HomeMy WebLinkAbout2017-00449 - water heater 1
` ' CITY OF ORONO * Z 0 1 7 - 0 0 4 4 9 *
• 2750 KELLEY PARKWAY DATE ISSUED: 05/03/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3470 BIRCH LA
PIN : 08-117-23-43-0001
LEGAL DESC : BALDUR PARK
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING ��NNb�
PROPERTY TYPE : RESIDENTIAL s
CONSTRUCTION TYPE : WATER HEATER
NOTE: WATER HEATER REPLACEMENT
VALUATION OF PLUMBING 600
APPLICANT PLUMBING F[XTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 030
APPLIANCE CONNECTIONS, INC. MAIL-IN FEE 2.00
12850 CHESTNUT BLVD
SHAKOPEE, MN 55379- TOTAL 52.30
(952)445-4803 Payment(s)
Minnesota State License#: mech-MB004165 CHECK 9123 52.30
OWNER
BERNARD, MR. &MRS.
3470 BIRCH LA
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 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 180 days at any time afrer 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 due cause. �
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Applicant Permitee Signature Date Issued ignature Date
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��p� City of Orono 1VE� FOR C�Y SE O _Y
O P.O. Box 66 RECE Date Received: � � �
2750 Kelley Parkway ��
Crystal Bay, MN 55323 Y Q 3 `�0�� Permit# ao l —Q�
y c? (952)249-4600-Main ��`
���'kFSN��`�` (952)249-4616-Fax 0 Approved By:
G�-�(Of �R�N Amount$: �
CITY OF ORONO – PLUMBING PERMIT ��
(All Commercial Permits Must be Approved by the State Prior to City App oval) ��A S
http://www.dli.mn.aov/CCLD/PDF/ae piumbalanrevapp 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 finro 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 property 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)
❑ New ❑ Additional ❑ Repairs [�Replace
❑ In Accessory Structure?
*You will need arior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information:
Site Address: , �� )�� .}��r�C-' �1 � v1 ���� �
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rJw^�r:��-I Y1 b1 �C✓I�C�.c Mailing Address: � ,5 I'l��_
City: Zip:
g 5;�- �- � ! '
Hor�e Phone: ���� Alternate Phone:
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Contractor Information:
Contractor: Contact Person: _1��M��F> ��D(�
Address: ���O�n�t� State Bond #: }�'�/'�'15 ,7�Ci1 �
- '��*���—
St�akopee, MN 55379
City: �����,�go� Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance — Current:
Page 1
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C � PLUMBING FIXTURES BEING INSTALLED
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FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1ST � � OTHER
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TYPE Floor Floor TYPE Flo Floor� ,
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Water Closet Floor Drains -L,.,
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater j �;
�Jisposal Water Softerer
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION
1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
x .0125 $ .5�% �% �
(contract price) (minimum $50.00)
2. STATE SURCHARGE
� ��� . C� �� x .0005 $ ` � �
(contract price)
3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00
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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 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.
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ApplicanYs Signature: �'�-��� ��'�- 4 Date: � I f�
,
1
Building Official/ Inspector: Date:
Page 2
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CITY OF ORONO r,�►L�D IN — �7
INSPECTION ,y,� G} SCHEDULED �L,CI��J� �-�D
PERMIT NO. ��� COMPL ED
ADDR
p�WNi �—TE HONE N .���7� �-��
co� c�roA �
�� DESCRIPTION ��'"' � G�' "'
❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI O EXCAVKiRADIN(i/FILLIN(3
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TAEE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑COMPLAINT
� �NAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
? TO YEET V�ll:_YE8_NO
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� ❑WORK 3ATISFACTORY:PROCEED �ROJECf COMPLETE
W ❑OORRECT WOfiK a PROCEED ❑18SUE CERTIHCATE OF OCCUR�NCY
D ❑OOFiRECT WOi�C,GLL FOR REtNSPECTION T6iAPORARY
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❑COFIRECT UNSAFE OONDI710N WITHIN FIOUR3. O PHOTO TAKEN
INSPEC7'OR 1MLL RETURN
O STOP ORDER PO�TEO.CALL IN3PECTOR ❑dTA710N ISSUED
O IN8PECTION REOUIRED.CI1LL TO ARRAN(iE ACCES3.
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