HomeMy WebLinkAbout2016-01431 - plumbing t * CITY OF ORONO Wll
* 2 0 1 6 - PJ 1 4 3 1 *
2750 KELLEY PARKWAY DATE ISSUED: 1U14/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1555 MAPLE PL
PIN : 08-117-23-33-0030
LEGAL DESC : CRYSTAL BAY VIEW
: LOT 008 BLOCK 006
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE ; WATERSOFTENER
NOTE: WATER SOFTENER
VALUATION OF PLUMBING 500
APPLICANT PLUMBING F[XTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
CULLIGAN SOFT WATER SERVICE CO. MAIL-1N FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 52.25
(952)912-7379 Payment(s)
CREDIT CARD 5107 5225
OWNER
Atlas Homes
14450 117TH AVE N
DAYTON,MN 55367-
AGRF.EMENT AIYD SWORN STATEMENT
The work for Nhich this pemiit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is Yor only the work described and does
not grant permission for additional or rclated work which rcquires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This pennit will
expire and become null and roid if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for�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
revoked at any time for due cause.
� � �l /
Applicant Permitee Signature Date Issued B ignature Date
11/14/2016 10:56 FAX 9529335049 CULLIGAN MNTKA C�002
• �Q� City of Orono �.�, .-_-,, ����� ,��:�'','° ';°�,;FdR,GI1Y USE O. LY,;P. ,;,.
b P_o. 6oxs6 �EC�., �l �»�.r .,D'ate�Receiv':e'd'� ',;,L�,� �,,,;''�° ,��r, ,::;rr' ',�i;�l"'i';r�,',',`i',''::;!''r
2750 Kelley Parkway ��;; r'I;,::•''a�c� ��yr,° „°; „�!r !��i,'
(} :'�',Peimit��#i: ���.°''���;:I�;;i:;',',
� Crystal Bay,MN 55323 � '� �� '
� 9 1' i'il�i� ���II�1i ���li� �ii�i iiiii i�..iil. ��II I'il�ii.
i � �V ...�il Il�..iiiiii�i�i '��.�iln��,li iiu�.i�iii�i.i�.�i^i.ii�i��lilin�iii.i�i�ii�i.i�i�ii.iii i.iiii.i.iu�i�,i�i, r.�i�,. �
� ` (952)249-4600—Maln NQV I �� r!,i'. ';ili,; .�..,I�,� � ,.I, i�� .i„ ,,'��., ,�,a,,
�,�t a�� I�Approved`:BY,:';i�;� ��I' :;i��„ �,G'�,i';uo�,� �;�j,�,�,'��; �,�,,:';ii�'i'i,
a
a �
s� 952 249-4616—Fax ��� ��"�
,..., .,.,, ,,, ,�;,�;°r,;, �,
i„, ._.,�., . ,,,,, ,.,.,.,. �.,��, , p, „,
( ) ,,,,.,,�';�����'��,,., �,,,.!„rc,�„���;,,.,,,��,i, , M� ,.,�,��,.'� „�a
y , . °I, .,.
. ,.�,,� �,., .�� .�
,... ;,.,�,.�,,.,,,,r����,�,.�' �,.," I ��,„��, ,�..„, ��,
, i .,,,.,,�„� �� � I �P �....a;,,,�i�.��,^;�tr;;;r�i��
O�ORO �„ �,�.� '�„����,, .,,, .:�..,: ���,,,.�,��:... ....... ....'„''��,�,.�.,.,,
.,,,.,,.,,,
CITY ND �Am�out�t:$:,�„�,�.�,.r,�.�,�,r,��: � , ,.,,,���� � �'� � ��':I,,,.„� , ���.�,,�,�,,,�,,,� �
� i. �,�.�,:,�, � �
CITY OF ORONO- PLUMBING PERMIT
(A11 Commercial permits Must be Approved by the State Prior to City Approval)
htp:l/www.dli.mn.aovlCCLQ/PDF/pe plumbplanrevavp.ndf
, „��, ,.,,�,,,, ,,, ,, ,, ,, ;,„..,:,, ...,„,�,,.,,,. .., „�.,,�,�,,,,,.. .,,.,,. ,,,.�.,�,..�,,,,,.,,,..�,�„ �„,,,, ��,,,.....,,.
