HomeMy WebLinkAbout2012-01069 - plumbing '" ,` CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 2 0 1 0 6 9 *
DATE ISSU D: 10/23/2012
' ; ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS � : 2670 KELLEY PKWY �Z f C7
PIN i : 33-118-23-12-0058
LEGAL DESC � : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE I : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYP�E : FIXTURES-MULTIPLE
NOTE: 2ND FLOOR:2 W�C,3 LAV, 1 TUB, 1 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER
VALUATION OF PLUN�BING 4000
I PPLICANT
PLUMBING F'IX\TURE FEE 50.00
AMERICAN MECHA ICAL CO,INC. STATE SURCHAR�E PLBG(VALUATION) 2.00
7120 71ST AVE.N. MAIL-IN FEE � 2.00
PO BOX 205 i
LORETTO,MN 55357-i l TOTAL 54.00
(612)750-0278 ,
� OWNER
Citizens Independent B
5000 36TH ST W
ST LOUIS PARK,MN�55416-
AGREEMENT ND SWORN STATEMENT
The work for which this pe �t is issued shall be performed according to
the approved plans and spe�fications,applicable City approvals,and the
State Building Code. This p�ermit is for only the work described and does
not grant permission for add�tional or related work which requires sepazate
permits. AIl provisions of lalws and ordinances governing this type of work
shall be compied with whet�er or not specified herein.This permit will
expire and bewme null and oid if construction authorized is not
commenced within 180 day�of the date of issuance,or if construction is
suspended for a period of 1�0 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance 'th the State Building Code.This permit may be
revoked at any time for due ause.
�' i � ��I'y2�-Q-z( i i
Applicant Permitee Sign ture Date Issued By S' ature Date
�SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV �.
� � Fot�ciT�:us�or��.�
, f�����., City of Orono
,�f� �,t P.O.Box66 Date�teceived: �'� PeCmit#
� � 2750 Kelley Parkway
i
4 a ;� � . � Crystal Bay,MN 55323 App1'oved By: AmounC$:
�'�d '�� �'�����^' (952)249-4600—Main
����a�� (952)249-4616—Fax
CITY OF ORONO — PLUMBING PERMIT
I (All Commercial Permits Must be Approved by the State Prior to City Approval)
htt r.1/��ww.dli.mn.�f�vICC;L[)1:P1)FI e �lumb.lanrev� f. df
GEN RAL IN�ORMATION
1.I You may apply for plumbing permits by mail or in person at the City offices. Applications ill be
reviewed and a permit will be issued within two working days.
2.I' Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
I VALiD UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
I PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property o ners
� residing in the dwelling.
4.j When any new construction or remodeling is involved,a separate building permit must be
obtained.
5.I All work must be done in accordance with State Code requirements.
6.I All work must be inspected and air tested before it is covered. Call(952)249-4600.
i (24-48 hour notice required)
' TYPE OF PERNIIT
Check All That A 1
I
.
R�sident�al ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Replace
❑ I Accessory Structure?
*�ou will need qrior aauroval and may need C1.!I'.(Per Orono City Code,Chapter 78,Article IV)
Job Si e/Owner Information:
Site Alddress: 0 < � �
Owne�: Mailing Address:
Citv: t___._�_��---_--------- Zin: --- —
Home IlPhone: Alternate Phone:
Contr ctor Information:'
Contr Ictor: �� tact Person: K
� �
Address: �U�X �� State Bond #: � l�� / %
City: � L� Zip:�3�Expiration Date: /�a?' ""/
I �/���6��CJ�7(g Alternate Phone:
Phone�
I � Insurance—Current:
1
. . � ����'�' - ��.
��Z,1�T�C���TU:��. __ �... ��
F[XT RE BSMT 1 2 OTHER FIXTURE BSMT 1 2 THER
TYPEI FL FL TYPE FL FL
Water Closet Floor Drains
Lavatc�ry Sewer Ejector
Bathtu f Laundry Tray
Showa�- � Washer
Kitchen Sink / Water Heater
Dispos I Water Softener
/
Dishw her / Wet Bar
Sillcoc s Miscellaneous
� ; <.
' 1��.�`.�1I.�.���C��{�� :�
�ER,.�'���+���
°BA��.S1����' �4��.�`�'A'1�����"IIE � �
❑ I Yes,this section applies
The rep�acement of only one Residential fixture or appliance that meets all three of the following
require�nents:
I 1. Does not require modification to electrical or gas service.
I 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and
I 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
! State Surcharge $ 5.00
Mail-In Fee(If Appticable) $ 2.00
Total Permit Fee $
(Permitl Fees Continued On Next Page)
I 2
, . :., II
- I
, �����,:�����.������.��� ���� ��������, ..... ;
If abo�ve does not apply;follow guidelines below:
1. CONTRACT PR10E * is 1.25% contract price with a(Minimum Fee of$50.00)
� ��� - ,�
, X.oi2s $
(contract price) (minimum$50.0 )
� 2. STATE SURCHARGE � �
�� �d �� X.000s $
(contract price)
I 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
! 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �) ( '
■ * ONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged or the
p itted work including materials, labor,profit, and other fixed costs. It is the amount to be c arged
to the customer for the work done. If any material, equipment, (abor or installations are furnis ed by
th owner, tenant or any other party, the reasonable market value of such items must be added to the
es imated cost or contract price for permit fee purposes. In the event that there is a dispute n the
a ount of the job cost, the City may reyuest the submission of a signed copy of the actuai c tract.
PLLIM�3I�iC'a �?��I�ITT AF"PI.I��`Ti+Q�,A.C'..iR���VTE1��I
The urhdersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to o all
work n strict accordance with the ordinances of the City and the regulations of the St te of
Minne ota, and certifies that all statements made on this application are complete, tru and
correc . �/�
Applicant's Signature: / Date: /�/��' ^
l �R£S�'� F,O�'t11
� �
�
�
3
� ao� � J
DATE TIME
CITY OF ORONO CALLED IN �Z�/y �Z-
INSPECTION OTICE SCHEDULED � Z �
PERMIT NO. ���a -��0� COMPLETED
ADDRESS a'� �� K-2�—�-�-/ p��cJ(i � �--1 D
OWNER TELEPHONE NO. q5� -a�5 a�63
CONTRACTOR f-tyl�lQ12-- ��/'�
� DESCRIPTION ���-/7'�h �� v��f
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEP��FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOH TO MEET YOU:��_YES_NO
� COMMENTS:
�
W
a
�
�
O
a
�
O
�
W
�
Q
�
Z
W
�
W
�
�
d
W ❑WORK SATISFACTORY:PROCEED C�tOJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHtN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on site:
Inspector.
White Copy/lnspector's File Canary CopylSite Notice