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Home My WebLink About2015-01503 - plumbing ' CITY OF ORONO * z 0 1 5 - 0 1 5 0 3 * ' 2750 KELLEY PARKWAY DATE ISSUED: 1U24/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 577 PARK LA PIN : 06-117-23-41-0046 LEGAL DESC : MINNETONKA SUMMIT PARK : LOT 012 BLOCK 006 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: (1)KITCHEN SINK AND(1)DISHWASHER VALUATION OF PLUMBING 1500 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 0.75 WESTIN PLUMBING&HEATING INC 15494 67TH STREET TOTAL 50.75 BECKER, MN 55308- Payment(s) (763)913-8613 CREDIT CARD 6236 50.75 Minnesota State License#: PLUM-PC645827,mech-MB003074 OWNER TEELE&AMY SULLIVAN-TEELE, BRENT 577 PARK LA LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within]80 days of the date of issuance,or if construction is suspended for a period of l80 days at any time after work has commenced. The applicant is responsible for usuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time fo ue cause. — �v � ,/S Applicant Perrp�e i nature Date Issued ignature Date ; FO CTT USE ONLY ,' , �O A T City of Orono �' � � ��Z 1 V P.O.Box 66 Date Receiv / Permit#� S � 2750 Kelley Pazkway Crystal Bay,MN 55323 Approved By: Amount$:� (952)249-4600—Main (952)249-4616—Faac ��' �� CITY OF ORONO—PLUMBING PERMIT ��k�SHo�`� (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://w�i�w.dli.mn. ov/CCLD/PDF/ e �lurt�b lanreva� , df GENERAL 1NFORMATION 1. You may apply far 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 wark 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) (L�'Residential ❑Commercial(Approval Required) ❑ New � Additional ❑ Repairs ❑Replace ❑ In Accessory Structure? *You will need prior apnroval and may need CUP. (Per Orono City Code, Chapter 78,Article IV) Job Site/Owner Information: , J / Site Address: -��7 d rGC (<<%,�.� Owner: '/�� f� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �S � � ti� �� y � � �/�t'"� Contact Person: �'' Address: �ryj� � %�� S� State Bond#: �< �`��C y� City: ��'`��r Zip: �r��'�Expiration Date: � Z�� Phone: �� ! >> � ��-} Alternate Phone: ❑ Insurance—Current: 1 \ PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1 2 OTHER FIXTURE BSMT l 2 OTHER 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 PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture or appliance 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 appliance:and 3. Is improved, installed or replaced by the homeowner or licensed plumbing contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 1.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 PERMIT FEE CALCULATION S —JOB� OVER$500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) / ,1/�� ,� x .0125$ (conVact price) , (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * 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 AGREEM�NT 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: � Date: I/ �� l� 3 / DATE TIME � CITY OF ORONO CALLED IN / -� INSPECTION NOTICE SCHEDULED //'�%U� �— PERMIT NO. DlS'D/ COMP�ETED ADDRESS �77 �- OWNER ^ TE� P ONE NO. ��z��l��jl CONTRACTOR � J""� � � � DESCRIPTION �� ly ❑ FOOTING ❑ DEM - INAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PIUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: � W �� a ^ ' J � � J O �a- , � _ �{,' � /1 ?`�/�1 O W � Q � 2 W � W � J d W ❑ RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � �. W CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � RRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDEH POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContractor on site: ' Inspector. � � White Copyflnspector's File � Cenary CopylSfte Notice � � �. �� " DATE TIME CITY OF ORONO � CALLED IN INSPECTION NOTIC�:rv,,�-,�SCHEDULED � I I •=� PERMIT NO. % � � f �J COMPLETED -r- ( ADDRESS '`;� I f� �-'�-��-�- �_ '{ OWNER TELEPHONE NO. CONTRACTOR � �`�� + Y'� I''I �:r"1't�� 1 � DESCRIPTION � '� �� ' '� � '��Y.�� ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF �^��MBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ��0 MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/RF(MOVAL J ❑ DEMO-SITE ❑i�PTIC INSTALL r"� �� `�/.�- � OWNERICONTRACTORTOMEETYQ�I:��:.._YES_NO � �J y COMMENTS: � � � � � �'�rKG,��l � - r��. � o��' b�b�3 ° r� �j�,w leL�� -- _ � ��z �L 0 � W ' � o�S a Q � d��.�.c.�' p��'. � � � a✓ � !� � � .w.;� � < , W � J O — W ❑WORK SATISFACTORY:PROCEED ROJECT COMPLEfE � ❑CORRECT VYORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-460� . OwnerlContra or on site: Inspector. ti White Copyllnapector's Flle Canary CopylSite Notiee