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HomeMy WebLinkAbout2012-00545 - plumbing CITY OF ORONO * 2 0 1 2 - 0 0 5 4 5 * 2750 KELLEY PARKWAY DATE ISSUED: 06/18/2012 ORONO, MN 55356- -� (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 880 PARTENWOOD RD PIN : OS-117-23-43-0001 LEGAL DESC : PARTENWOOD : LOT 006 BLOCK 001 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: 2 KITCHEN SINK,2 DISHWASHER,2 S[LLCOCKS VALUATION OF PLUMBING 1500 APPLICANT PLUMBING FIXTURE FEE 50.00 MANATEE PLUMBING STATE SURCHARGE PLBG (VALUATION) 0.75 11525 199TH CIRCLE SILVER LAKE, MN 55381- TOTAL 50.75 (612)756-1 172 � Minnesota State License#: 005923PM OWNER GRAY,JERRY&CYNTHIA 880 PARTENWOOD RD LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approvcd plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are i requested in conformance with the State Building Code.This permit may be .C` .> oked at any tim or due use. �, � / ��j/ i,?�_��,_,�_�: �`;y'�'��C_�_?��/ (� ��- � /.-: App icant Per tee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � FOR CITY USE'ONLY � ��` City of Orono (,'� ��' 4 `Y P.O.Box 66 Date Received: Permit# '� � i ��,, � 2750 Kelley Parkway �1a �'��r. � Crystal Bay,MN 55323 Approved By: Amount$: x*�� u (952)249-4600—Main ��YR��4� asso$ (952)249-4616—Fax CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) ht��:/Iww��.dli.mn.Rov/CCLD/PI}F/ e lumb lanreva �.�df GENERAL INFORMATION 1. You may apply for plumbing pemiits by mail or in person at the City offices. Applications will be reviewed and a pernut will be issued within two working days. 2. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pernuts 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 pernut 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) � � I �Residential ❑ Commercial(Approval Required) � New �Additional ❑ Repairs �Replace ❑ In Accessory Structure? *You will need urior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/ Owner Information: - Site Address: ��� ��.v�-zr,,v o�e� �� Owner:�.��d y���e Y�y �r�,� Mailing Address: City: C`�r�� O Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: Y���a�_� ��vt,,���«S Contact Person: �u�_g .LJ�, � b� C. Address: �lS aS I �l 5�l'` L��-�1� State Bond#: City: 5� \�r -er `4k-� ZipsS381 Expiration Date: Phone: Cp l�-7 5�o�� I? a. Alternate Phone: ❑ Insurance—Current: 1 � � FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 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 r� Water Softener d� Dishwasher � Wet Bar Sillcocks Miscellaneous ❑ Yes,this section applies The replacement of only one Residenrial 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;excludine the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next secrion,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 ' Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Nezt Page) 2 �,. � • 'If above does not apply; follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) I S�O x.0125$ (contract 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 chazged to the customer for the work done. If any material, equipment, labor or installations are fiuvished by the owner, tenant or any other party, the reasonable market value of such itexns 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. 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: �y ` �g— �oZ 3 �� � �� � / DATE TIME V OF OR O CALLED IN (L' C�� ��' INSPECTION NOTICE SCHEDULED �' __L�� PERMIT NO.�L� _C���SCOMPLETED ADDRESS_ �,} ��-fP�ri �l�� OWNER TELEPHONE NO. '-� '"' /S�''�� 7� CONTRACTOR / �' ,�l'LlL�f eE' ����� I >; DESCRIPTION � � �r � � ❑ FOOTING ❑ PLUMBING FINAL ❑ � CAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEP I FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a � � � � v'-�-- � i.�-��' c��� _ Q I � 0 � W � Q � Z W � W � � GW WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WiTHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary Copy/Site Notice