HomeMy WebLinkAbout2004-P08196 - plumbing PERMIT
• �:���Y O F O RO N O permit Number:
2750 Kelley Parkway- PO Box 66 P08196
Crystal Bay, Minnesota 55323 Permit Type: FiXcuTes
(952) 249-4600 Date Issued: 11�1��2ooa
SITE ADDRESS: 2625 North Shore Dr
Wayzata,MN 55391
P I D: 09-117-23-42-0003
DESCRIPTION:
Proposed Use:
Pemut Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Multiple Fixhues
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 99.94 Valuation: $ 7,995.00
State Surcharge Fee: $ 4.00
TOTAL FEE: $ 103.94
APPLICANT: Elander Mechanical Inc OWNER: Bartholomew&Elizabeth Butzer
591 Citation Drive 2625 North Shore Dr
Shakopee,MN 55379 Wayzata,MN 55391
TI�UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Reauired), 1-A�licant, 1-Monthlv Reports, 1-Assessin¢, 1-Finance Page 1
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.
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
Residential Commercial
JOB SITE: ��as N�• `f'� ��o�� �/�r v.c_ Zip:
Owner's Name: �3 K T-� ��z Telephone Number:
Mailing Address: lo�-S" • o•-� City: 6�0�� Zip: ss 3 S/
Contractor's Name: � G � ��� /Ll�� a�, c�� Telephone Number: ssd-�y..r-Y�'s�-
Mailing Address: 5�/ C� �c�, .— City: Sl.4-�oP�,�Zip: SS-3 7�
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1 ST 2ND OTHER FIXTURE BSM 1 S 2ND OTHER
TYPE FL FL TYPE T T FL
FL
Water Closet � Floor Drains (
Lavator � Sewer E'ector
Bathtub Laund Tra
Shower � Washer
Kitchen Sink � Water Heater (
Dis osal � Water Softener
Dishwasher � Wet Bar �
Sillcocks � Misc list
PERMIT FEE CALCULATION(S)
2002 State Statute ❑ Yes, This Section Appiies
The rep(acement of a Residential fixture or a�pliance that meets all three of the following requirements:
1) Does not require modification to electrical or gas service.
2) Has a tota( 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:
1. Contract Price* is .0125 % of job with a Minimum Fee of ($35.00�
�g � s°' X .oi25 $ �9 ��
(contract price) (minimum$35.00)
2. State Surchar�e. **Add the State Building Code Division a (Minimum Fee of$ .50)
'7 9 S s°=' X .0005 � y =
(contract price) (minimum$.50)
3. Posta�e and Handlin� (Only mail-in applications) � �-i-��-
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ l 0 3 �y
* 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 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 $I,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.
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Applicant's Signature: Date:
� .,p TIME �
CITY OF ORONO CALLED IN �'�
INSPECTION T SCHEDULED � - 'D ��Q_
PERMIT NO. COMPLETED
ADDRESS ��a� �dY� �
OWNER CONTR. �jf�,Ij�JI /�l �
TELEPHONE NO. CDI a �_,��
� DESCRIPTION ���'rn'�� ,`-�-�
� 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTAI.L. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 WARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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� �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Catl for the next inspection 24 hours irt advance. (952) 249-46��
Owner/Contra o ite:
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
� ;��-°� � ��: _ c�
� , DATE TIME
CITY OF ORONO CALLED IN !' '� I,
INSPECTION NOTICE SCHEDULED �y iG -�cir'�'�
PERMIT NO. / ,� � ;'i ( COMPLETED
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ADDRESS , ; u . �.,:� �.. � ; .-i - n , -
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OWNER CONTR. �/���i'�.,� !-s S�.<
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TELEPHONE N0. �-� % �� �%/(� /�/��/
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� DESCRIPTION���"�- ����'�r'"�> .
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOILOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATfON/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORKSATISFACTORY:PROCEED f� PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOl1RS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (J52� 24J-460�
Owner/Contract ite:
Inspector. �
White Copyllnspector File Canary CopylSite Notice