HomeMy WebLinkAbout2015-00661 - plumbing �� ` CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 5 - 0 0 6 6 1 *
DATE ISSUED: OS/26/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2850 LITTLE ORCHARD WAY
PIN : 09-117-23-21-0007
LEGAL DESC : LITTLE ORCHARD
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: PLUMBING FIXTURES:
(1)KITCHEN SINK
(1)DISHWASHER
(1)LAUNDRY TRAY
VALUATION OF PLUMBING 3200
APPLICANT PLUMBING FIXTURE FEE 50.00
TRADESMAN INC STATE SURCHARGE PLBG(VALUATION) 1.60
PO BOX 26731 TOTAL 51.60
MINNEAPOLIS,MN 55426- Payment(s)
(612)581-4472 CHECK 2154 51.60
OWNER
SWENSON,JAY
2850 LITTLE ORCHARD WAY
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
'fhe work for which this pertnit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. 1'his permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
request in nfortnance with the State B ding Code.This permit may be
re at y tim r due e.
� � / /
plicant Permitee Signature Date Issue y Signature Date
� ' R C USE ONLY
�' �O� City of Orono `��� �D/ �� _`/
O P.O.Box 66 D�e Ru�v Permit# ��l/�
2750 Kelley Perkway �\
Crystal Bay,MN 55323 Approved By: Amount$; �, CJ
(952)249-4600—Main
(952)249-4616—F�
y�' �`� CITY OF ORONO—PLUMBING PERNIIT
l9kFS�0�� (All Commercial Permits Must be Approved by the State Prior to City Approval)
htt :I/www.dli.mn. ov/CCLD/PDF/ 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 cazds 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 pemuts may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construcrion 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.
(2448 hour notice required)
TYPE O�PERMIT
(Check All That A 1
�Residential ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs Replace
❑ In Accessory Structure?
*You will need orior anuroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
�ob Site/Own�r Information:
Site Address: �g�� �-��� a��� w�y
Owner: --1 � 5 w�=��� Mailing Address: ��u,,�-
City: �Kr�wf� Zip:
Home Phone:��c3 -`f(Qy-t�`1`�'� Alternate Phone:
Contractor Information:
Contractor•. ��+-+4-d ES�-�-� ��-
--� Contact Person: �1��C�� �
Address: � �K a��7 3 f State Bond#: ��31�7 2 g
City: 14.1�w�u�.��ous Zip:�Z�Expiration Date: JrFuJ I 1 �� ► �
Phone: �e�Z - so � - �-f�f�7�- Alternate Phone:
❑ Insurance-Current:
1
, �
. ,
,�
• .
. PL'L��i�C�3�'i'U�:�3��1,- :T�T � ` " �. '�� �
rirt� �
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
.I.ypE FI, FI, TypE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray r
Shower Washer
Kitchen Sink j Water Heater
Disposal Water Softener
Dishwasher � Wet Baz
Sillcocks Miscellaneous
Y Y '. � y� P .f� . ,. + �� �a y� .�,\
.. 't'° '' .1 {` �,}} .- � t Tt� � � t 9E." } � �.y_'fk,�
�� ���sri��„ ^>'rt* �,,•°�'v �r ,:�% f:4�j �' � �
� ��['�
�,;G
.6 a '4'�:. � ' '' rZ .b. +4'",��.
❑ Yes,this section applies
The replacement of only one Residential fixture or appliance that meets all three of the following
requirements:
1. Does not require modification to electrical or gas service. .
2. Has a total cost of$500.00 or less;excluding 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 Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
.-•
' • '
.; '
. �F:�'�.FE���L+�Ui:�+l'TIfJI�i $ JC)BS aV�R,$$UU.O� ' � ;:
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
31���• � x.0125$
(conVact price) (minimum 550.00)
2. STATE SURCHARGE
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � '• `C��
■ * 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 aze 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.
. � ,.
, �'�iJ�3�G'�' ..�. . ;�'P�.��A{i7�;�A,��.r�EI�1�fiT .' ., .,.,; ,
t_
The undersigned hereby pli to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accord w' the ordinances of the and the regulations of the State of
Minnesota, i e all statement ade o is applica ' are complete, true and
correct.
�
�—
w � 2� �S
Applicant's Si ture Date:
3
� DATE �
CITY OF ORONO cnLLED IN s
INSPECTION TI E / SCHEDULED " ��
PERMIT NO. "'� ( GOMPLEf _
ADDRESS U �
OWNER TELEPHONE N�� - 7�
CONTRACTOR
� DESCRIPTION � � ^
W ❑ FOOTING ❑ DEMO NAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO
v�, COMMENTS:
o�
a
j
o - ��,
�
o _
�
W
�
Q
� �
W
�
W
�
J
W RKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
� ❑ RRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR W{LL RE�URN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
�INSPECTION RE(]UIRED.CALL TO ARRANGE ACCESS.
Ca�1 for the next inspection 2a hours in advance. (g52) 49-4600
OwnedComractor on site:
Inspector:
Whits Copyllnspecto�'s Flle Canary CopylSke Notice
��G' � � DATE TI 1�
CITY OF ORONO CALLED IN � �
INSPECTION NOTICE SCHEDULED
PERMIT NO. �'�/_S --(�GYDb l COMPLETED
ADDRESS 7�S C� � ���F I E'_ ('�rC'�1 L.(.�r,�/
OWNER TELEPHONE NO.�/2-����?
CONTRACTOR �Ck�C',CyYY.t!�
� DESCRIPTION � �j���Ils�'1b 2 —
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
�4 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
_
v ❑ DEMO-SITE EPTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEi YOU� YES_NO
c�.� COMMENTS:
a �s �a. k.��� ��.��.�� -
o t�r� v �I/3s 5�• 40
�.
� . .
o � ��y�,, I/e n� �si.«•�'�t�r�rn� rx� �j� �.,ir•%� .
W
Q �� �� �jo�c c,iaeQ� � G���� �..rsG �
� � P���n� ,��� ,���� .�o� i��Y��
a
� .�.o«�� -�- 6 K �*a cv��
�
�
d
W ❑WORKSATISFACTORY:PROCEED O PROJECT COMPLEfE
� �GORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑ STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector.� '�' �
White Copyllnspector's File Canary CopylSite Notice
_.�.r�.4-
p T TIME �
CITY OF ORONO cnLLED IN 6�-'�S
INSPECTION N TI / SCHEDULED — -�` %��
PERMIT NO. � ��� OMPLETED
ADDRESS v'�'+��-
OWNER TELEPHONE NO.
CONTRACTOR � �
� DESCRIPTION �
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ 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
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YiOU:_YES_NO
y COMMENTS:
a�
W
�
j
O
�
O
�
W
�
Q
�
2
�
W
�
j
� ❑WORKSATISFACTORY`.PROCEED f�PROJECTCOMPLETE
� ❑CORRECT NfORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CdVERING PERMANENT
❑C�iRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WFIL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSU
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 • advan� 2) 249-4600
OwnerlCorttractor on site:
Inspector.
wn�a coprnnspecto►�s F��e c.nary copyy�sn.Na�ce