HomeMy WebLinkAbout2012-00320 - plumbing CITYOFORONO * 201z - 003z0 *
, 2750 KELLEY PARKWAY DATE ISSUED: 04/24/2012
ORONO,MN 55356-
� 952 249-4600 FAX: 952 249-4616
ADDRESS : 2690 RAINEY RD
PIN : 04-117-23-43-0016
LEGAL DESC : TREES TO BE
: LOT 003 BLOCK 002
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIdN TYPE : FIXTURE
NOTE: 2 FLOOR�RAINS IN GARAGE
VALUATION O�PLUMBING', 400
APPLICANT pLUMBING FIXTURE FEE 50.00
MR.ROOTER PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.20
5155 E.RIVER ROAD
FRIDLEY,MN 55421- TOTAL 50.20
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Minnesota State License#: 58659PM
OWNER
SMITH,JASON&JODY
2690 RAINEY RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans 8nd specifications,applicable City approvals,and the
State Building Cod� This permit is fOr only the work described and does
not grant percnissiou for additional or related work which requires sepazate
permits. A(1 provisions of laws and otdinances governing this type of work
shall be compied with whether or not Specified herein.This permit will
expire and become aull and void if cqnstruction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a peri of 180 days at any time after work has commenced.
The applicant is r nsible for assuring all required inspections are
requested' ance ith the State Building Code.This permit may be
revok at ' e for e ca
/ / / /
Ap �cant itoe Signature Date Issued By i ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO .
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, � �,¢��� City of Orono ' ;
P.O.Box 66 �at��2eca���d, Perrn�t�
2750 Kelley Parkway 3 K t;; _
. aa � Crysta]Bay,MN 55323 ��p��1�y�r ���t� '�='�
7 (952)249-4600-Main � " �
� (952)249-4616-Fax
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
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1. You may apply for plumbing permits by mail or in person at the City offices. Applicarions will be
reviewed and a pernut will be issued within two working days.
2. Permit cards will be sent by retiun 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 work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
�: T�.'E ��P�R`NII'�'
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[�Residential ❑ Commercial(Approval Required)
❑ New 1[�Addirional ❑ Repairs ❑Replace
❑ In Accessory Structure?
*You will need urior aaprovat and may need CUP. (Per Orono City Code,Chapter 78,Article N)
�te 1=:C��" �r.I�ifoi�cnat�on �
Site Address: 2 G d •
OwnB�/ Mailing Address: r�1��-�r�
City: Zip:
Home Phonc: Alternate Phone:
' '����rv :or�natu�� ,:
Contracto . � ontact Person: �✓d l�1�'! !�v`L4Gei�
�.�"flos� cr
Address: �� State Bond#:
City: �/� Z��j Expiration Date:
Phone�.�/G� `-5���'05� Alternate Phone: �l������
❑ Insurance—Current:
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FIXT'URE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
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Water Closet Floor Drains
Z
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 modificarion to electrical or gas service.
2. Has a total cost of$500.00 or less;excluding 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 Pernut $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Nezt 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$50.00)
yea� X.o�25$
(contract price) (minimum$50.00)
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 xnaterial, 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
esrixnated cost or contract price for pernut 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: Z y '�
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