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Home My WebLink About2012-00175 - plumbing � CITY OF ORONO 2750 KELLEY PARKWAY * Z 0 1 2 - 0 0 1 7 5 * . DATE ISSUED: 03/07/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1590 LONG LAKE BLVD PIN : 26-118-23-33-0026 LEGAL DESC : JOHNSTONS RGT ALBEES LONG LAKE : LOT 012 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NOTE: WATER SOFTENER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00 6030 CULLIGAN WAY MINNETONKA,MN 55345 MAIL-IN FEE 2.00 (952)912-7379 TOTAL 22.00 PAID WITH CC# 0597 OW1vER COGBILL,CHARLES&JENNIFER 1590 LONG LAKE BLVD LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to [he approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate perrnits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoke any time for due cau e. 3� 7 �� , , � Applicant Permitee Signature Date Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. I 03/07/2012 13:48 FA% 9529335049 CULLIGAN ffiVTRA C�002 i : .. .. .. ... _. . . .. . _..._ . . . • FOB CI'I'Y IJSE ONLY O�p� City of Orono 0 P.O,Box 66 Date Received: Pennit N 2750 Keiley Perkwey 4 r Crystal•Bay,'MN 55323 . Approved By: Amoimt S:: ��0� (952)249-4600 CITY OF ORONO-PLUMBING PERNIIT " (All Commorciol pertnits mwt be approved by the Building Official or inspectar) I , . � GENERAL INFORMATION 1. You may appty for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit wiU be issued within two working days. � . , 2. Permit cards will be sent by retum mail a$er a review is completed. PERIWTS ARE NOT VALID UNTIL YOU RECEIVE A PERMTf. WORK MUST NOT BEGIIY UNTIL TRE PERMIT CARD IS POSTED ON THE JOB Sl'TE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property ovmers i residing in the dwelling. � � 4. When any new construction or remodeling is involved,a separate building pamit must be' , �. ..-- ,. , . ,- . . _ . .,- obtaieed,m.. ,_ _ ��,:,;,.. 5. All work must be done in accordance with State Code requirements. j 6. AIl work must be inspected and air tested before it is covared. Call(952)249-4600. (24-48 6oar notice nquired) TYPE OF PERMIT Check All That A 1 ' � �Residential ❑Commercial(Approval Requirod) �New ❑Additional ❑Repairs ❑Replace ❑ in Accessory Structwe? *You•will noed�rior annroval and may need C�U .(Aer Orono City Code,Chapter 78,Article IV) ! Job Site/Owner Information: � � . Site Address: � Jr90 ��q �a� D(vv( . . Owner: �� a�.v �� Mailing Address: ' S5 34 (�� i . City: Zip: Home Phone: �a5 (• �3�- 5643 Alternate Phone: � Contractor Information: Contractor: Coptact Person: � CULLI4AN WqrER CONDITlONIAJG g��Bond#: Address:6030_Ct 1� MJNNETONI(q, MN��r� � #rCity: (9�21 g�a_�� ZTp�S Expiration Date: Phone: Alternate Phone: 95a -9�a-7311 � I • ❑ Insurance-Current: l � 03/07/�012 13:48 FA% 9529335049 CULLIGAN �ITRA C�003 i I _ - �. �' ... . . . ... ... . ... . � � - j • . . . . �, , •..• , .4�..�.�,:.:. ,,. ,�;_��s.�;,�-;. . .i .�;..,.ti'�•'�'y�;n;t..r, �i7il�n�� '� i k.i.`�.:��':��,-��4,{�fy�+'v:�+.rTR�..� 4 �� .�.F .t.- :WM1i ' F,IXTURE •BSMT 1 2 � OTHER FIXTURE BSMT 1 2 OTHER � ii 'CYPE FL FL TYPE . FL FL . Water Closet Floor Draitis , ' Lavatory Sewer Ejector � Bathtub Laundry Tray ' Shower Washer � Kitchen S'uik Water Heater , � � _ . , ._ Disposal -. ^ .- . Water Softener ., , � Dishwasher W�B� I Sillcocks Miscellaneous . , , .r. ., ' � i � 5 z�G. � ' Yes,this section applies ' The replaccment of a�esidential fixture or,�ppliance that meets all three of the following requirements: ; 1. Does�o�require modifcation to electrical or ges service. ' . 2. Has a t cost of 5500.00 or less; xcl ' tha cost of the fixture or appliance:and • � � � 3. ts improved,installed or repl$ced by the homeowner or licensed contractor. , Skip next section,if this applies; Cost of Permit � 15.00 ' � Stato Surcharge $�UU ' ' . Mail-In Fee(If AppGcabie) $ Z.00 ' Total Pcrmit Fee S � (Permit Fees Continued On Nezt PAge) , � • . . • 2 ,� 03/07/2012 13:48 FA% 9529335049 CULLIGAN �1VTKA f�004 I ^ ' . � - .. . _ . . " �i��'�.s; ,t. k. •j �.s t �s"�".. lf above does not apply;follow guidelines below: 1. �ONTRACT PRICE ;is 1.25%of contract price with a(Minimam Fce of SS0.00) - x.0125$ � (contract price) (minimum SS0.00) 2. E S C E **Add tfie State Bldg Code Div.Surcharge(Minimum Fee otS5.00) x.0005 $ ' (conaecc price) (minimum S 5.00) 3. POSTAGE&HANDLING(Only on Mail-in Applications) $ 2.00 I �,. . 4. TOTA.L PERMIT FEE(Add Lmes 1-3 Above) S�r� .O� _ n��'!"� " " ''. _",'. - _ _ _- , , �f�,�, 'i � • CON['EtACT PWCE or JOB COST mcans the actual ar estimated dollar amount charged for tha� ; permitted work including materials,labor,profit,and othee fixed costs. it is the amount to be charged ' . to the customer for the work done. If any matarial,equipment, Iabor or installstions are fumished by the owncr.tenant or any other party,the roasonable market value of such items must be added to the estimated cost or contract ptice for permit fee purposes. [n the event that there is a disput� on the ' amount of the job cost,the City may request the submission of'a sign� copy�of the actual contract. � � **Ttic STAT'E SURCHARC3E is.0005 of the contract price under$1,000,000 or SS.00—whichever is ! greater. For valuations over$1,000,000 call the Building Departrnent at(952)249-4600 for the price. ; The undersigned heceby applies to the City for issuence 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 i Minnesota, and certifies that all statements made on this application are complete, true and � correct. Applicant's Signature: Date: 3- � � � ,� � ,I . II , • i � '' I �, 3 �� D�E TIME �/ CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED ' � Z � PERMIT NO. a4�a -��75 COMPLEfED ADDRESS �5 D L ��L OWNER _��L TELEPHONE NO. lO�z ZZ7 OS�� CONTRACTOR �^�� DESCRIPTION � � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z0 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v BING RI S AL ❑ FOUNDATIOWREMOVAL WNE ONTRACTOR O MEET YOU: Y NO v�, MMENTS: � W a � J O � � O � W � Q � 2 W � W � � � � ❑WORKSATlSFACTORY:PROCEED �6.PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUiRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�0 OwnerlContractor on site: inspector. White Copyllnspector's File Canary CopylSite Notice