HomeMy WebLinkAbout2012-00673 - plumbing � CITY OF ORONO
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2750 KELLEY PARKWAY DATE ISSUED: 07/16/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 3180 RIDGEWOOD CIR
PIN : 04-117-23-23-0021
LEGAL DESC : ROUTSON ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: WATER SOFTENER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345 MAIL-IN FEE 2.00
(952)912-7379 TOTAL 22.00
PAID WITH CC# 0597
OWNER
EMERY,BRYAN&MEREDITH
3180 RIDGEWOOD CIR
LONG LAKE,MN 55356-
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 dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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App ic�ant Permitee Si�g�fure Date Issu y ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
07/16/2012 14:37 FA% 9529335049 CULLIGAN �IVTRA C�002
� R�'rY Y1SE ONLY
CityotOrono ���� aa�a (�j'�
O�'�'�� P.O.Box 66 Deu Rxeiv � Pemut k
� 2730 Kelley Perkway a
Z r Crystal�Bey,MIV 55323 Approved By, AmountS:. •
��b� (952)249-4600
CITY OF ORONO—PLUMBING PERMIT
'� (All Commerci�l permits mus[be approved by thc Building Ot6cial o�lnapector)
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 wili be issued wlthin two working days. .
2. Permit cards will be sent by return mail after a rcview is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PSRMIT. WORK MUST•NOT BEG��1V UNTIL THE
PERMIT CARD IS POS'T�D ON THE JOB SI'�.
3. Plumbing pem�its may be issued ONLY to(icensed plumbing contractors and to property owners
residing in the dwelling. �
4. Wben any new construction or remodeling is invotved,a separate building permit must be�
_ . _ , . . _ _ obtained. _ _
5. All work must be done in accordana with State Code requirements.
6. All work must bc lnspected and air tested before it is covered. Call(952)249-4600.
� (2448 hour noHce require�
TYPE OF PERMIT
� . Check All That A 1 -� �
�Residential ❑Commercial(Approval Raquired)
�New ❑Additional ❑Repair� ❑Replacc
❑ In Accessory Structwc?
. '�You wfll ns d orior aon�ova!and may need�.(Per Orono City Code,Chspter 78,Article[V)
Job Site/Owner Information:
Site Address: 3� D I�� d0� C1 rc.� ,
Owner: D rva�n 'c,ww,r Mailing Address:
City: Zip; -SS 3 5 �
Home 1'hone: Alternate Phone: �(� � b 55- bs�7 �
Contractor Inforcnation:
O�t��i Wg7'�_R GntvniT�nN�tiG Contact Person:
6030 CULLlGAN WAY
AddAA�iNETONKA. MN 553a5 State Bond#:
` (952)�33-7200 ,
City: Zip: • Expiration Date: �
. Phone: Alternate Phone: 95a -9�a-1317
, ❑ -Inswance—Current: �
1
07/16/2012 14:37 FA% 9529335049 CULLIGAN MNTRA 1�003
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•�i il �'�' `�. {td.^�if� a �::r.Y_.-�.�r �
FIXTURE BSMT 1 2 OTHER PCXTURE HSMT 1 2 OTHER
TYPE FL FL TYPE FL FL .
Water Closet Floor Drains
Lavatory Sewer Ejector
g��b Laundry Tray
Showcr W��'
Kitchen Sink Water Heater
Disposal ater o ener I
Dishwasher Wet Ber
Sillcocks Miscel►aneous
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Yes,this section applies
� The replacement of a Residential fixture or anplianc�that moets all thrce of the following requirements:
1. Does not require modification to electrical or gas servica. �
2. Has a total cost of SS00.00 or less;�xciudinE the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeovmer or licensed contractor.
. Skip next section,if this applies; Cost of Permit S 15.
State Sutchazge $ 5.00
Mail-In Fce(If Applicable) $ 2.00
Tatal Permit Fee S
` (Permit Feee Continued On Next Page) . � �
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07/16/2012 14:37 FA% 9529335049 CULLIGAN MNTRA [�004
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If above does not apply;follow guidelines below: �
1. CONT CT PRICE *is 1.25%of contract price with a(Minimum Fee o!$50.00)
� x.O125$ � '
(oonaact price) (minimum 550.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Miatrnum Fee otSS.00)
x.0005 $ '
(conuaccprice) (minimumS 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) S Z.00
4. TOTAL PERMI7'FEE(Add T.ines 1-3 Abovc) S a� -0�1
■ * CONTRACC PRICE or JOB COST means the actual or estimated dollar amount cherged for tfie
permitted work including matorials,labor,profit,and other fixed costs. It is the amount to be charged
to the customer for the worlc done, If any materiaf,equipment, labor or installations are fumished by
the owner,tenant or any otha party,the reasonable market value of such items must be added W the
. est9mated cost or contract price for pennit fee purposes. ln tho event that there is a dispu� on the
smount of the job cost,the'City may request the submission of a signed copy o�the actual contract.
■ **The STATE SURCHARC3E is.0005 of the contract price under$1,000,000 or$5.00—whichever is
greater. For valuallons over 51,000,000 call the Building Department at(952)249-4600 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 statemants made on this application are complete, true and '
correct.
Applicant's Signature: Date: �] ' �� - I� .
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