HomeMy WebLinkAbout2013-01277 - water softener Im
CITY OF ORONO * Z PJ 1 3 - 0 1 2 7 7
2750 KELLEY PARKWAY DATE ISSUED: 12/10/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS 2585 OLD BEACH RD
PIN 21-117-23-22-0020
LEGAL DESC THE MARSH AT LAFAYETTE
LOT 007 BLOCK 001
PERMIT TYPE PLUMBING(<$500)
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE FIXTURE
NOTE: WATER SOFTENER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO.
STATE SURCHARGE PLBG(<$500) 5.00
MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345 TOTAL 22.00
(952)912-7379 Payment(s)
CREDIT CARD 0597 22.00
OWNER
FREIVALDS,JOHN&LINDA
2585 OLD BEACH RD
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 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.
L 24/13
Applicant Permitee Signature Date Issued By Signature Date
12/09/2013 15:14 FAX 9529335049 CULLIGAN MNTKA R002
FO CITY USE ONLY
" U�� City of Orono
0¢ h0 P.O.Box 66 Date Receive �� Permit#
I 4 2750 Kelley Parkway
I, t t rf Crystal Bay,MN 55323 Approved By: Amount 5:
_ (952)249-4600
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
I. 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)
Residential ❑Commercial(Approval Required)
New ❑Additional ❑RepairsReplace
❑ In Accessory Structure?
*You will need Rrior anyroval and may need BJP.(Per Orono City Code,Chapter 78,Article iV)
Job Site/Owner Information: nn Q
Site Address: a5S5
Owner: 7-0\ Vrt:"j.\&5 Mailing Address:
City: Zip: 5539 1
Home Phone: bl A-334 - 1a b I Alternate Phone:
Contractor Information:
CUC1QKVAft ATFR noNnlTIGNI tri Contact Person:
6030 CULLIGAN WAY
A98UNETON_KA, MN 55145 State Bond#:
(952) 933-7200
City: Zip: Expiration Date:
Phone: Alternate Phone: q5 a -91 d - 13 3
❑ Insurance—Current:
1
12/09/2013 15:14 FAX 9529335049 CULLIGAN NNM IM 003
FIXTURE BSMT 1 2ND OTHER FIXTURE BSMT IST 2 NDOTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
Yes,this section applies
The replacement of a Residential fixture or jMliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service,
2. 'Has aLo.W cost of$500.00 or less;excludins the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,ifthis 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
12/09/2013 15:14 FAX 9529335049 CULLIGAN KNTKA lit004
If above does not apply;follow guidelines below:
1. C NTRA RICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(convect price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of 55.00)
x.0005 $
(contract price) (minimum$ 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) 00
■ * 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 to 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$1,000,000 or$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 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.
Applicant's Signature: U Date:
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CITY OF ORONO CALLEDIN I 01- )q_3
INSPECTION NOTICHEDULED -
PERMIT NO. ��co L D
ADDRESS
OWNER PHONE NO-6473
CONTRACTOR
DESCRIPTION
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[I FOOTING ❑ PLUMBING FINAL &4EXCA GMN❑ POURED WALL ❑ MECHANICAL RI LAKESHDS
❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
Q ❑ DEMO-SITE ❑ SEPTIC MAINT. El FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
&,2nNTRACTOR TO MEET YOU:)CYES_NO
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Q!tORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑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
Ownsctor on site: i
Inspector:
White C"ynnspecWs File Canary CopyfSne Notice
DATE TIME V
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMfT NO.a)D/3_,6/7_7 7 COMPLETED
ADDRESS 26-1967 AM Arm-Ai
OWNER TELEPHONE NO.
CONTRACTORki
DESCRIPTION
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C ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
❑ FRAMING ❑ MECHANICAL 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
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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�j BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑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 advarfcs. (952) 249-4600
OwnedContractor on site:
Inspector. �i M. —
White Copynnspectoes File Canary CopyWo Notice