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Home My WebLink About2002-P04850 - plumbing � PERMIT CITY OF ORONO Permit Number: � 2750 Kelley Parkway - PO Box 66 P04850 Crystal Bay, Minnesota 55323 Permit Type: FiXtures (952) 249-4600 Date Issued: �i3oi2oo2 SITE ADDRESS: 1290 Lyman Ave Wayzata,MN 55391 PID: o2-1i�-23-21-000t DESCRIPTION: Proposed Use: Kesidentiai Permit Class: Plumbing Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: 1 ice maker FEE SUMMARY: Permit Fee: $ 112.50 Valuation: $ 9,000.00 State Surcharge Fee: $ 4.50 TOTAL FEE: $ 117.00 APPLICANT: Symington Plumbing OWNER: Steve Melberg 5267 Dominick Drive 1290 Lyman Minnetonka,MN 55434 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVENIENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. .� �f' � � ��'�'"-'z� �%"- �_ ��-� �f� , `" ��'`"`_= �� APPLICANTPERMIT SIG ATURE ISS � BYSIGNATURE �j� Copies: 1-File(Sienitures Reauired). 1-Aoplicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 .� �o� g 5 � , � CITY OF ORONO APPLICATION FOR PLUMBING PERMIT Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. 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 the State Code requirements. t 6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice required. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call (952) 249-4600. •� . ,. Please check one: New Addition Repair Replace � '*p� Residential Commercial JOB SITE: f 2 ��C�% � �f�;<� ,� ,1/ i"��,� Zip. Owner's Name: �-i�-.%z M-, �• M�� Telephone Number: Mailing Address: City: Zip: Contractor's Name: �'�' �,��- ��vM r;r`��'�=. Telephone Number: ��j z �3� --/ 7,�0 ; Mailing Address: 5...z-�."7 7r,r�i,�� ,�r'� City: ,�1��NK-lUn�,c.�J Zip: 5 j� �( 3 PLUIVIBING FIXTURE SCHEDULE FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL F�L TYPE FL FL , Water Closet �— Floor Drains ,' — Lavato 3 Sewer E'ector Bathtub � Laund Tra Shower � Washer } Kitchen Sink � Water Heater > Dis osal � Water Softener Dishwasher ,� Wet Bar � Sillcocks � Misc (list) ��`_ v�`"k z,� I �. � PERMIT FEE CALCULATION(S) 2002 State Statute ❑ Yes, This Section Applies The replacement of a Residential fixture or a�liance 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; excludin� the cost of the fixture or appliance: and 3) Is improved, installed or replaced by the homeowner or licenced contractor. Skip next section; Cost of Permit $ 15.00 State Surcharge $ .50 Mail In Fee $ 1.50 If above does not apply, follow guidelines below: l. Contract Price* is .0125 % of job with a Minimum Fee of ($35.00) � ' G��l x .0125 $ (contract price) (minimum $35.00) 2. State Surcharge. ** Add the State Building Code Division a (Minimum Fee of$ .50) x .0005 $ (contract price) (minimum$ .50) 3. Postage and Handlin� (Only mail-in applications) $ 1.50 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 incIuding 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 installation 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. ** 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 Department of Inspection Services for the price. 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. ' � `W � '-^% Date: �'— 3 0__�� Applicant s Signature: DATE TIME CITY OF ORONO �ALIED IN INSPECTION TICE SCHEDULED v:� %�, civ PERMIT NO. .S d COMPLETED ��L ��-=' ADDRESS /� O % . �----� OWlVER , _CONTR. - �� TELEPHONENO. _ �5 � -� �.3-3 �-l7g C• � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 � 15 SEPTIC INSTALL. 