HomeMy WebLinkAbout2015-00976 - water softner , � CITY OF ORONO * Z 0 1 5 - 0 0 9 7 6 *
2750 KELLEY PARKWAY DATE ISSUED: O8/03/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3115 NORTH SHORE DR
PIN : 09-117-23-32-0013
LEGAL DESC : REG. LAND SURVEY NO.0269
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOPT TYPE : FIXTURE
NOTE: WATF,R SOFTENER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG(<$500) 1.00
WATER DOCTORS TOTAL 16.00
8201 CENTRAL AVENUE Payment(s)
SPRING LAKE PARK,MN 55432- CREDIT CARD 6404 16.00
(763)535-1800
Minnesota State License#: mech-WC645002
OWNER
CONNELLY,THOMAS
3115 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
permits. All 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 wi[hin 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Iss ed Signature Date
Jul 31 15 06:48a Water poctors 7635351805 p.2
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f/���� City of Orono / / �n��
/ � P.O.Box GG Date Rece: c . Permit#_� ��
�� � 2750 Kc[Icy Purkwa}'
( � � Crystal Bay,hIN 553!3 Approved By; Arnounl S� ��•
j 1 (9��)249-=4GD0—i�lain
4� . �� (9�')244-4G16—Fas —
\'����H oR�� J CITY OF ORn�0—PLL`MBING PERMIT
(AII Commercial Permits 1liust be Approved hy thr State Arior to Cit_y Appro��al)
iitt :,7�si�r���.dli.mn.�so��l�C'T�:])!i'D�'?ue �I��mb�fasu•ct�si . df
GENERAL TNFORMATTON
I. You may appiv for plumbing pennits by mail or in persou at the City ofPices. Applications�viil be
re�'iewed znd a penni�will be issued with�n Rva workine days.
2. Percnit cards wi]]be sent by return mai]after a review is com�leted. PF,[�LIITS r1RE NOT
VALID UNTIL 4"OU RECEIVE A PER1�fiT. �y"ORK IYIUST NOT R�Gi�I UNTiL THF
PF,R1YIlT CARD 1S POSTEll OiV 7 HE JQB SITE.
3. Plumbing permits may be:s.sued OIVLY to licensed plwnbing conu•actors and to property owners
residin�ui thc dwclline.
4. 1'�'hen any veti��coastructio�or remodeling is involved,a separate build'u��pe�rnit inus[be
obtaincd.
5. All work rnust be done in accordance with 5rate Code requi;ements.
6. A!l tivork must be inspccted aad air tested before it is covered. Cal](952)249-�600.
(24-48 hour notice required)
TYPE OF PER�vLiT �
Check All That A Iv
�`Residential ❑Commercial(Approval Required)
l `
�Ncw ❑Additionai
❑Repairs ❑Replace
❑ in Accesso.ry Struciure'?
*You�3•ill tteed nrior apprnval and may need Ct:fi.{Per Orono City Co�e,Chapter 7b,AiYic(e IV)
7ob Site i Ou�ner Information: �
Si�e Address: � � � � �Q I-'�� ��j�-� ,��^(✓�
O�vncr:�GYL✓Y�d Lf Mailing Address:
Ciry: Zip:
Home Phone: Altcrnatc Phone:
Cvntractor Information: �
Contraclor: (�(.J��V' { O'G�drs Contact Person: �.Y' .� e5
Address: D �I � �'f✓�(f/�✓�. L'►cec�fe� ' C �-s ��Z
� + State Bond�#:
c�t S �;� C,..�.J�e p o�� 3�Q3
Y= � � 'Gip:S�3ZExpiration Date: _j�! /'�-v/6
Phone: !�3�� 3.S � �� Al#ernate Phone:
pC Insurarice—Current: 4..�7��'}�err�� vvgf�Prh
I
Jul 31 15 06:48a Water poctors 7635351805 p.3
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, �` �_: PLUM�LNG FIXTURE��ETNG I�I�TALI,�I3 -. :; : `
FiXTURE BSMT ]' 2 OTHBR FiXTURE BSMT l 2 OTHER
TYPB FL FL TYPE FL FL
Water Closet Floor brains
La��atory Sewer Ejeccor
Bathtub Laundry Tray
Shower �'asher
Kitchcn Sink � l�'ater Heater
i
Dispos�l tiVater Sofcener
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Dishwasher Wet Bar
5illcocks A4iscellaneous
_ ` F�RI'v�1�''�£..CA�.CI7I:A�'IC1N(S) . ':
- , : :B.AS�I7�}FF-"�OU�S'TA�'E-�-'�`�T�.I'E' ;
� Yes,this section applies
The replacement of only ane Residential fixture or appliance thai mcets all chrcc of thc Collowing
requirements:
1. Does not require madification to electrical or¢as service.
2. F1as a total cost of$SOQ.00 or less;exe]tulinQ the cost of the fixCure or appliance:and
3_ Is improved,installed or replaced by the homeowne�or Iicensed plumbing contractor.
Skip ncxc scetioii,if dii�appliw, C�el otPerii�it $ 15.00
State Surcharge S I.OQ
Mail-In Fee(If Applicable) S �99�-
To[al Permit Fee 5 �(o.CTO
(Permit Fees Condnued On Nerc Page)
2
Jul 31 15 06:48a Water poctors 7635351805 p.4
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� ': : :PER.�I�'-��E CRL�LiLATIaN 5 -JL1�S��ER�54a:44 . .: : - : ::
lf above does not apply;follow guidelines below:
l. COIVTIiACT PRICE * is 1.2�%of contract price w ith a(hiinimum Fcc of$50.00}
x.0125$
(conlracl pricc? (minimum SSO.DO)
2. STATE SURCHARGE
x.0005 S
(contrrct pricc)
3. POSTAG6&HANDLI[vG(Oniy on vfail-In Applications) $ 2.00
4. TOTAL PERA'IIT FE�(�ldd Lines 1-3 Abovel $
• " CONTRACf PRIC� or JOS COST means the actuai or estimated dollar amou��t chatged for the
permitled work including rnaterials; Iabor,profit,and other fixed costs. It is the amount to be charged
to the custorner for the work done. Cf any macetial,equipmznt,labor or installations are furnished by
the owner,tenant or an}'other parry, die reasonable market value of such items must be added to the
estimated cost or contract price for permi� fee purposes. In the event that �here is a dispute on ihe
arnount of the job cost, the City may rcqucst the submission of a signui copy of the actual contract.
_ : = : - - . ��.cn�ts�v����fi���,�e��r�ort�a+����rr� � :;; -. . ..
The undcrsigned hereby applies to the City for issuance of a Plumbin� Pcrmit, agrees to do a(I
work in strict accordance ��ith the ordinances of the City and the regulations of the State of
Minncsota, and cer[ifies that al) slatemettts made on this application are complete; true and
correct.
F�f
Applicant's Signature: / G�� �Date: �/�r �G��
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DATE TI
CITY OF ORONO CALLED IN �
INSPECTION N TICE SCHEDULED
PERMIT NO. Q���20MPLETED
ADDRESS � 1 f S N• ��0 ►r'�_ D�..
OWNER TELEPHONE NO.
CONTRACTOR V1� ��-�r$
� DESCRIPTION �'"` �r ��Q�- ��
lL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING �MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMFLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
w ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
Z
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES�NO
y COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED PROJECT COMPIEfE
� ❑CORRECTVYORK 8 PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY •
V BEFORE CO'VERING PERMANENT ,
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WFLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-460�
OwnerlContractor on site:
Inspector:
White CopyAnspector's Ffle anary CopylSite Notice