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Home My WebLink About2010-00356 - water heater � , CITY OF ORONO PERMIT NO.: 2010-00356 , 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: OS/17/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1375 REST POINT RD PIN : 07-117-23-32-0037 LEGAL DESC : SUBD REST POINT PARK LAKE MTKA : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 BAXTER MECHANICAL STATE SURCHARGE PLBG(<$500) 0.50 PO BOX 591 ELK RIVER, MN 55330- MAIL-IN FEE 2.00 (612)227-6710 MISC FEE 0.00 Minnesota State License#: 066036 PM TOTAL 17.50 OWNER GERLICHER,MR. &MRS. 1375 REST POINTT RD MOUND,MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming this type of work shail be compied with whether or not specified herein.This pertni[will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if consWction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with tae State Building Code.This permit may be revoked at any time for due cause. `�C� �-�- i i d-7i�.�-n, i i Applicant Permitee Signature Date Issued By Si ture SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED AB . r � � FOR C[TY USE ONLY ' '-�A''__� City of Orono '(�_ i� `�` ' P.O.&�x 66 Date Received: Pennit# �`� �.,;� `�� / �;,, I 2750 Kelley Parkway �� t` ji�'�• �� Crystal Bay,MN 55323 Approved By: Amount$: � ��:Q,o�� (952)249-4600 �� ,�� CITY OF ORONO—PLUMBING PERMIT (All Commercial permits must be approved by the Building Ofticial or Inspector) GENERAL INFORMATION 1. You may apply for 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 UNTTL YOU RECEIVE A PERMIT. WORK MUST 1vOT 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 dwel(ing. 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) TYPE OF PERMIT Check All That A 1 ) �esidential ❑Commercial(Approval Required) ❑New ❑ Additional ❑Repairs �Replace ❑ In Accessory Structure? *You will need arior aaproval and may need Cl'P.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: � �� ,J Site Address: � ��`7 ��F'��-�� f,.'��": �"- �'G�1��1 Owner: �l��h�- � �J�C'i' �� t`'��`�'y' Mailing Address: � ��j ��I-�1� I�-� c��y: ��fUY1 p z�p: SS�y Home Phone:C��"�� t�'��!`� Alternate Phone: Contractor Information: � i'� ►(�,�{ ( i!� l";i�l�.(� � / '`Y'., Contractor: � , v '- Contact Person: `�C�� "�� M ��'✓ � i r� Address: ��•�•�� 7 � State Bond#: � �� / ;-, � {� v° City: � I�o��'� Zip: ��Expiration Date: ��"� I Phone: !�'�T' ��"� �/� Alternate Phone: ❑ Insurance—Current: '�, �!�- � Vr i�( � 1 PERMIT FEE CALCULATION(S)-JOBS OVER $500.00 If above does not apply;follow guidelines below: 1. CONTRACT PR10E *is 1.25%of contract price with a(Mioimum Fee of$50.00) x.0125$ (contract price) (minimum a50-00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) x.0005 $ (contract price) (minimum$ .50) 3. POSTAGE&HANDL[NG(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar arr►ount 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. � ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicant's Signature: � Date: � �_ Reset Form 3 , , 1 � �yX t� � ��.� • � t/ FIXTURE BSMT � 2 oTf�x r�xTURE TYPE FL FL TYPE Water Closet ��r�� Lavatory Sewer Ejector Bathtub Laundry Tray . Show� Washer Kitchen Sink W�H� Disposal Water So$ener Dishwasher W�� Sillcocks Miscellaneous :�:; ��r :# � Yes,this section applies The replacement of a Residential filcture or anniiance that meets ail three of the following reqnirements: 1. Does not reqaire modification to electrical or gas service. 2• Has a total cost of$500.00 or less;excludi�the cost of the fixture or appiiance:and 3. Is improved,inshalled or replaced by the homeowner or licensed contractor. Skip next seclion,if this applies; Cost of Pemvt $ ]5.00 State Surcharge a .SO Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee s F�, � -�—f— (Permit Fees Continued On Nezt Page) 2