1991-003523 (plumbing) - Laserfiche WebLink

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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT Box 66 (1335 So Brown Rd) Cry_,tal Bay, MN 55323 ***X***�•***********************************� ,***************************j��-� General Instructions 1. You may apply for plumbing permits by mail or ir person at the City offices. . 2. Mailed in applications are subject to the po�;tage and handling fees shc�wn below. p, Permit cards will be sent by return mail the sa�te day the application is recEived. 3, permits are not valid until you receive a permit card. 4. Work must not begin unless the permit card is available on the job site. � 5, Plumbing permits may be issued to licensed contr�ctors only. 6. When any new construction or remodeling is invoLved, a separate building permi` must 1 � i be obtained. 1991 � j � 7. A1 1 work must be done in accordance with State Ccde requirements. J A� � g - 8. All work must be inspected before it is covered. Call 473-7357. ;_ >'; 24 hour notice reqnired. � ;;'. *****************,t****�c********************** a*********,t*********,t******a�** , JOB SITE ADDRESS: �Jf� �n �r�','i n r��' r'1 Occupancy Type: ,�(� Residential C��mmercial OWNER'S NAME: r(�� Phon�� No. : �r� - �n �`7�� Mailing Address: G� e_ City: �,-��.,r, ��MtJ�.1� Bus. *..o. : ��j��'"�'�� l CONTRACTOR'S NAME�' � -T- c i ty: V�-t-�-1L�i� z�i p�`�3�� Mailing Address: 1`�':C:C ti� � City Cert. No. : Master Plumber' s State License No. : � � *************************************************, *,t***************k******* PLUMBING FIXTURE SCHEDULE: (Show number of fixtures of each type cn each floor) FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTAER FIXTURE TYPE :3SMT 1ST FLOOR 2ND_FL�)OR OTHER ---a----- - ------ ------ ------- ---- ----�-- ------------- ---- — --T----- . � Water Closet J Sewer Ejector --------- ---- ---- --- ( Lavatory � ) Laundry Tray --- ------- ----- ------ ------------- - ------------- - - Bathtub � Washer : ----�------ ------- ------ ------------- ---- ---^---- --------- ----- ------------- - - Shower � � Water Heater �� ---�----- --------•- ----- ------------- ----- -------- ------ ------------- ---- , _ Water Softner ' Kitchen Sink _____--..- ----- G�: -------------' ----�--•---- -------- ----- ------------- ---- --------- = _ Wet Bar �" �: .. Disposal -------••- ----- i ------------- ----- ------ ----- Dishwasher Sump Pump '� `.' ----- -------- --------- -- ---------- ----- ------------- Sillcocks Misc. (List) --�----- --- --- ---------•- ----- ' �' -------- ------ ------------- ----- ---^- ----------- •--- - i. Floor Drains t � ----- � : ___1_ __ �_____ �______1_____________ ___.. ________�_________- , �.i�� .��. . �'*'�C*'�f*�f 1k�C�C�(�f]�C�C7t**7�(�C�f*�[*�C'�C*i!1k7�C�C7�C**�C*�C�C�C7t'�(!�G*�(�C*�C*'k�CiC*�(�"k'1f*'�f'k iC'�C*'k**�f*�C'k'k�7*'k**'�C 4f,.'.i.: Y U l. Fixture Fee The minimum �;ermit fee is $30.00 $_ ��U � ' Compute number of fixtures ��x $5/fixtu�k . � $-3�fixture rese�:: ;.'. $ .5 0 ,_ 2. State Surcharge 1.50 3. Postage & Handling (Only mail-in applications) $ — $ ��, �� 4. TOTAL PERMIT FEE (add lines 1-3 above) _ ****7kit1k7k*'***i�*****icic7k�k7k*�k****'****�cit7k*it�/t*7ki[icir****�c*ir7kit�t**tk*7k7k**7k****7k7k�k**k** The undersigned hereby apPltrictoacco dance fwithntheoo d n incesoof the City andmthe agrees to do all work in s regulations of the State of Minnesota, and certifies that a:l.l statements made on th_s �, application are comp].ete, true and correct. ;�' �I . p _ Date: / ��7 �� . ` Signature of Applicant. � �'� ' i. , �,_ ,., _. , . . : �