,.� , .�,.,., � � �.,�.,�,,... ,,.,,.,..„.,,�,„,,, ,.,,���.�„�„a.... ............... ....i.....,, �,....�,,�;,,,.,,,,„,,�„..,,,,,..,,,,,.,.„.,,,��.�,.,;,,�;:, ,,
� il„�� ,�i�i�o-�,ir.:�,.m�,����1,�.�����,wni�:e���•,lu���lk;;l"e616i��i"II'I'I%i�"" �'�;i'�I'�";i'��
GENERAL.,�1NF,�RMATION��: ,���•�:r��:o,;,;�,;���;�r����:�;r�.c,,�,�;�,�,..�.„�.��.����,,.��,�,��,�,����.�,����,���.,�„�.���,�,�� ,��,,,,i� �� �, ,� ���,,��, i� �� �:::�, ,�.,�.
uu:: .i ..i. ,.i. � .i !„i, iill•,,.I.li...,,i,.��„,hl,l,i,:l.. �i.l., ,.l.i ,,.i„.a...i,,ai�. I..i,
���� �
1_ You may apply for plumbing permits by mai] or in person at the City offices � ,,,
� �1 � 1 Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail 2�fter a review is completed. PERMITS ARE NOT VALID
UNTII.YpU R�C�IVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARQ IS
PdST�D ON TWE JOB SITE.
3. Plumbing permits may be issued ONLY to (icensed plumbing contractors and to property owners
residing in the dwe(ling.
4. When any new construction or remodeling is invofved, a separate building permit must be obtained.
5. All work must be done in accordance with State Code requiremenfs.
6. Al[work must be inspected and air tested before it is covered. Call (952)249�60�.
(24-48 hour notice requirad)
,eiw„Iinw��eee�uiuiun�Lnioun:nnnla6';I;diliilal��rll'II,�Jir.�;�lil�llif�l��l:�'�drGm�'�'�:d I���� ,,. „�� „ .�d.,��� ���� 4•i��un.�w�i�i�i ��a.��.��•�.,„i„„„w„r��i.�r�.��•��n���.��kw�w�o-��ln,e,�i�.,i��, nuiwmm��.dm�iie�r��iwi•nm�l.�oha�•������i„��.�����
rm��.,,,�i, a,wry�.�.w�m����r "r��r d.we
,„I,,.I I I� r .����,�ul.l�,.l..�� X I �,��I���I�,II.� �.�I.,,,
: ,
,";Y,;:'7'IRI47�I8� ��'141'"I 'P'��1;:I�II9���ICI�I'
,.��„,,.,,,�i,��,��1����,�,.��.�,.� ,�.�.,,,,� .��,,.,�.�,,..,��. � k��"' ". : ..,.,,, , ��,�, .,,�,�.,,. ,,,..,,,
I n�i`I.�i„i�Pn�"1�4��, ���I��„IIM,.�,��ir.i ,i�.l T P �I;I i ��� 'I ��,li i� .��n„�,�rv� .i .���i
,.,���,�.,�,,,.�.,�,.,�.,.�,��,�.,�,�.��.,.��.,..,�,,,,.,„��,�„,.,���I,�,�;an��„,�.,��.��.,.,r�.�.,,.„�..,,�,.;0���,�p��MYY�,G�ec,��41.�,T.,,hat,A I �.,�,. ��I � .�, �,r�:.�,,,a ,,, �, ,,.
i. ,il�,i i..i i..i. „\.. .� ,PA.Y},,,,,,u,,�����.'.o. a.,,�i:�ciia��;r„Vi,i�.�i.f:l"°'°iu'ri'���I�;,a��,�,i;i�r:�9ir.r.r,;;
�Residential � Commercial (Approvaf REquired) [�ackflow bevice_0 A`trB ❑pVB]
�New ❑Additional ❑ Repairs ❑ Replace
❑ ln Accessory Structure?
*You will need priar approval and may need CUP. (Per Orono City Code, Chapter 78, Article I�
,,:,,,,�,�� r;�., ,.,, ,��„�. ,�,,��,,�,. ;,: ,,. ,.,.„,�,.,,,,,.,:,,�,.,.,�,��,„�„��.,,�„„,��,,,,�„������ „�,�,�„�,�.,.,,�,,,
,°��b�S.►te��'/�i,Qwner�ilnformat,or�':�:!��c�p,!,:���;;:����;,��,,,��°����„,����s;,���: ;;��i;:��;1.
