HomeMy WebLinkAbout2010-01169 - plumbing � . �
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; CITY OF ORONO PERMIT NO.: 2010-01169
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 12/OU2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3556 LIVINGSTON AVE
PIN : 17-117-23-43-0040
LEGAL DESC : NAVARRE HEIGHTS
: LOT 000 BLOCK 003
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
' CONSTRUCTION TYPE : FIXTURE
NOTE: REPLACE KITCHEN SINK
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APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(<$500) 5.00
3670 DODD ROAD-SUITE 100
EAGAN,MN 55123- MAIL-IN FEE 2.00
Q TOTAL 22.00
Minnesota State License#: 61770PM
OWNER
LONG,CHRISTIAN&NANCY
3556 LNINGSTON AVE
WAYZATA,MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and the
' State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances governing this type of work
' shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
' The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for du cause.
� / ��i �v
, App icant Permitee ignature Date /��/� l�
Iss By Signature Date
' SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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FO� USE ONLY
�`�� City of Orono /
� '��g ���4 P•O.Box 66 Date Receivedi �� �Permit#��Q s ��
�;a �,� ` 2750 Kelley Parkway
�����t i1 Crystal Bay,MN 55323 Approved By: Ainount$: �•
`�a�c� (952)249-4600 � � � �
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CITY OF ORONO—PLUMBING PERNIIT
(All Commercial permits must be approved by the Building Official or Inspector)
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 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 separate building permit must be
obt��a. RECEIVE�
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) DEC "' � �010
TYPE OF PERNIIT G�-� � ORON�
Check All'That A 1
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �Replace
❑ In Accessory Structure?
*You will need nrior annroval and may need CiIP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information: '
Site Address: ���� �-1 Y��l�-j�l'� /�f�
Owner: IV GU'1 C� (�Q�(�,G� Mailing Address: ��•UMPJ
c�ri: zlp: 553�J I
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' Home Phone: ��J 2=�{1� � ��� Alternate Phone: V'
Contractor Information:
• Contractor: Champion Plumbing Contact Person: �
70-PM
Address: 651-365-1340 State Bond#:
Eagan, MN 55123
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
1
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
• TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
� Yes,this section applies
The replacement of a Residential fixtwe 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;excludine the cost of the fixture or appliance:and
, 3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ :sg S��
Mail-In Fee(IfApplicable) $ 2.00
, Total Permit Fee $ 2•�V
(Permit Fees Continued On Next Page)
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
. � � xA125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
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 mstallations are furnished by
the owner,tenant or any other party,the reasonable mazket 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.
■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
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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.
FM1/�f ,�k x
Applicant's Signature: l�� �°��"�°"a"�'Y� Date: ` I" ��` I V
��;� „ffi� ya�'i f'� .
3
��� �.'� � DATE / TIME �/
CITY OF ORONO CALLED IN � I�3� �
INSPECTION NOTICE C,q SCHEDULED �� ^ ��
PERMIT NO. al`)1(�--L�l I ls"' 1 COMPLETED
ADDRESS � S � Vl� �
OWNER TELEPHONE NO. �J� J I . (�
CONTRACTOR �� � �
� DESCRIPTION � 1 ��rn ��,�i
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHORE/WETLANDS
� ❑ 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
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FI L ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YE��NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED (�ROJECTCOMPLETE
W ❑CORRECT WORK 8�PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor o site:
Inspector. �� J'd
White Copyllnspector's File Canary CopylSite Notice