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Home My WebLink About2015-01212 - water softener CITY OF ORONO * 2 0 1 5 - 0 1 z 1 2 * � 2750 KELLEY PARKWAY DATE ISSUED: 09/2U2015 � ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2523 KELLY AVE PIN : 20-117-23-12-0039 LEGAL DESC : REG.LAND SURVEY NO. 1428 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER SOFTENER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(<$500) 1.00 3670 DODD ROAD-SUITE 100 MAIL-IN FEE 2.00 EAGAN,MN 55123- TOTAL 18.00 � Payment(s) CHECK 31670 18.00 OWNER SACHS,BEN 2523 KELLY AVE EXCELSIOR,MN 55331- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This permit is for only the work described and dces not gant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction suthorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be n_ revoked at any time for due cause. 6� Q l � �U�� --��`1 �CJ � / Z l / 1 Applicant Permitee Signature Date Issued By Signatur Date , ` a = FOR CITY USE ONLY � A T City of Orono q` 21 Zb1S �<y P.O.Box 66 Date Received: I S Permit# b Z � Z_ � 2750 Kelley Parkway pU Crystal Bay,MN 55323 Approved By: �Amount$:�_ (952)249-4600—Main (952)249-4616—Fa�c F �� CITY OF ORONO—PLUMBING PERNIIT l�'�ESHO�� (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://www.dli.mn.Qov/CCLD/PDF/ e lumb lanreva . df 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 retum 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 sepazate building permit must be obtained. � 5. All work must be done in accordance with State Code requirements. . 6. Ail work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice-required) _ 'TYPE OF PERNIIT Check Al1 That A 1 �Residential ❑Commercial(Approvat Required) �New ❑Additional ❑Repairs ❑Replace ❑ In Accessory Structure? *You will need arior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: � '� �Q rs 1'�'l � '�) Owner:�� JU,C.�� Mailing Address: � � c;ri: ��)1� z�p: 5s3g1 Home Phone: "I,� � `��'� �� Alternate Phone: Contractor Information: F Contractor: " �,^i V1�c.{ Contact Person: J Address: �� li�� State Bond#: City: k��iL�� Zip:��>>Z-Z'Expiration Date: Phone: �Q�,��J��`'� � Alternate Phone: ❑ Insurance—Cunent: 1 �1 �� r ° , �. PLLTMBING FIXTURES BEING INSTALLED , �, u�...� � - FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 T 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Wate Disposal Water Softener � Dishwasher Wet Bar Sillcocks isce eous � �'' F�:T :� uPERMIT FEE�CALCULATION(S) �,� ��f - � �- :-- �_ t _ ,n__ .;BASED:9FF. �2002 STATE_STATUE . : ' � � Yes,this section applies The replacement of only one Residential fixture or ap�liance that meets all three of the following requuements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;exciudine the cost of the fixture or appliance:and 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 Surchazge $ I.� Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $� � (Permit Fees Continued On Next Page) 2 � . r � . . PERMIT.FEE CALCULATION S —JOBS OVER•$500:00 = If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERIVIIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the � permitted work including materials,labor,profit,and other fixed costs. It is the amount to be chazged to the customer 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 contract 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. .....r PLUMBINGl'ERMIT`:APPLICATION AGREEN�NT`3��'.�..j..vu��Y�a�;�� The undersigned hereby applies 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. F:� Applicant's Signature: � � ��C�ate: �S I-� 3 DATE TiME CITY OF ORONO CALLED IN iNSPECTION NOTI�,E SCH�ULED �� PERMIT NO. 6iC5 •O �eZ CpMPLEfED ADDRES8 oZ 5�.3 1Cel�y f��e - pMINE�i TELEPHONE NO. CONTRACTOR C��"'`'�� '�"'' �'�' . � DESCRIPTION IN�C�C�' �J'G��rta/ � �s�q � ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL e ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN(i �O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL � ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION � ❑ FHAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BUHNER/FIREPLACE ❑COMPLAINT v ❑ FINAL ❑ WATER HOOK-UP �W-UP 4�1 ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ r ❑ DEMO-SRE ❑ SEPTIC INSTALL i OAMNBIICONTRACTOR TO MEET YOU:_YES_NO � COMMENT� � j Permit has expired per MN Building Code Sec. 1300.120 subp. 11 � Expiration, no record of a Final inspection. Q � W � Q � � W � j W ❑WORK SATISFACTOR1f:PROCEED ❑PROJECT COMPLETE � ❑pppqECT WpFtl(8 pqpCEEp �ISSUE CEHTIFlCATE OF OCCUPANCY W � ❑CORRECT YMORK,CALL FOR REINSPECTION TEMPORAii11 V BEFORE CdVERINO PERMANENT ❑CaRFiECT UNSAFE CONDITION WRHIN ��• O PHOTO TAKEN INSPECTOR WILL RETURN ❑qTATION ISSUED ❑STOP O�P08TED.CALL INSPECTOR O INSPEC710N iiE0U1RE0.CALL TO ARRAN(iE ACCESS. ceN�«n�.��2a no�s�,�►�os. (952j 249-4600 owr�erlcontrsctor on siee: �. � r�.. wnn.oo�nn+a•��or.Fx. c.n.ry�oPr�a Noa�s