. STATE SURCHARGE PLBG(VALUATION� 2.00
7120 71ST AVE.N.
PO BOX 205 I TOTAL I 52.00
LORETTO,MN 55357+ PAID WITH CC# 9327
(612)750-0278
OWNER
Citizens Independent B
5000 36TH ST W
ST LOUIS PARK,MN 55416-
AGREEMENT D SWORN STATEMENT
1'he work for which this pe it is issued shall be performed according to
the approved plans and spe ifications,applicable City approvals,and the
State Building Code. T'his ermit is for only the work described and dces
not grant permission for ad itional or related work which requires sepazate
permits. All provisions of 1 ws and ordinances governing this type of work
shall be compied with whet er or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 da of the date of issuance,or if construction is
suspended for a period of 1 0 days at any time after work has commenced.
The applicant is responsibl for assuring all required inspections aze
requested in conformance ith the State Building Code.This permit may be
revoked at any time for du cause.
/ / �� / /
Applicant Permitee Si ature Date Issued By gnature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB .
� 06/19/2012 22:59 FAx 7634773629 I f�0011003
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P.O.Box 66 '�
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CITY OF ORONO—PLUMBING PER T �3
(All Cammerci�l Permits Must be Ap�toved by the State Prior to Ci A ro al
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I I. You ma 1 for lumbin �
Y apP Y P g permits by mail a�in pe:snn at the City offices. Appl cati ns wi Il be '�;
reviewed and a pr�rmit wi11 be issued within two workin�days. E
I 2. Permit cards will be sent by rEtum mail aftor a review is compl�ted. PERMi1'S A N �� +
VALTD UNTIL YOU RECEIVE A pERMIT. O B G UN L '�
�V RK ML�-T N�T
�R1VI1T CARD IS p0 D ON TA� � B SIT ,�
! 3. Plumbing pormits msy be issucd ONLY to licensal plumbing contraelors and to p pe owners '
t+esiding in the dwelling, :
�I 4. When any new construction or remodeling is involved,a separate buildin P
obrained. 6 P�it st c .E
j 5. _All work must be donc in accordance with State Code requiremcrrts. ��
.
I 6. All wprk must be inspected and air tested before it is eovcred. Cal)(952)249-4600 ..�
' (24-48 honr noticc required) I ;
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Rcsiden i I
� t al ❑Commcrcial(Approval Required) .�
❑INew ❑Additional ❑Repaiis
❑Repl ce I ..�
$
� ❑ �'I In Accessory Structure? � �
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j`You wiU need nrior s�ooroval�d may need�,l�P.(Per Orono City Code.Chaptcr 78 Arti�le IV) c
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Job ite/Owner�ln�ir�nat�'tot�:� �•� � � �
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Site ddress: ` :'f
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Own�r: Mailing Addtess: �
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CitY�l� Zip: �
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Hom�Phone: Alternate Phane; �;
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C;ont ctor Infor.ma�ion: � �'' .� " ' �
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C;ont ctor: ,t�/f,�y��pntact Person: I ` `
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Addr�ss: D �• '� State Bond#: � � �� i
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City: �'' Zip;����Expiratian Date: J ' � ��
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I hone f J c� Alternate Phone: 7G'� '� r " � ,.�
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F TURE BSMT 1 2 OTHER F1X7URE BSMT l OTFIER :
T PE FL FL TYPE PL LI •�
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ter Clpszt 1�loor Drains �
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L atory � Sewer�jector :;
Ba htub Laundry TYay ,j
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Sh wer / W�� '�
Ki �en Sink r Water Hcater 4
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Di osal Water Softener {
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Dis washer ( W�Baz I :r
Sill ocks Miscellaneous .�
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❑ II Ycs,this section applies `
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1'he replacement of only one R,esidential fi�cture or aonliance that meets�Il three of the follo ing .�
requ��ements: -r
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1. ces ot require modification to electricai or gas senrice. .�
2. I•Les a to s of$500.00 or lcss;cxcludine the cost of the fixture or applianc :and �
3, ls improved,installed or replaced by the homeowner or licensed plumbing cont ctor. �
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Skip next section,if this applies; Cost of Pcrmit S 15. �
Stete Surcharge $ 5 :�
Mail-In Fee(If Applicable) $ 2. 0 ;�
Tpt91 Perm![Fce $ �;
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(Perm�t Fees Continued Oa Neut Page) ;
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06/19I2012 22:39 FAX 7634773629 I f�0031003
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iflabove does not apply;follow guidelincs below• � €�
I. �ON7'RACT PRICE + is 1.25%of conurract price with a(Minimum Fee of 50.00) �
act
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x.ol2s$ . ��
�����P�a) (mini um 0.00) 4
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2. $TATE SURC1�ALtGE /y�//� v �
���w x.0005 $ �
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(coat�aat pri�x) � �
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3. POSTAGE&HANDLING(Only on Mail-In Applications) S ,0 €
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4. TOTAL P�RMIT FL�(Add Lines 1-3 Above) � �3
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• � '" CONTRACT PRIC� or JOB COST means the actusl or estimated dollar amount a ed for tha � '�
- - � permitted wotk including materials, labor,profit,and other fixed eosts. it is the amou t to e chargcd ;�
I to the customer foc the work dono. If any mate�ial.equipmoat�labor or instaUations fu ishcd by ��
II the owner,tbnunt or any other par[y.the reasonsble market value of such itCms must e a ded to die ;
estimatod cost or contract priee for porntit fco purposes. In the event that th�re is disp te on the :!
�I amount of the job cost, the Giry may rr,quest thc submission of a signed copy of the etu�contract. '•
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Th� undersigned hereby applies to the City for issuance of a Plumbing Permit, rees to do all ,�
wo m strict aceordance with the ordinances of the City and the regulations the State of :g
Mi�nesota, and certifies that all statements made on this application are com ete, ttrue and ,E
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Applicant's Signature: Date:�� ��
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e<�'�/' DAT TIME �
�� 7 O /�
1'OF ORONO CALLED IN �
PECTION OTICE SCHEDULED �f/�.,�/�
iMIT N0. - DOS,3 COMPLETED �
)RESS � /
NER TE HONE NO. � °�-�S-a��
NTRACTOR � �'
SCRIPTION � r � v `��"" 5
OOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
OURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
RAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
JSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTtON
IADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
INAL ❑ SEWER HOOK-UP ❑ COMPLAINT
)EMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
)EMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
'LUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
VERICONTRACTOR TO MEET YOU:_YES_NO
�MMENTS: ��'l��T ���- �D/o7 - DU,�� DO�J 7 ✓
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WORK SATISFACTORY:PROCEED �ROJECT COMPLETE
CORRECT WORK&PROCEED SUE CERTIFICATE OF OCCUPANCY
CORRECT WORK,CALL FOR REINSPECTION T PORARY
BEFORE COVERING PERMANENT 7-�' ��
CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL FETURN ❑CITATION ISSUED
STOP ORDER POSTED.CALL INSPECTOR
INSPECTfON REQUIRED.CALLTO ARRANGE ACCESS.
" Cal1 for the next inspection 24 hours in advance. (952� 249-4600
►wnerlContractor on s' e: � '
,cnoctnr_ ` �`✓J fi� /� �