HomeMy WebLinkAbout2014-01326 - plumbing ` ` CITY OF ORONO * 2 0 1 4 - 0 1 3 2 6 *
2750 KELLEY PARKWAY DATE ISSUED: 1]/13/2014
ORONO, MN 55356-
952) 249-4600 FAX: (952 249-4616
ADDRESS : 1150 PINE VIEW DR
PIN : 28-118-23-42-0009
LEGAL DESC : PINE VIEW
: LOT 3 BLOCK 1
PERMIT TYPE : PLUMBING(>$500)
PROPERTY T1�PE : RESIDENTIAL
CONSTRUCTIbN TYPE : FIXTURES-MULTIPLE
NOTE: WATER T-IEATER
VALUATION�F PLUMBING 825
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.41
CITY VIEW PLUMBING&HEATING TOTAL 50.41
1880 WAYZ�ITA BLVD W Payment(s)
P.O.BOX 150 CHECK 34947 50.41
LONG LAK�,MN 55356
(952)473-8793
OWNER
Stephenson'Holdings
1850 FOX I�IDGE RD
LONG LAI�E,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work fof Which this permit is issued shall be performed according to
the approved pians and specifications,applicable City approvals,and the
State Buildipg Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be con`�pied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commence�within 180 days of the date of issuance,or if construction is
suspended�'or a period of 180 days at any time after work has commenced.
The applic�nt is responsible for assuring all required inspections are
requested ib�conformance with the State Building Code.This permit may be
revoked atli any time for d cause.
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A ar#t Permitee Signature Dat Issu By Signature Date
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FOR CITY USE ONLY
�/�O�\ City of Orono
� �� P.O.Box 66 Date Received: Permit#
2750 Relley Parkway
{ Crystal Bay,MN 55323 Approved By: Amount$:
(952)249-4600—Main
y� \ (952)249-4616—Faa
� CITY OF ORONO—PLUMBING PERMIT
��k�stin��� (All Commercial Permits Must be Approved by the State Prior to City flpproval)
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GENERAL INFORMATiON
l. You may apply for plumbing permits by mail or in person at the City oftices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards wifl be sent by return mail after a review is completed. PERMITS ARF,NOT
VALID UNTIL YOU RECGIVr A PERMI'I'. 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 Slate 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 A 1
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑ Repairs �Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUI'.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address: �� J�� �,�✓��_� , ��� �..J �
Owner:S�C►4 n 1� � /'/r.CA �l et� Mailing Address: ��IG� � ��v�O ,�,r
c►ty: L.a�GI-� 1��, z�p: 5�35�
Home Phone: ������ ���� Alternate Phone:
Contractor[nformation:
Contractor:C� ����� ���`Y►'!�1✓��'"��� Contact Person: �v�✓��Yt ����I��
Address: �����W�S��"�°���'t�� Q��� State Bond #: PC�P�I� I 7 g
City: ��r� ���- Zip:�.�3.}e Expiration Date: ��' �J � °2���
Phone: ���y�3 �� I 3 Alternate Phone: �l� '�i�� �3���')
❑ Insurance—Current: ��'-.�
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FIXTURE BSMT 1ST 2''1D OTHER FIXTURE BSMT 1ST 21'1D OTHER
TYPE FL FL TYPE FL FL
, Water Closet Floor Drains
I Lavatory Sewer Ejector
' Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater �
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ 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;excludine 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 $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
�as ° X.o�25$
(contract price) (minimum 550.00)
2. STATESURCHARGE
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 fumished 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.
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: �� �J� �L`
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