HomeMy WebLinkAbout2017-01441 - plumbing CITY OF ORONO I*Izll I IhI_I'�I I I 4I4I III
2750 KELLEY PARKWAY DATE ISSUED: 11/03/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 930 COX FARM RD
PIN : 27-118-23-33-0013
LEGAL DESC : SHADOWOOD FARM
: LOT 010 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (1)WATER CLOSET,(2)LAVATORIES,(1)SHOWER,(1)FLOOR DRAIN
VALUATION OF PLUMBING 3000
APPLICANT PLUMBING FIXTURE FEE 50.00
NRH PLUMBING INC. STATE SURCHARGE PLBG(VALUATION) 1.50
8751 162ND LANE NW MAIL-IN FEE 2.00
ANOKA,MN 55303- TOTAL 53.50
(612)900-7728 Payment(s)
Minnesota State License#: CHECK 5248 53.50
plbg-PC644503,HV AC-MB004 801
OWNER
KILLINGSTAD,MR.&MRS.
930 COX FARM RD
LONG LAKE,MN 55356
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 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/it08/ /7
Applicant Permi ee Signature Date Issued By Sature Date
-�SON City of Orono FOR CI �S ON
O P.O. Box 66 Date Received: !' ��
II 2750 Kelley Parkway a
Crystal Bay, MN 55323 �u.`°
y`�:.. Permit# /7�
y�� �L` (952)249-4600-Main
Approved B
osHOQ- (952)249-4616—Fax r''.' ��..' PP Y
Amount$: 53
CITY OFCdIONO - PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.gov/CCLD/PDF/pe plumbplanrevapp.pdf
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 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)
sidential ❑ Commercial (Approval Required) [Backflow Device: AVB 0 PVB]
❑ New ❑ Additional ❑ Repairs VR eplace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site /Owner Information:jjj%�� 12OAzD
SiteAddress: CMJ C(/ ✓ OQ1Q _
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Owner: IfigikK.. �� IL ailing Address:q/V `D/ FP Rt _
City: . Zip:
Home Phone: to Alternate Phone: .P l7-- - lDq -1 c
Contractor Information:
Contractor: \ r .Illi L . Contact Person: `(
044 :3((_-_
Address: 4.), ---T1+
�oF , O 4L _mg.: \ .tate Bond #: --VC,
Zip: 5 Expiration Date: 12_ 170fl
Phone: 1121L- C1CD "-11 Lo Alternate Phone: LQ l2 Z41 e2-( XC)
E(Insurance - Current: c 61 q 01, n - 02.11?)
jrli&d.L * UlCOL 1.104-a_uriBit.t6 , COfl
Page 1
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet t Floor Drains
Lavatory 2 Sewer Ejector
Bathtub Laundry Tray
Shower t Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION
1. CONTRACT PRICE * is 1.2��5��%yy off�contract price with a (Minimum Fee of$50.00)
r')Cst..�C 7 x .0125 $
(contract price) (minimum $50.00)
2. STATE SURCHARGE
ibCW x .0005 $
(contract price)
3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ tJ
______
* 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 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.
PLUMBING PERMIT APPLICATION AGREEMENT
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: fOl, jtifftiz___
Date: 11/0420/20/7
Building Official/ Inspector: Date:
Page 2
...- 1 ii---
D TIME
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CITY OF ORONO CALLED IN 01° /1
PERMIT N ,5 CE v,, c41/ SCHEDULED /Z /$"/D:30
COMP ED
ADDRESS 930 ✓ ZLh-1'Yl j(40/—
OWNER p}� PHONE NO.���_03345_7A gO
CONTRACTOR /OA ` , �� - „ro _____,
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1
�, DESCRIPTION t1b r
._L ❑ FOOTING 0 DEMO-F , 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMB 0 EXCAV/GRADING/FILLING
Q0 FOUNDATION DRAIN TILE 0 PLUMB FINAL 0 TREE REMOVAL
❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
Z
❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
14.1 ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
2 COMMENTS: 4l! li' ,ter+( S_<leT L/a/1 c s
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Cl• jilFWORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
CCW
0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site: ,
Inspector. .7-47,0-- A
• White Copy/Inspector's File Canary CopylSite Notice