HomeMy WebLinkAbout2000-P03261 - plumbing PERMIT
C�TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P03261
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(612) 249-4600 Date Issued: llilai2o
SITE ADDRESS: 3180 Ridgewood Cir
LONG LAKE,MN 55356
P ID: 04-117-23-23-0021
DESCRIPTION:
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PI'OpOSCd US2: nwiuouuai
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 400.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Norblom Plumbing Co OWNER: LOREN GROSS TRUSTEE
2905 G�eld Ave South 3180 RIDGEWOOD CIR
Minneapolis,MN 55408 LONG LAKE MN 55356
TI�UNDERSIGNID HEREBY REQUFSTS PERMISSION TO MAKE TI-�E REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII,DING CODE REQUIREMENTS.
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�t�i TEE3R°f�TO� SUED BY SIGNATURE
Copies:City,Applicant,Assessor,Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for plumbing pemuts by mail or in person at the City offices.
2. Permit cards will be sent by return mail after a review is completed. PER1�fITS 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 the State Code requirements.
6: All work must be inspected and air tested before it is covered. Call 249-4600. 24-hour notice required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date
the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 249-4600.
Please check one: New Addition Repair _� Replace
�� Residential Commercial
JOB SI'TE: �j�� �,i oi oOc� .�z- Zip: 553�
Owner's Name: c�-�{p� ,, ��c,J� Telephone Number: 9�g-Z00�
Mailing Address: ' i� Cl C�-e. CitY: 61,rc��G Zip: �S35Z�
Contractor's Name: ;� Telephone Number:
Mailing Address: Z�OS G�ar�,��d-��.S� City: 1'VI- 'S Zip,��
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT iST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater I
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Misc (list)
PERMIT �EE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
yG7� oo x .0125 $ 3S . G�
(contract price)
2. State Surchar� ** Add the State Building Code Division
Surcharge to each permit. ��'� `= x .0005 $ 5�
(contract price)
or $.50, whichever is greater
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ��j�O b
* 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 installation are furnished by the owner,
tcnant or any other pa.-ty tl-�e reasonable market value o;sach iter,Is must he ud��d t� t�e csti;nat�d ccst
or contract price for pemut fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ci�y 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 Department of Inspectional Services for the price.
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:
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