����, ���.��, :i,�'i,,,. ,;.
Site Address: 1555 t'f�r,�o P(a(�
c7wner: �c�� �u�",r� Mailing Address:
c�t�: z�p: ss 3 � y � _ �� �
Home Phone: l�(� --_55� - �f.5 6�Alternate Phone:
�i �,��.���,.���n.���,.��,.�i��.�.,�,,�n.,a���:�,�,�i�,�„i�a,�������.�.��,i,u���,.��,��,���m�i.��•,i,�ui�.�n�i�,�„��,���,�,�,I,.���e.i���,,,:,i��l�.��,���
�� ��,��.��.,�.�
�,�,�,�,,,ac
,.� o o�:� n;,�,:,,�:,:,�,�����,���i,:;�:,,��,,,.,��,.��.,,.,,.,�,,..������,. , �„,,,
ntr .�
„ n arma i�,
�.�,,.�, .,,i,��„,.�,.i�.�,�„..,,i i:�.r,�r� ;,�;s��hl;�,!'''d�i��,,,��.�r;
Contractor: Contact Person:
'� � A!V 4NA��R C��pp��-{ONING State Bond #:
Address: ���0 Ct1 �
ETOIVf(,q, MN 5�345
City: ��.� �. �952� 9a�-7200 Zip: Expiratian Date:
Phone:`� Alternate Phone: RSa -q��" 73 ��
❑ Insurance -Current:
Page 1 �
il/14/2016 10:56 FA% 9529�35049 CULLIGAN MIVTKA 1�00a
. • y� I�
.
:W�aiw�mqwwn�ni�4 ,�,�, �%+IunVHu�IV Mhly� ,-��y� �j, y�II � 11 � 1�I T i�b xM^�i���� �� i y�g�n�@� �� ��w�CN W� �
�1iaN�i�i �,�,,+���. � li�' � G -0 ��[� 11 i lY 5 AM I �W�}�u
�ll:,W.u.�'�`�` '��""� �����M �Sw�!a'�Can'i7:PL,�; �O i�47�1���,'U',l'f`'E "'�.' .'_� � ����°!���I�'f id ruaw
�:�h.,`���n u� A�u' � w _ � �� �ii �ei �'.wi�i"��Imwy��Fn���wmn.�Yl'C..,��
FIXTURE �SMT 1sr 2ND QTHER FIXTURE BSMT �sT 2No qTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet _ Fioor Drains .
L.avatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
fGtchen Sink Water Heater
Disposal Water Softener �
pishwasher Wet Bar
Silicocks Miscellaneous
w W'�� �wjhuy'��e� ' 'I �•."" 4HL�N i �� A� ��'• � f "' y1,��� �y�ywy �y�y� ,� 4�
N� M �e o�II^ . .� ��' � �/I�,VYti�,i ' � II '-,.`�' .W� �uAr �
1. CON7RACT PRICE "is 1.25°� of contract price with a (Minimum Pee of$50.00)
x.0125 �$
(contract price) (minimum $50.0�)
2. STATE SURCHARGE
x.0005 $
(contract pnce)
3. POSTAGE�HANDLING (On1y on Mail-In Applications) $ 2.00
4. TOTAI.P�RMIT FEE (Add Lines 1-3 Above) $
* CONTRAC7 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 fumished by the
owner, tenant or any other party, the reasanable 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.
"7'�' me W'���„�„��� ��' �I�� ~.R�,l;a,"�1:••I.' I �� ��ir"�'":��',"::!imL;M�i�J�1�1i° ,�IM�1"6���Y hl� � I.� M„677.��h13?'�'"M
� � �I�I� rn � 1. i Ma. me ..I
The undersigned hereby applies ta the City for issuance of a Plumbing Permit, agrees to da all work in
strict accordance with the ordinances of the City and the r'egulations of the State of Minnesot2�, �nd
certifies that all statements mada on this application are complete, true and correc#.
Applicant's Signature: Date: �I� � - �
Building Official/Inspector: Date:
Page 2