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Home My WebLink About2011-00217 - plumbing �- � CITY OF ORONO rERMiT�vo.: 2011-00217 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 04/13/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3085 NORTH SHORE DR PIN : 09-117-23-32-0015 LEGAL DESC : REG. LAND SURVEY NQ.0670 : LOT 000 BLOCK 000 ' PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: WATER CLOSET,LAVATORY,AND SHOWER VALUATION OF PLUMBING 4136 APPLICANT PLUMBING FIXTURE FEE 51.70 WEST SIDE PLUMBING, INC. STATE SURCHARGE PLBG(VALUATION) 5.00 9735 SHADY OAK DRIVE TOTAL 56.70 CHASKA,MN 55318 (952)443-2104 Minnesota State License#: 002983 OWNER OLSON,PAUL&MARTHANN 3085 NORTH SHORE DR WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permiu. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit wifl expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. i l� i�/� i/3i / ' a e itee ure Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. i r R CI Y USE ONLY �� City of Orono /-� '-7 O4 �O� P.O.Box 66 Date Receiv : � Permit# �� v��/ �,,,,,_ � 2750 Kelley Parkway � 3, �'�'y ' �.� Crystal Bay,MN 55323 Approved By: Amount$:�� '7��.��:>,}.o j�` (952)249-4600—Main I ��rs�% (952)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://www.dli.mn. Jo�/CC'LU/PDF/ c �lumb lanreva . df 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 two 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 S[TE. 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 arior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: ��5 /1��.'?'hj_�'h�D�F 1�,Q, D.��i�o , Owner�r�� SOi1� Mailing Address: �'4�3�/l�r�@�',/ S'/�Gt��',L��O,��'n c�ty: Qt2Uvr.C� zip: -� S 3�'J Home Phone:��_��,J�`� �.5� Alternate Phone: Contractor Information: Contractor: L�'�� S/,d E ��.(1.��'�'/Nt�'/��ontact Person: ��,E'�'",� ,�'I•Q�i''S'T SlaA/> Address: �733 �� 3�� State Bond #: it,�.��/C�`��/Of� City: CH.�S/11' Zip:S�f,� Expiration Date: /��-' �l-�/% Phone: �,� �.�� 3 arc� �.•- Alternate Phone: l�� /�'�S�.�y�� ❑ Insurance-Current: 1 � - �� , , � �t . ,�;` §� '" �' y�" .,;,, If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contxact price with a(Minimum Fee of$50.00) �/�G� X.oi2s$ 3/.70 (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00) y�3�� X.000s $ .�mo (contract price) (miaimum$ 5.00) 3. POSTAGE&HANDLING(Only on Mail-In Appiications) $ 2.00 4. TOTAL PERMIT F'EE(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 instailations 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$5.00—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. � �r��';F�'�� ,,' ` 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: ��` 3 , , _ k �+�� ;;� , �� FIXTURE BSMT 1 2 O'THER FIXTURE BSMT 1 2 OTI-�R TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Wate,r Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous � � ,��: , , � , � ��°��' � �� .� ,= �: ❑ Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three of the following requirements: 1. Dces 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 ne�ct section,if this applies; Cost of Permit $ 15.00 State Swcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 House heating test record CenterPointm Energy owner ��_5�� Controls Conversion Address p; /�. ��Of r- �( 3�3's � '� {J/'�Thermostat Heat plug Ueni size „3 �, City ��lV(� Ualue i.(J�� Kind of liner/size S, � 7 ,/ Heat loss Date htg. inst `1:��j`O,� Limit ��y�� Drafr hood��n�� Regulator Sold by CenterPoint Ener�y Limit setting ��p� Filters:Size�(y�J,sy(1 Number f Installed by CenterPoint Ener�� Fan setting ��rt,� Chimney location: (t�Inside � Outside Electrical work by Cer,terPoi;,t �ner�7y Pilot type S�f��I?� Chimney construction Q^ �� Heat type: �—FA � Space heater Pilot make Wirin�rt Test tag Vrs Gas line by �Q r'�y� Pilot model Lighting Inst s„r� Date te,sted/;�'.2$`Cf _ � . Unit heater Other Pilot timing Company testing CenterPoint EnerQ� Pressure: Hi fire/Lo fire 3,� / �� o Tester's name �Y� Gas design Y p u _ n ��,pK ^p� Percent COz • � Make f� H•�� 0�� £��' �,��,�3 Y Input CFH '7� Percent Oz '�'f*� Serial no. �� j�-�� Stack temp "�'�� Percent CO �j �Om Input `�.5�� 02005 CenterPoint Energy - Form 235 Rev.1/05 ID�2352 � � C� A TIME " CITY OF ORONO CALLED IN �/� INSPECTION NOT SCHEDULED �� PERMIT NO. O��`�� COMPLETED ADDRESS Q -� � ✓\ ' OWNER 'TEL NE NO. a � CONTRACTOR >; DESCRIPTION � � � ❑ FOOTING ❑ PLUMBING FINA EXCAV/GRAOING/FILLING Q ❑ POURED WALL ❑ MECHANICAL R ❑ IAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a � J O a � O W e �� o Q � � �!' h�c7 Cz � � 2 W � W � � W �K SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDiTIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice �� Dp�E TIME � CITY OF ORONO CALLED IN � 3 INSPECTION NOTICE SCHEDULED .T- -1! �O: � PERMIT NO.�DII-ooa r� COMPLETED ADDRESS 3085 /Uv�'T�� JV1,�T7:(� '�'�/ OWNER •TELEPHONE NO.��Z �I�O�F d5�� CONTRACTOR C�'/'�6�� DESCRIPTION � ' � ❑ FOOTING ❑ PLUMBING FI ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 ❑ PLUM I ❑ S AL ❑ FOUNDATION/REMOVAL � OWNERI NTRACTOR TO MEET YOU: YES NO y COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � � ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ E CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WFLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑IfVSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on e: Inspector. o t . s./-1 . , White Copyllnspector's File Canary CopylSite Notice