HomeMy WebLinkAbout2017-00350 - plumbing CITY OF ORONO * 2 0 1 7 - 0 0 � 5 0 *
� 2750 KELLEY PARKWAY DATE ISSUED: 04/12/2017
` ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 465 LINDEN AVE
P[N : 06-117-23-41-0109
LEGAL DESC : LINDEN WOODS
: LOT 002 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: REPLACING: 1 WATER CLOSET, 1 LAVATORY, 1 SHOWER
VALUATION OF PLUMBING 4500
APPLICANT PLUMBING FIXTURE FEE 56.25
STATE SURCHARGE PLBG(VALUATION) 2.25
BOE PLUMBING TOTAL 58.50
15481 KIOWA ST.
ANDOVER, MN 55304 Payment(s)
(763)757-1991 CHECK 4508 58.50
Minnesota State License#:plbg-PC644079
OWIYER
KADUE, BRADLEY& EMILY
465 LINDEN AVE
LONG LAKE, MN 55356-
AGREEMENT AKD SWORN STATEMENT
The work for which this permi[is issued shall be performed according to
the approved plans and specitications,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 l80 days at any time after work has commenced.
The applicant is r ponsible for assuring all required inspections are
requested in co rmance wi the State Building Code.This permit may be
revoked at any e for due use. �' ,
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Applica ermitee Signature Date Issued By Signature Date
�Q� City of Orono FOR CiTY USE ONLY
O P.O. Box 66 Date Received: U- � i
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. 2750 Kelley Parkway '�—f �
a > Crystal Bay, MN 55323 Permit# �{� �� -- �;�; �`J�_;
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CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.qov/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 properry 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)
[� Residential ❑ Commercial (Approval Required) [Backflow Device: ❑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: ��� ���� //✓�"'
Owner: Mailing Address:
CitY: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �v���V` Contact P � ��'��
ers�n.
Address: _
� �-I � ��� w� � �' State Bond #:
/[ � - t�
City: �`1`� �� Zip�5^�� ( Expiration Date:
Phone: � �' 3 7S� 7 l �� � Alternate Phone:
�Insurance — Current:
Page 1
PLUMBING FIXTURES BE1NG INSTALLED ��
x
FIXTURE BSMT 15T 2ND OTHER FI�PE E BSMT Floor Floor OTHER .
TYPE Floor Floor
Water Closet � Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower � Washer
Kitchen Sink Water Heater
Disposai Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
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� ,��. �_ � ` � �� �,����-';�'� ��;.� PER(�IIfi�fEE GALCULATION � � �
1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) �C C�
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x .0125 $
(contract price) (minimum $50.00)
2. STATE SURCHARGE ,,-� �l'.C'
x .0005 $ `
(contract price)
3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ ��
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4. TOTAL PERMIT 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 charged 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.
PLUMBING PERMIT APPLICATION AGREEMENT . � �
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
strict accordance with the ordin ces of the City and the regulations of the State of Minnesota, and
certifies that all statements mad o this ap i ation are complete, true and correct.
Applicant's Signature:
Date: � r � (
Building Official/ Inspector: Date:
Page 2
� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION TI E SCHEDULED — 2 - J��_
PERMR NO. a CO LETED .
ADORESS �.S �/ O
O'WNER ONE NO. ��L�S����
CONTRACTOR
� DESCRIPTION � � "'—
W ❑ FOOTING ❑ DEMO-F ❑ SEPTIC FINAL
� ❑ POURED WALL �PLUMBI RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF PLUMBING FINAL ❑TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z dWNERlCOI�ITMCTOR TO MEET YiOU:_YES_NO
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W CORRECT WOFiK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORE COMERINf3 PERMANENT
❑CORRECT UNSAFE OONDITION WITHIN HOURS. O PNOTO TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR ��TATION ISSUED
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
caa ror u�e���e�tro�za no���,�►a�. (952) 249-4600
owneriComractor on site:
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DATE TiME
CITY OF ORONO CALLED IN � �
� Q �� SCHEDULED
PERMR N � COMPLET D
ADDRESS �J� � ����Q
OMINER TELEPHONE NO. ��3 ���r
co�ac�roR �C3e `cstm�-r�
� DESCRIPTION
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBINCa RI ❑ EXCAVKiRADING/FILLING
`f ❑ FOUNDATION WATERPROOF PLUMBING FIN ❑TREE REMOVAL
Z ❑ RADON SLAB ANICAL RI ❑ SITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑WOOD BURNERIFIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z GWNERICOKTAAC7'aR TO MEET YOIk_Y68_NO
� COMMENT& _
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� ❑W�ORK SA7ISFACTORY:PFiOCEED �ROJECT COMPLETE
W ❑OOqRECT WORIC 3 PROCEED O ISSUE CERTIFlCATE OF OCCUWINCY
00 ❑CORRECT YMORI(,CALL FOR REtNSPECTION TEMPORAR'Y
V BEFORE CdVEi�NO PEqMANBdT
❑(�ORRECTUNSAFEGONDITIONWITHIN Ha1RS• D PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER P08TED.CALL IN3PECTOR ❑pTATION 18SUED
❑INSPECTION REOUIRED.CJ1LL TO ARRAN(iE ACCESS.
ceN w�a�e��,�za n�h�►�o.. (952� 249-4600
on site:
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