HomeMy WebLinkAbout2016-01379 - plumbing � CITY OF ORONO * 2 0 1 6 - 0 1 3 7 9 *
2750 KELLEY PARKWAY DATE ISSUED: 10/3ll2016
V ORONO,MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 940 NORTH ARM DR
PIN : 07-117-23-I 1-0014
LEGAL DESC : PIRATES COVE
: LOT O10 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: PLUMBING FIXTURES CAME WITH THE MANUFACTURED HOME. THIS PERMIT IS FOR A PLUMBING FINAL INSPECTION
OF FLOOD RIM TEST ONLY.
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
PRIORITY PLUMBING TOTAL 50.25
17325 EUCLID AVE Payment(s)
FARMINGTON,MN 55024- CHECK 16929 50.25
(763)292-1615
Minnesota State License#:plbg-PC644739
OWNER
OLSHANSKY,ROMAN
76 KINGSVIEW LANE N
PLYMOUTH,MN 55447-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued s6all be perfortned according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires sepazate
permits. A(I 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at ti or due cause.
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lic t ermitee Signature Date Issued gnature Date
�p� City of Orono FOR CITY U E ONLY -
O P.O. Box 66 Date Received: �� ��^/�
� 2750 Kelley Parkway
-� Crystal Bay, MN 55323 Permit# c��f�J 'LS f 3 7�
� o`� (952)249-4600—Main
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CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.qov/CCLD/PDF/pe plumbplanrevaqa.pdf
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 finro 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 Apply)
�esidential ❑ Commercial (Approval Required) [Backflow Device: ❑AVB ❑PVB]
❑ New ❑ Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site/ Owner-Information:
Site Addres . �� � >V ��/'•��
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
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Contractor: ►�"�av'rJ��,� � �/`� Contact Person: or.�a✓f
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Address: ��v � State Bond #: �� �'�8��
City: � � Zip: �� Expiration Date:� �� �
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Phone: '-��, ��/ �� � Alternate Phone:�5�a�� l��
Insurance — Current: `� �
Page 1
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FIXTURE BSMT �sr 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER "
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
.Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
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1. CONTRACT PRICE " is 1.25% of contract price with a (Minimum Fee of$50.00)
�O'Q �_ 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.
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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.
ApplicanYs Signature� / -------- - Date: �
Building Official/ Inspecto,�: Date:
Page 2
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TE TIME �
CITY OF ORONO CALLED IN �0 ����
INSPECTION E SCHEDULED �/����i �
PERMIT N �1���MPLET D
ADDRESS � V�
O'WNER ' � T rpN�E �lS.? -a2 lo�-/l�a/
CONTRACTOR � �J
� DESCRIPTION /,J "�-
� ❑ FOOTING ❑ DEMO-FINA ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/(iRADIN(3/FIWN(i
Q ❑ FOUNDATION WATERPROOF �PLUMBING FINAL ❑TREE REMOVAL
2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑COMPLAINT
� ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP
41 ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP 0 FOUNDATIOWREMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
� TO MEEf lf�lh._Y86_NO
� COMMENT� _ , .
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� ❑WORK SATISFACTOFiY.PROCEED ECT COMPLETE
W o oo�crwor�c a P�m issue c�n�►�oF ooa�cr
o ❑�CT WORK,CALL WR REINSPECTION TBAPORARY
� ���� PERMANBVT
O COFiRECT UNSAFE OONDITION WITHIN HOURS_ ❑PHOTO TAKEN
INSPEC70R YVILL RETURN
O STOP OiiDER P08TED.CALL INSPECTOR �qTAT10N ISSUED
O INSPEC'TION REOUIRED.C/1LL TO ARRIIN(iE ACCESS.
caN toruie next tnspecaon 24 nairs�ad�►��o.. (952) 249-4600
on site:
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