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Home My WebLink About2011-00778 - plumbing CITY OF ORONO PERMIT NO.: 2011-00778 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUEn: 08/02/2011 ` 952 249-4600 FAX: 952 249-4616 ADDRESS : 1045 NORTH ARM DR PIN : 07-117-23-14-0019 LEGAL DESC : LINDEN BEACH : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(<$500) 5.00 3670 DODD ROAD-SUITE 100 EAGAN,MN 55123- MAIL-IN FEE 2.00 �� MISC FEE 0.00 Minnesota State License#: 61770PM TOTAL 22.00 OWNER RHYLICK, SALLY 1045 NORTH ARM DR MOiJND,MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate pertnits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring a►1 required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � `�I�r`�'�i`^• �� l l l l Applicant Permitee Signature Date Issued By S' ature te SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �� * � rg,Q�,, City of Orono FUR CTTY USE ONLY . i� 0 P.�.Box 66 Date Received: Permit N � 2750 Kelley Parkway !��, � Crystal Bay,MN 55323 Approved By: Amount$: �* ``+} �y,4�' (952)249-4600—Main ��"°g (952)249-4616—Fax CITY OF ORONO— PLUMBING PERMIT (All Commercial Perrnits Must be Approved by the State Prior to City Approval) R ^c 8itt :/l�vtivw.dti.mn.00v/CCLD/PDF/ e lumb lanreva . df �vc'V�� GENERAL INFORMATION 1. You may apply for plumbin G O , z��1 g permits by mail or in person at the City of�ices. Applications wil reviewed and a permit will be issued within two working days. ��FQR 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT �N� 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 I �Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs �Replace ❑ In Accessory Structure? *You will need�rior anoroval and may need CL P.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: �� N, � �( � Owner:1"1�P�(�" �T�,{�,QW�� Mailing Address: �GVY1/1-� ��Ty: )U�.Ot�� Z�p: ��3�� Home Phone: � (Z'��U`�p�p�� Alternate Phone: Contractor Information: Contractor: _� Contact Person: �� ( S #8'I 3��0-PM �np ` n Address: __��_��;� y,,,,,, State Bond#: �(� � J" V 3670 Do� City: Eagan, IV�(1'��123 Expiration Date: �`� Phone: Alternate Phone: ❑ Insurance-Current: 1 - �� _ '. . � � ��" 4 y �� ; �� .�. �� :. FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Ploor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink �Vater Heater Disposal Water Softener Dishwasher Wet Bar Sil lcocks Miscellaneous ' u �-w"��.1��,.� � � �;,. '� t} a$t �g •�,�> :�i��#�': ^:a��s �-�.r`t��, � �... ...�� .�.��,}�„�'x• � Yes,this section applies The replacement of only one 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;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 $ 2 Z•0� (Permit Fees Continued On Next Page) 2 `+ ` � � - - � PERMI�'v �C ��:� ;.�� „�_=�� Y 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 550.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 55.00) x.0005 $ (contract price) (minimum S 5.00) 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 fuced 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. ' **The ST.qTE SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. �'` P1:,U '' � � ��- �� 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: 7�� -�,�� . : ��e�`FOrm x: � �z. 3 '� � AT TI V C Y O ORONO --�� CALLED IN � INSPECTION �O��C,E��SCHEDULED PERMIT NO.��J � COMPLETED ADDRESS � Dr OWNER • TELEP E NO.��._�_�� CONTRACTO �� C- >: DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE � SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J RI ❑ SEPj.IC FINAL ❑ FOUNDATION/REMOVAL TRACTOR TO MEEf YOU:��_YES_NO � COMMENTS: � W � � J O � � O � W � Q � Z W � W � � d W� ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED y�ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �95Z� 249-46QQ Owner/Contractor on site: Inspector. �oft / �/'� ^/,� i� � White Copy/lnspector's File Canary CopylSite Notice