HomeMy WebLinkAbout2014-00357 - water softner ' CITY OF ORONO * Z QJ 1 4 - 0 0 3 5 7 *
, 2750 KELLEY PARKWAY DATE ISSUED: 04/23/2014
ORONO,MN 55356-
952) 249-4600 FAX: 952 249-4616
ADDRESS : 1462 PARK DR
PIN : 07-117-23-42-0015
LEGAL DESC : SAGA HILL REVISED
: LOT 003 BLOCK 014
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00
STATE SURCHARGE PLBG(<$500) 5.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345 MISC FEE 0.00
(952)912-7379 TOTAL 22.00
Payment(s)
CREDIT CARD 8645 22.00
OWNER
JENSEN, DEBRA
1462 PARK DR
MOLJND, MN 55364-
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 goveming 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 l80 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.
/ /
Applicant Permitee Signature Date Issued By Signature Date
04/23/2014 11:56 FAX 9529335049 CULLIGAN MNTKA �]002
FOR CITY USE ONLY
p City of Orono
$' � P.O.Box 66 Date Received: Permit#
�",,F„ � 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved 9y: Amount S:
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CITY OF ORONO—PLUMBING PERMIT
(All Cammercial permits must be appraved by the Building Officisl or Inspector)
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 retum mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMTT. WORK MUST N'OT BEGIN UNTII.THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing condractors and to property ovmers
residing in the dwelling,
4. When any new conskruction or remodeling is involved,a separate building permit must 6e
obtained.
5. All work must be done in accordance with State Code requirements. �
6. All work must be inspected and sir tested before it is covered. Catl(952)249-4600,
(24-48 hoar notice required}
TYPE OF PERMIT
Check All That A 1
�Itesidential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �Replace
❑ In Accessory Structure?
*You we11 need urior aanroval and may need CUP.(Per Orono City Code,Chapter 78,Article 1V)
Job Site/Owner Infarmation:
Site Address: �y 6 a 1�K D ri�
Owner: �r0. .1�e.r MailingAddress:
City: Zip: S�
Home Phone: 7�3'o�g� ' �1 �O Alternate Phone:
Contractor Information:
CUL�1GaAN�IA G Contact Person:
Aadr��T ULLIGAN WAY State Bond#:
M7
�,.. City: �5'2� 933��20d Zip: Expiration Date:
Phone: Altemate Phone: �J'ra1- 5 ��- �3 1 �
❑ Insurance—Current:
1
04/23/2014 11:57 FAX 9529335049 CULLIGAN MNTKA f�003
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FIXTU1tE BSMT 1 2 OTFiEit FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower W asher
Kitchen Sirilc Water Heater
Disposal Water Softener '
Dishwasher Wet Bar
Sillcocks Miscel laneous
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❑ Yes,this section appties
The replacement of a�tesidential fixture or ap,pliance 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;excludin¢the cost of the fixture or appl iance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.,
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(1f Applicable) $ 2.04
Total Permit Fee S
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(Permit Fees Continucd On Next Page)
2
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04/23/2014 11:57 FAX 9529335049 CULLIGAN �NTRA C�004
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If above does not apply;follow gvidelines below:
1. CONTRACT PRICE *is 1.25%of contract pricc with a(Minimum Fee of$50.00)
x,0125$
(contract prico) (minimum 550.00)
2. S'FA1'E SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of s5.00)
x.0005 $
(wntract price) (minimum S 5.00)
3. POSTAGE&HANDLING(Oniy on Mail-In Applications) �._ __ 2 00
4. TOTAL PERMIT FEE{Add Lines 1-3 Above) S .�
■ * CONTRACT PWCE 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 fumished by
the owner,tenant or any other party,the reasonable mazket value of such items must be added to the
estimated cost or contract price for petmit fee purposes. In the event that there is a dispute on the
amount of the job cost,the City may requast 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 vaivations over$1,000,000 call the Building Departrnent at(952)249-4600 for the price,
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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.
ApplicanYs Signature: Date: �` �3- j�
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��� D E TIME �
CITY OF ORONO cA��eo iN 5- �
INSPECTION NOTIC�ob 3S'"] SCHEDULED —5 2/-� y �
PERMIT NO. ��� ` COMPLETED ,i
ADDRESS ` lOZ ��-� �'�
OWNER �� C'�� TELEPHONE N0.7�o?J Z� �q j�
CONTAACTOR
� DESCRIPTION �� ��7�r�2
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ 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_HO
y COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED CT COMPLEfE
W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46�0
wnerlC ntractor on site: /�Q �r�t �e�t 5�1
Inspector. �►..._
White Copyllnspector's File Canary CopylSite Notice