HomeMy WebLinkAbout2018-00361 - water softner '• t CITY OF ORONO I I Fit 'III 11 L [ 11' 1F11
*
2750 KELLEY PARKWAY * 2 1 8 - 0 0 3 1
DATE ISSUED: 03/27/22 018
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 235 HOLLANDER RD
PIN : 25-118-23-43-0026
LEGAL DESC : HOLLY ACRES 2ND ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: WATER SOFTENER
VALUATION OF PLUMBING 2949
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.47
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 53.47
(952)912-7379 Payment(s)
CREDIT CARD 6828 53.47
OWNER
KELSEY,DAVID&CHERYL
235 HOLLANDER 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 tim for due cause.
a ., 2S, ! •
Applicant Permitee Signature Date Issued B ignature Date
03/27/2018 12:19 FAX 9529335049 CULLIGAN MNTKA l 002
• t
*lc,0� City of Orono FOR USE
N
0
2 P.O.O KeIle6Parkwa Date,Received:( /A 7 { 6
Kelley Y Permit# ,A0.12,..,_60.3:&
Ot S �0b)
-\ Crystal Bay, MN 55323
to (952)249-4600-Main Approved By0$00 (952)249-4616-Fax
Amount. . .... .:..... ... ... . ...
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
htto://www.dli.mndoovICCLD/PDF/De p.lumbplanrevapp.pdf
GENERAL':INFORMATION :a
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)
a: _...... hecK .._lt .:: . . Apply F:1e ,:
..:_�;.:-: ;,:TYPE OF_PERMITFC .. �'- �
Residential ❑ Commercial (Approval Required) [Backflow Device: ❑AVB ❑PVB)
NIXNew ❑Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78,Article IV)
'Jab Site!Owner fnformatidri- > ti n
Site Address: 035 Nb» r
o. ,c``i r Ra
Owner: Do,v'v& ,2--k5 k-y Mailing Address:
City: Zip:
Home Phone: 9 5 a - '113 a.9 I t Alternate Phone:
Contracforinformation:`;_
Contractor: Contact Person:
Address: ,ULLIGAN WATER CONDITIONING State Bond #:
8030 CULLIGAN WAY
City: MINNETONKA, MN 55345 Zip: Expiration Date:
(9 ) 933-7200
Phone: Alternate Phone:
❑ Insurance—Current:
Page 1
03/27/2018 12:20 FAX 9529335049 CULLIGAN MNTKA 2003
- kt.
.;:rPLUiVIBING.1.EIX l RES„BEO,NG NSTP►L QED
' 4s
' FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1ST 2N0 OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener I
Dishwasher Wet Bar
Silicocks Miscellaneous
(...j.-.y.._aoq„K:,:.:. .::. �::�:. ^_�,'i i:,:.;d':::qk.;. ... .. � .. �.t `:ti ;'4_Fa. n�ya:.:::::y;D��:�:y�i,.;u.a::.6:�.;,:.r;,'h.l'..�..:,�_:...��h.._: ti� S";
cl....... ..,4i5.t... . ....•�.,.;T.�::L II�gN,A- 5.'•_.• l_._:;. .'�,. ':.: _:"Y - ::5...,.+..+.1.:d•..-:. '--;w�, .:PL
[„tl�,a.��bSe.�: r.d.�„4!4�� Y`_v:r -+:+fri: - k.]:'� � 'y ,., r. �..�T.-�t' ... .__.__... .... :$�:�,',k�f[b P' a':�=-:,�.e�'p"b.`-�f'�. ',�"`,`�'.: �� �P.�V.
1.- CONTRACT PRICE *is 1.25% of contract price with a (Minimum Fee of-$50.00)
c 94 '3. 00 x .0125 $ SD. 00
(contract price) (minimum $50.00)
2. STATE SURCHARGE
x .0005 $ J. 9
(contract price)
3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ 3a. 971
* 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 cbntract'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.
.
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: 4 2±71 Date: 3- d`? - I D C/
Building Official/ Inspector: Date:
Page 2
DATE TIME
CITY OF ORONO CALLED IN
INSPECTIO 8 ESCHEDULED '/Vf' C'•49
PERMIT NO. - - __ I COMPL D-n F/3,.7ADDRESS Z3-5" ►moi�� c 1
OWNER TELEPHONE NOPit• L113" 2ge4
CONTRACTOR (5L- .,-._ ____.
.�
DESCRIPTION - � 4- . -rorty -./1-ie
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
wa 0 FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL
C
Z ❑ LATHE 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
Z OINNERICONTRACTOR TO MEET YOU:_YES_NO
vvi COMMENTS:
cc
r7
o /)d— 6s'u2-- hfrt-e--
cc
o A-144..7 — /9 Gr- ,Al s4vKl —
W
cc
/1ffD ,4 s fid— his 5e<��
W
W
et
W 0 WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE
CCW
0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
c 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
❑ OP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
ECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contra site:
Inspector. Y
White Copyllnepector's File Canary Copy/Site Notice
DATE TIME /
CITY OF ORONO CALLED IN
INSPECTIONO CE SCHEDULED �/oZ5 4 �3 b
PERMIT NO. /�-00,S(0) 1COM LETED
ADDRESS a 6 b l vK -
OWNER /1 TELEPHONE NO.96 Z -1/7?—2��J�
CONTRACTOR Ct1l!!. t h
>; DESCRIPTION Wa- (�k�'1� IVa fI vr7 -0
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
y ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL
Z ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION
'ct 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
v 0 WATER HOOK-UP 0 FOLLOW-UP
- 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
✓ ❑ DEMO-SITE 0 SEPTIC INSTALL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
• COMMENTS:
4.1 Q..
i MA, -i, 16,e_✓ dX.��✓
- tiS,d�TGr sl6, /K,SLL4.A)
CC
/bf0 3 P�S
CC — 4,- - G ypec)✓(p
0
W
cc G)orK. m,feep -
Q
W
Z T
IQ
CC
"S ,,09-4-,4a.1—. riid.0
U4 ❑WORK SATISFACTORY:PROCEED RO C COMPLETE
W ❑CORRECT WORK&PROCEED CIISSUE CERTIFICATE OF OCCUPANCY
CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
LI CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
IIISTOP ORDER POSTED.CALL INSPECTOR CI CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. /ii,-
White Copyllnspector's File Canary Copy/Site Notice