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Home My WebLink About2013-00913 - plumbing � � CITY OF ORONO 2750 KELLEY PARKWAY * � 0 1 3 - 0 PJ 9 1 3 * DATE ISSUED: 09/06/2013 ORONO, MN 55356- (952)249-4600 FAX: 952)249-4616 ADDRESS : 135 LUCE LINE RIDGE PIN : 31-118-23-34-0007 LEGAL DESC : PAINTERS CREEK : LOT 005 BLOCK 001 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: 2ND FLOOR: 1 WC,2 LAV, 1 TUB, 1 SHOWER VALUATION OF PLUMBING 3000 APPLICANT PLUMBING FIXTURE FEE 50.00 PARK PLUMBING STATE SURCHARGE PLBG(VALUATION) 1.50 P.O. 896 WINSTED, MN 55395- TOTAL 51.50 ( (p l 2 `jQ 8 �v��` PAID WITH CC# 1110 Minnesota State License#: PC643184 OWNER ANDERSON,DAVID 135 LUCE LINE RIDGE MAPLE PLAIN,MN 55359- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permiu. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construetion is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the e Building Code.This permit may be revoked at ti for du aus -�b q l D l a2�1,3 / Appli nt erm'ee Signature Date Issued By Si a re Date SEPARATE PERMITS REQUIRED FOR WORK OTHER T N DESCRIBED ABOVE. t � J . FOR CTfY USE ONLY �O�O City of Orono P.O.Box 66 Date Received: Permit# 2750 Kelley Pazkway Crystal Bay,MN 55323 Approved By:' Amount$: (952)249-4600-Main (952)249-4616-Fax y�tq ��` CITY OF ORONO—PLUMBING PERMIT K�sHo� (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://www.dli.mn. ov/CCLD/PDF/ e 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 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 A ly)' �Residential ❑ Commercial(Approval Required) ❑ New ❑ Additional ❑Repairs ❑ Replace ❑ In Accessory Structure? *You will need arior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job`Site/0wner Information: Site Address: I3� �--t�e� ��vlQ �� e �Q 1 l lG�i ✓l, Owner:�t�►.1f2 '��t.v'SO Y�• Mailing Address: /3S Lk�t (,'KP t�ady� city: IN�a.�t��R�� • zip: SS3�"`� Home Phone: �S��`l 7d1�3�7 Alternate Phone: Contractar'Information: ' Contractor: r < �kw�b] ��t c� Contact Person: �t�b�.lti �t�s�'e� Address: 1�.� . ,Dd X $`�,�_ State Bond#: � t (901 `-� �• City: f� �v�.S-�ec� Zip: s' .S�Expiration Date: Phone: �!a�-,�R�j'��{.3� Alternate Phone: ❑ Insurance—Current: �,�5, 1 � , � .�_ ,u.: _. . _ _, . . . . - � F :., ... ,�� ..A.... � � . ,,- . .. ro�_ �� ... . � .,. �.. �� _ �� „ � �,_� �� FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet I Floor Drains Lavatory � Sewer Ejector Bathtub I Laundry Tray Shower � Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous ❑ 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;excludine 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 , _ � � � z �_. n�� ,,��: 1�: r ; , � � . ,_ . m. �,.. q �.;. ... . .-_.� ., � � �<< �. f , . �. If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) _�_ ��p x.0125$ (contract price) (minimum$50.00) 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) $ • * 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. > � �. . 2 ,. �� a � �� . � � r .; 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. Applicant's Signature: Date: `�G �� 3 � , Minnesota Department of Labor and Industry Licensing and Certification Services Construction Codes and Licensing Division Phone: 651.284.5034 443 Lafayette Road N Emaii: DLI.License@state.mn.us Saint Paul,MN 55i55 Website: www.dii.mn.gov/ccld.asp NOTICES NOT TRANSFERABLE CHANGE YOUR BUSINESS STRUCTURE PARK PLUMBING INC SUBMIT A NEW APPLICATION FOR NEW ENTITY 151 LINDEN AVE E RENEW OR REPLACE INSURANCE POLICY WINSTED, MN 55395 SUBMIT NEW CERTIFICATE OF INSURANCE NOTIFIC THE DEPARTMENT OF A CHANGE IN YOUR BUSINESS. _ Fa�lure to do so,subjects you to administrative penaities ofi up to$10,000. 