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Home My WebLink About2009-00778 - plumbing CITY OF ORONO �ERMIT NO.: 2009-oo��s ' 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISsuEn: 1UO2/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 2636 LYDIARD AVE PIN : 21-117-23-22-0012 LEGAL DESC : VERN-MAR MANOR : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT WATER HEATER 15.00 CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(<$500) 0.50 3670 DODD ROAD-SUITE 100 EAGAN,MN 55123- MAIL-IN FEE 2.00 O MISC FEE 0.00 Minnesota State License#:61770PM TOTAL 17.50 OWNER THOMPSON,TELFORD 2636 LYDIARD AVE EXCELSIOR,MN 55331 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with tJ�e State Building Code.This permit may be revoked at any time for due cause. ��ti(.Q,(.�j C•�.� i i � i Applicant Permitee Signature Date Issued By Si ture SEPARATE PERMITS REQUIRED FOR WORK OTHER T N DESCRIBED A 1 * ) • FOR CITY USE ONLY ,j�g�� City of Orono � � P.O.Box 66 Date Received: Permit# � a�„f 11 2750 Kelley Parkway li i: s a ;�� i; Crystal Bay,MN 55323 Approved By: Amount$: �\� , ' �o�� (952)249-4600 \\�'�y%/ CITY OF ORONO-PLUMBING PERMIT (All Commercial permits must be approved by the Building Official or Inspector) GENERAL INFORMATTON 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a pernut 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 TAE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to properiy owners residing in the dwelling. 4. When any new construction or remodeling is involved,a sepazate 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 1 �Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs (�Replace ❑ In Accessory Structure? *You will need arior anaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: ` Site Address: 2-e3� ��r�rd i9'✓� Owner:�� C�PYIp,`�Y� Mailing Address: �S G r'Y�- c�ri: �xce1 si or z�p: � 53 3 � Home Phone: -1�2 `i'7�� /�7 2— Alternate Phone: Contractor'Information: . /� Contractor: ChSI'riplon Rlumbing Contact Person: �� s V " 770-PM Address: 651-365-1340 State Bond#: Eagan, MN 5�5123 f a ' City: ip: Expiration Date: I�� / Phone: Alternate Phone: ❑ Insurance-Current: 1 ��s7 � L . '�.a�� .:� '�' FIXTURE BSMT 1 2 OTI-�ER 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 Baz Sillcocks Miscellaneous �. ._- .. �., - � . _..:: , , w,.,. .. .. , � � Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modificarion 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 Surchazge $ .50 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $�� (Permit Fees Continued On Nezt Page) 2 ,�^ 3 �u � �� 'k�' r �'� '.3 � �-fi � "y�,�a2�� ?'�� ',U.��Sle�,,�a�.�`'�:�„��, If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (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 chazged to the customer for the work done. If any material, equipment, labor or installations aze fumished 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. ■ ** 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. �.. �.. , .r , ,u _ „ .., , , , r � , A ,. . s _ . <� . � �:� 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 sta.tements made on this application are complete, true and correct. � ��f�� i .� {� ,l� Applicant s Signature: ` � �' Date: IU� L(J—V � s� � ,.,�,r �� . � 3 � �� `� — - ATE TIME CITY OF ORONO CALLED IN I� g INSPECTIO NOTICE SCHEDULED g •' PERMIT N 6 -04�I� COMPLETED ADDRESS a OWNER TR. TELEPHONE NO. — — ` �-� � DESCRIPTION �.�� LL:�� i�Z7�tt.E' � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING � ❑ FRAMING ❑ MECHANICAL FINAL � LAKESHORENVETLANDS O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPIAINT � ❑ DEMO-FINAL O SEPTIC INSTALL. ❑ FOLLOW-UP � ❑ PLUMBING RI p SEPTIC FINAL ❑ HARD COVER REMOVAL MBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO ti COMMENTS: ¢ W a � � O >. � O � W � Q � 2 W � W � � d W� ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W O CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE C�/ERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTiONREQUIRED.CAILTOARRANGEACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-46�� OwnedContractor on site: . Inspector. � White Copyllnspector's File Canary CopylSfte Notice