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Home My WebLink About2016-01011 - plumbing f _ r CITY OF ORONO 11 1 II I 11 I Ir * 2750 KELLEY PARKWAY * 2 0 1 6 - 0 1 0 1 1 DATE ISSUED: 08/22/2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 540 OLD CRYSTAL BAY RD S PIN : 04-117-23-42.0023 LEGAL DESC : WHITE OAK OVERLOOK : LOT 001 BLOCK 001 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENT CONSTRUCTION TYPE : FIXTURES- TIPLE NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)IKITCHEN SINK,(1)WASHER VALUATION OF PLUMBING 3000 II APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 1.50 PLUMBING WEST,INC. MAIL-IN FEE 2.00 23248 WALDEN AVENUE HUTCHINSON,MN 55350 TOTAL 53.50 (320)587-0300 Payment(s) CHECK 4696 53.50 OWNER ROGOSHESKE,GEORGE FUNK&JUDY 540 OLD CRYSTAL BAY RD S 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. 6.744_42:44ecet) 1€15firg 67- Applicant Permitee Signature Date Issued BrSignature Date pN City of Orono FOR CITY USE ONLY P.O. Box 66 Date Received: �5--��— f ( ' 2750 Kelley Parkway )� a y Crystal Bay, MN 55323 tke'CeIV Permit# OVJ/�o—�� 1 (952)249-4600—Maino1B A roved By:kFs►io (952)249-4616—Fax 2 pp �UQ 2 Amount$: .yoF °RANO CITY OF OF 3MO— 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) Residential ❑ Commercial (Approval Required) [Backflow Device: ❑AVB ❑PVB] ❑ 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 / Owner Information: Site Address: `1() D Id CYyStLt I Eat 12--c1 c1 S • Owner: AtAdi taecty. wogs IISk Mailing Address: City: Zip: Home Phone: 415-.5811 Alternate Phone: Contractor Information: Contractor: Pi lAmbk (1C� INC St- Contact Person: S'te1V Q WC/9 h tl,/ Address: 23242 V NO CtRAl /'tV-t State Bond #: PC_LQ`t 5Z. q(Q City: HIXrcy)k 1501 Zip: 553 J O Expiration Date: I Z./ 13/ ) 7 Phone: 320 - c1-1 `d 30 Alternate Phone: ❑ Insurance - Current: Cy nvi ( I Mutual 0000305 /41 .exp . 1/11/`Z0 7 Page 1 • FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE Floor Floor TYPE Floor Floor Water Closet IC Floor Drains Lavatory I Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink I Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous 1. CONTRACT PRICE * i 1.25% of contract price with a (Minimum Fee of$50.00) 14 000 . 00 x .0125 $ 130 . 00 (contract price) (minimum $50.00) 2. STATE SURCHARGE it ', 000. 0 0 x .0005 $ I . GJO (contract price) 3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00 4. TOTAL;PERMIT FEE (Add Lines 1-3 Above) $ 53 . 0 * 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 orny 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 jobcost, the City may request the submission of a signed copy of the actual contract. P ,,$.avuv 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. -.--,7::E. Applicant's Signature: Date: �/lq//c-Q Building Official/ Inspector: Date: Page 2 L ,_____3 s ed-- BATE TIME ,iTY OF ORONO CALLED IN v .... INSPECTION N T / SCHEDULED ;YAW - 1•'ex) PERMIT NO. L(i/ 'I' ` C COMP ETED ADDRESS 55 /2 `=/'/S/ S OWNER a i TE EPHONE NO. ."/ - AZ13.3 --5-- 9 CONTRACTOR Fla - —' `S DESCRIPTION I �� —(�` lu ❑ FOOTING 0 DEMO-FI i : 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMB! 0 EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF 0 PLUMBING INAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI ❑ SITE INSPECTION Q 0 FRAMING ❑ MECHANICAL FINAL 0 RATED WALLS • ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK- • i : DA ` /REMOVAL v ❑ DEMO-SITE 0 SEPTIC ALL Z OWNER /CONTRACTOR TO MEET YOU:— —NOI A,-c0.) COMMENTS: cc W Q. CC Ilik O J (944 C O i W CC Q 2 W Z W CC J W // WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE WEl CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CZ LI CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p 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. (9 j' ) 249-4600 Owner/Contractor on site: _.?"-_....,,,No Inspector. ,,t,. ,? / ' / White Copy/Inspector's File Canary Copy e Notice E. - ✓` D / TIME CITY OF ORONOT E CALLED IN //' `� INSPECTION y� �(YJ_�-t d`� SCHEDULED !/—o"i —L(� a: C'� PERMIT NO. /� COMPLETED p ADDRESS �� _/ - 5 OWNER TELEPH ENO. l'''.''.3 7- CONTRACTOR-f,,��JJ��f�+'IA-rnhivi/Lç` C E DESCRIPTION 49 h Vit �� LU 0 FOOTING 0 DEM -F INAL 0 SEPTIC FINAL Q 0 POURED WALL 0 PLUM NG RI 0 EXCAV/GRADING/FILLING C ❑ FOUNDATION WATERPROOF LUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL ❑ DEMO-SITE 0 SEPTIC INSTALL si 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: W — iu �i1/ab c,✓ w�c refee,,-i V/S Ute' Lt 0 > Gvor R- ca►v)lie 0 W B: Q 12 W tLi — PrAM/4-� vl4L/`D- LU0 WORK SATISFACTORY.PROCEED OJECT COMPLETE W 0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY Q 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION 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 OvvnerlContractor on she: / Inspector. % '41'"' White covynn:p•oeor'.FIN Canary Copy/SIM Notice