HomeMy WebLinkAbout2017-00434 - plumbing CITY OF ORONO I I I III IIII II 111 LI1 II' ll I I I 11
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*
2750 KELLEY PARKWAY * 2 1 - 0 0 4 4
DATE ISS -
05/02/22 017
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 1380 ORONO LA
PIN : 02-117-23-34-0012
LEGAL DESC : REG. LAND SURVEY NO. 1350
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: WATER SOFTENER
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
RICHARD GRASSIE INC. TOTAL 50.25
6121 EXCELSIOR BLVD
Payment(s)
SUITE 206 CHECK 14560 50.25
MINNEAPOLIS,MN 55416-
OWNER
Luke Beltnick Revocable Trust
BELTNICK,LUKE&ELENA
3018 EMERSON AVE S
MINNEAPOLIS,MN 55408-
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 responsi. for assuring all required inspections are
requested in conforman.- with the State Building Code.This permit may be
revoked at any time .r due cause.
/6) / C9- /
licant `ermitee Signature Date Issued B ature Date
PP � Y �
,-:----7--0- --., Cityof Orono FOR CITY USE ON Y
VQ `, P. ox 66 Date Received: -07 —
t 2750 Kelley Parkway
1" Crystal Bay, MN 55323 Permit# 4*7
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. (952)249-4600-Main A roved B
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Amount$: �5O, , 1�-i'
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CITY OF ORONO - PLUMBING PERMIT �r /
(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: \33C) C'(-C. '(-1C'c 1 rir
Owner: 'i:::S-C,an \C__,Y Mailing Address:
City: O`(3nO Zip: 53C11
Home Phone: 101 Z - ,S t -QCT Alternate Phone:
Contractor Information:
Contractor: Pi rcj Cfd C.. co,.r r 0. „Inc Contact Person: �.‘c xm rc Grc 6�
Address:-1U00 u5. 0110-- S -. #Q14 State Bond #: li3C.u -13?
City: SA-. Lbr 5'-1Po K Zip: 52„Lo Expiration Date: ID I'�1 �17
Phone: G1c)2-2)kD-Cy-110 Alternate Phone: e152_,-G 2,0 12XC3
Insurance — Current: Pref ci . d rk.fp . c r C� SefvicerD
aa, e p c d rc-�,r, .c.c.:,c�
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PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower j Washer
Kitchen Sink Water Heater
Disposal Water Softener 7
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CLCULT1O [ - z. `.
1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
5C)C .C'\d x .0125 $ L 25
(contract price) (minimum$ 0)
2. STATE SURCHARGE
St)b •C ,C x .0005 $ L5
(contract price)
3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ 5C) . Z5
* 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 the City and the regulations of the State of Minnesota, and
certifies that all statements made o pplicati are complete, true and correct.
Applicant's Signature: Date: S 12.R l I
Building Official/ Inspector: Date:
Page 2
rJ6 J. - J
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED "'7/ -V/ 7 2.-. 7
PERMIT NO. c(")/ 7 '7COMPLETED
ADDRESS / / .% ?() (J1 -C v—•?Li /,i
OWNER TELEPHONENO. 952 7`9 7,77,
CONTRACTOR /C•4/C- 1,c /
DESCRIPTION �, c'�%� �� �.�Zec� yr�4-1_,74-
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/F LLII NG
❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
O
❑ RADON SLAB 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
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
h COMMENTS:
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W 0 WORK SATISFACTORY:PROCEED JOJECT COMPLETE
1414 ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O 0❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.I BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
LISTOP 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: Ca
White Copyllnspector's File Canary CopylSlts Notice