22 FOLLOW-UP � PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v MBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � � a j •.� � S, o �.�.'�� S `z`V�'- >' �y/- �. , � O � W � Q � 2 W � W � � d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W �ORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN �CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector.��`�C.c� ��'t�/ White Copyllnspector's File Canary CopylSite Notice � � DATE TIME CITY OF ORONO � V cALLED IN INSPECTION �TIC �_ SCHEDULED iz��`„�_ , v o PERMIT NO. , O J � COMPLETED � �' ��0� ' ADDRESS O � �� OWNER CONTR. TELEPHONE NO. �� DESCRIPTION v��.��u�(J'-C � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBi �� 23 SEPTIC FINAL 35 HARD COVER REMOVAL = PLUMBING FINAL ~ 36 FOUNDATION/REMOVAL R TO MEET YOU:_YES_NO � M TS: � � a �S � Y�G��- D�. ?� � a , L,,�. � W a-�� C Q � z - � L� � � W � � � ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE � [�"�ORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY �(��CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR W{LL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContra or on sit • Inspector�' CZ� l G White Copyllnspector's File Canary CopylSite Notice HOUSE HEATING TEST RECORD .� ADDRESS, � � 1 O•� ►� (� .��`'� APT. FLOOR CITY SUBUR��-`��_ OCCUPANT l.E. ' OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY ' Electrical Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MODEL � ��/� � V�r �'I�l�� MODE OF BURNER SERIAL `;C°� n �:1 '��P? MAX. BTU RATING INPUT MAKE OF FURNACE MODEL CONTROLS THERMOSTAT,�� HEAT PLUG VENT SIZE � J L VALVE�'v�jeJ+ ShJ>�✓ KIND OF LINER SIZE NONE LIMIT C` fl,�/'v" i�if� DRAFT HOOD REGULATOR LIMIT SETTING 2d� FILTERS SIZE NUMBER FAN SETTING tY�n�Ja CHIMNEY LOCATION INSIDE��ZS �OUTSIDE I ^ PILOT TYPE S � CHIMNEY CONSTRUCTION PILOT MAKE PILOT MODEL SMOKE BOMB WIRING PILOT TIMING DRAFT TEST TAG L.W. CUT OFF DOOR PRESSURE `�'�'�MO �� 3�:. C( ��ib�a �C:z_D�f�! 1�'i"�$E_E'7' i�-i i ia � kli-� PRESSURE 3 '�Jr"' � '`� PERCENT CO2 U DATE TESTED - ; �^, - r r?�^ r INPUT CFH l� PERCENT 02 Co COMPANY TESTING � � � ' - , : � ,� STACK TEMP. �� PERCENT CO U NAME OF TESTER _ ; = FORM 235 �� u HOUSE HEATING TEST RECORD / i' {�/�� ADDRESS ` � / C�' C- �- C./'(,/V` APT. FLOOR CITY SUBURB (Uvl OCCUPANT OWNER " HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY • Electrical Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS D�SIGN CONVERSION MODEL ' � �(� � �r MAKE OF BURNER �O J MODEL SERIAL `-' t• � ��,� MAX. BTU RATING INPUT MAKE OF FURNACE MODEL CONTROLS THERMOSTAT �F�`� HEAT PLUG VENT SIZE VALVE t�-aJ`c we-� KIND OF LINER SIZE NONE LIMIT L5�1.!i✓L , DRAFT HOOD REGULATOR LIMIT SETTING �c�. FILTERS SIZE[[�(25�� ( NUMBER � FAN SETTIN�,nn°Z(J CHIMNEY LOCATION INSIDE �C OUTSIDE PILOT TYPE �LEC.TPc�NV C CHIMNEY CONSTRUCTION GL�S G l PILOT MAKE l.4.N 1� o 'I� PILOT MODEL SMOKE BOMB WIRING PILOT TIMING DRAFT TEST TAG L.W. CUT OFF DOOR PRESSURE r�� "IT��N�10EC, li�!C. .— �y +�b�: GOL►�;_�d 1;'�`,LI f�';' i r i� ;:� ,^,�i3 PRESSURE � � S PERCENT CO2 o DATE TESTED � -� ;^ �� , INPUT CFH `� � PERCENT 02 � COMPANY TESTING � '- - STACK TEMP. 3�, S PERCENT CO v NAME OF TESTER _ FORM 235 � -�----...�.._��