15-Day Notice Requirement—Forms availebie online at www.dli.mn.aov/CCLD/LicUndate.asn • Change in business'physical address,mailing address,phone number,or email address • Change in control,owners,olficers,directors,members,partners - • Change in business'legai narne andlor assumed name • Loss of or change in MASTER PLUMBER • Change in generai liability insurance or workers'compensation insurance coverage immediate Noti�e Requirement—Notification to DLI in writing • 3udgment Debtor: A licensed contractor has 15 days to provide written notice of the finding that it is found to be a judgment debtor based upon conduct requiring licensure. • Bankruptcv Petition Filed. A licensed contractor has-15 days to provide written notice that it filed a petition for bankruptcy: • Conviction Notice. A iicensed contractor has 1'0 days fo provide written notice that it has been found guilty of a felony,gross misdemeanor, misdemea�or:or any comparable: offense related to the license, including convictions of fraud, misrepresentation,misuse of funds,theft,criminal sexual conduct, assault,burglary,conversion oi funds, or theft of proeeeds in this or any other state or any other United States jurisdiction. `YOUR CERTIFICATE IS BELOW THE PERFORATION. -,SHOW CERT[F{CATE WHEN OBTAINING PERMITS. > � ` ""'""�"DEP"�"'�"`� pLUMg1NG CONTRACTOR i LABaR & 1MDUSTFtY _ _ Construction Codes and Licensirtg Divtaion Licansing and Certification Services 443 Lafayette Road N St Paul,MN 55155 Websde: www.dli.mn:aov/ccld.asu Emall: dH.ticen_�state.mn.us Phone: 651284.5034 This is to certify that the certificate holder is licensed as a PLUMBING CONTRACTOR in the state of Minnesota annd is in compliance with Minnesota Statutes 32bB.46,and may perform or of�'er to perform plumbing work in all azeas of the state dwing the licer►se period; provided the responsible individual is at all times a MASTER PLUMBER and the certificate ho9der maintains compliance with the required bond,general fiability insurance,and workers'compensation laws. License : PLUMBING CONTRACTOR Lic Number : PC643184 PARK PLUNfBING INC Effective Date : 01/oi/2o12 15'# LINDEN AVE E Expiratlon Date : �2/31/2ot3 W�NSTED, MN 55395 VEF�tFY tJP-TQ-QaTE STATUS,BOND,AND INSURANCE INFO ATwww.dli.mn.�ov/ccld/LicVerifv asp (ENTER NUMBEFi). MIIVNtJIJ I H UtF'I.Ur LAtfUFi HIVU IIVUU�I FSY CONSTQUCTION CODES AND LICENSING PLEASE CHECK YOUR CARDS FOR ACCURACY. 443 Lafayette Road N IF YOU FIND AN ERROR,PLEASE CALL 651.284.5031 ST.PAUL,MN 55155 IMMEDIATELY. GIVE THIS CARD TO EMPLOYER WALLET DISPLAY COPY STATE OF MINNESOTA STATE OF MINNESOTA MASTER PLUMBER `�°"""�` MASTER PLIN76ER License# PM060880 . � License# PM060880 Expiration Date 12/31/2014 Expiration Date 12/31/2014 - -- Effective Date O1/O1/2013 �':, . Effective Date Ol/O1/2013 � �*.....�: Originai Issue Date 04/29/I992 Original Issue Date 04/29/1992 � DANIEL J FISHER DANIEL J F�SHER BOX 896 BOX 896 WINSTED,MN 55395 WINSTED,MN 55395 � DAT TIME ✓ CITY OF ORONO CALLED IN INSPECTION OTICE��g�3 SCHEDULED — —I � PERMIT NO.��3� COMPLETED ADDRESS3 �� OWNER TELEPHONE NO.��Z' � 4 g ��L� CONTRACTOR �� DESCRIPTION �� "� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/F�LLING y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATEF HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUM8ING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: � W � o � �� _ f n ul� � ST e - - Q J„� ° � — � � ��C� W t3 CL�CT (� �� ^T� 1 � Q z �� c ��c-f- F��/�/ W �� W � a �wµ�� .�Q(ORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE � �ORRECT WORK 8 PROCEED �rA��^� ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 �CORRECT WORK,CALL FOR REtNSPECTiON "� TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITAT�ON ISSUED ❑STOP ORDEH POSTED.CALI INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site:. Inspector. . �, White Copylinspector's File Canary CopylSite Notice � DATE TIME ✓ CI ORONO � ^ CALLED IN /C�- � INSPECTION NOTICE SCHEDULED lD_�'E—aDl3 � PERMIT NO��D/3'Ov '�f I J� COMPLETED . -� ADDRESS C�LH--�� OWNER ELEPHONE NO. CONTRACTOR �J i DESCRIPTION � � ❑ FOOTING ❑ PLUMBING F AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANIC RI � LAKESHORFJWETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL � ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE O SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J O PLUMBING RI ❑ S AL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YO ._YES_NO y COMMENTS: � W � o �D�" , /�j- �' �/�v�P � ,� � ��c?!C�cl N 0 � W � Q z , /n,T.S h �- �O.it!'�Q W � W � J d W� ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSfte Notice