HomeMy WebLinkAbout2013-00064 - plumbing HHHUIEFEM
CITY OF ORONO * 2013 - 00064 *
2750 KELLEY PARKWAY DATE ISSUED: 01/24/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS 990 NORTH SHORE DR W
PIN 07-117-23-22-0018
LEGAL DESC ENGLUND THIRD ADDITION
LOT 001 BLOCK 001
PERMIT TYPE PLUMBING(>$500)
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE FIXTURES-MULTIPLE
NOTE: 5 WATER CLOSETS,8 LAVATORY,3 BATHTUB,4 SHOWERS, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER,4 SILLCOCKS,
1 FLOOR DRAIN, 1 LAUNDRY TRAY, 1 WASHER, 1 WATER HEATER, 1 WATER SOFTNER
VALUATION OF PLUMBING 15500
APPLICANT PLUMBING FIXTURE FEE 193.75
NRH PLUMBING INC. STATE SURCHARGE PLBG(VALUATION) 7.75
6460 153RD LN
RAMSEY,MN 55303- TOTAL 201.50
(612)245-7280 PAID WITH CC# 8476
Minnesota State License#:067436 PM
OWNER
WILSEY,JASON
8151 33RD AVE S
#206
BLOOMINGTON,MN 55425-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is respon ible for assuring all req red inspections are
requested in conform cc with the Stat u' g Code.This permit may be
revoked at any time f due cause.
/� �Y/ /-3-
Appli nt PermKee Signatur Date � C �� �� / ~`�
Issued By Sig ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
f
F0A CM 1JSE:0N X'
City of Orono
�40�0 P.O.Box 66 Date Aecerved; Pernvt#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: tinount$ '
(952)249-4600—Main
(952)249-4616—Fax
CITY OF ORONO —PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dH.mn.gov/CCLD/PDF/pe 1plumbp1anrevapp.pdf
GENERAL IN,FOR A'TION- "
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.
(2448 hour notice required)
n
TI'PE O TERNTIT
Check AU'Th4t 1
Residential ❑Commercial(Approval Required)
New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
Job"Site J,Ovnex,i4rmation:
Site Address:
Owner: ".TtaS oral w i c..5 f,--j Mailing Address: O H-ew
City: QRVA16 Zip:
Home Phone: l-P1 Z -31,6 nl gY- Alternate Phone:
Coxitraet�ir ItfQrriaaxioi:
Contractor: /V014 10.0 Contact Person: AA t-) ALIeal
Address: State Bond#: VC- fa N Y S'ba
City: Zip:�s3.P 3 Expiration Date: 03/01/, 2 n y
Phone: !o/z z V S 7 z 20 Alternate Phone:
❑ Insurance—Current: y es
1
FIXTURE BSMT IST 2 ND OTHER FIXTURE BSMT 1 2 ND OTHER
TYPE FL FL TYPE FL FL
Water Closet 1 Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower ` 3 Washer 1
Kitchen Sink ' Water Heater '
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
IRS
Or-
QN�� fir"-::..
A0 nj
❑ Yes,this section applies
The replacement of only one 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;excluding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
t
eE
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
r-5-
j SPJb x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE
1,5� 57ay x.0005 $ 7' -7 S
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(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 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.
.�I BTNG P] RR
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: -7d )�44Date:
3
r —5 :5� DATE TIME
CITY OF ORONO CALLED IN 1 r r
INSPECTIONMT
SCHEDULED _..l 13
PERMIT NO. - COMPLE1E,D
ADDRESS
OWNER EPHONE NO.'P�O� �S- 7
CONTRACTOR
DESCRIPTION
L1 FOOTING ❑ PLUMBI INA ❑ EXCAV/GRADING/FILLING
Q
El POURED WALL ❑ MECHA IC RI ❑ LAKESHORE/WETLANDS
y
El FRAMING ❑ MECHA AL FINAL El TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES—NO
COMMENTS:
cc
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cc
J
cc
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LU )R7ddORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
QO ElCORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
11STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor onsite:
Inspector. ('
White CopylInspector's File Canary CopylSite Notice
��J DAT TIME
CITY OF ORONel,2 VeALLED IN �,2 /
INSPECTION �Q�� ✓SCHEDULED �- r �'
PERMIT NO.o2o43-0oD(f:5 COMPLETED /�
ADDRESS �9D M-9 �J_A
OWNER _ TELEPHONE NO.
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CONTRACTOR �2N110// �� /&
DESCRIPTION 12_.L_, �(
❑ FOOTING L1 PLUMBING FINAL (� R DING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
❑ FRAMING ❑ MECHANICAL FINAL
O El TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ElDEMO-FINAL ❑ SEPTIC INSTALL ElHARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES NO
COMMENTS:
ac
W
Q.
CC
cc
0
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CC
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Z
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W SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W�❑ CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
Q1 Ll CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. D PHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
NN
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
( � T% TIME
`CITY OF ORONO CALLED IN4_1
INSPECTIOIE � SCHEDULED _ 3 ��"oo
PERMIT NO. COMPLETED
ADDRESS `-Y`'fy �� Of .
OWNER TELEPHONE NO. �Of Z 2c[E• 7`-
CONTRACTOR N tZ f4 — -J z ,, Com'
DESCRIPTION ���-�-%� F(cx-y
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILUNG
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREIWETLANDS
Oy ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
2 ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
h COMMENTS:
W
C _ ) i�
j r l 00'r �y/�-S r1l�n� $ (Te
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LmA1NG$KSATISFACTORY-PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFECONDITION WITHIN HOURS. ❑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
Ovmr/Contmctor on site:
Inspector.
White CopyMspectoes File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO c ED IN 3�
INSPECTION NOTI SCHEDULED1 —
PERMIT NO. 20 F — OMPL D
ADDRESS
OWNER 02 1 TELEPHONE NO.
CONTRACTOR fl �
DESCRIPTION G
❑ FOOTING ❑ PLUMBING N L ❑ EXCAV/GRADING/FILLING
q:rLlPOURED WALL LiMECHANI L I El LAKE SHORE/WETLANDS
O ❑ FRAMING EJ MEC HANI L FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
W
A0 �s' �- d
Cr
0
LL
W
CC
Q
2
W
W
cc
j
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W W60CAK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
cc ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN J CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice