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Home My WebLink About2011-01545 - plumbing CITY OF ORONO PERMIT NO.: 2011-01545 ' 2750 KELLEY PARKWAY ` ORONO,MN 55356- DATE ISSUED: 12/13/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3820 NORTH SHORE DR PIN : 08-117-23-33-0059 LEGAL DESC : CRYSTAL BAY VIEW : LOT 000 BLOCK 007 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 1313 DANITA CR. SHAKOPEE,MN 55379 MAIL-IN FEE 2.00 (952)445-4803 MISC FEE 0.00 Minnesota State License#:057209PM TOTAL 22.00 OWNER HAAS,EVELYN 3820 NORTH SHORE DR WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and dces- _ .. .... not grant permission for additional or related work which requires sepazate permits. Al(provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if consVuction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with ttle State Building Code.This permit may be revoked at any time for due cause. i�� - / / / / Applicant Permitee Signature Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A . FOR CITY USE ONLY ,¢p� City of Orono P.O.Box 66 Date Received: Permit# • ��;,.,f � 2750 Kelley Parkway � ,11tl'�` Crystal Bay,MN 55323 Approved By: Amount$: 'Sf,F�_ �:�� (952)249-4600 `ssmio� CITY OF ORONO—PLUMBING PERMIT (All Commercial permits must be approved by ihe Building Official or Inspector) 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 retum 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) �Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs �Replace ❑ In Accessory Structure? *You will need nrior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: 3SoZC� �� 5Y�-�e 1J � Owner��- ��('I�� a5 Mailing Address: 3��J ND�-1�1� Shc�2e CJ�- City: vV(��L(��' Zip: _ "l � Home Phone: �5a-�I� � -aSng Alternate Phone: Contractor Information: Contractor: Contact Person: �Cl,l�l le T\��'� � Address: 31�181587� State Bond#: �� n ectic►ns tnc c��y: 1313 Da�� Circ�PiratiQn Date: Shal apee, MN 55379 Phone: aS'�2'l.(�I,�—�{�'C3 Alternate Phone: ❑ Insurance—Current: 1 PLUMBING FIXTURES BEING I1�iSTALLED FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water H�ater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATIQN(S) BASED OFF-2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance 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;excludin¢the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surchazge $ 5.00 Mail-[n Fee(If Applicable) $ 2.00 Total Permit Fee $ b��•� (Permit Fees Continued On Next Page) 2