HomeMy WebLinkAbout2005-P09216 - plumbing PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway- PO Box 66 P09216
Crystal Bay, Minnesota 55323 Permit Type:
Fixtures
(952) 249-4600 • Date Issued: 9/23/2005
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SITE ADDRESS: 2080 Salem Ct Unit#
Long Lake,MN 55356
P��� 27-118-23-31-0016
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Fixtures Permit Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 Valuation: $ 2,524.00
State Surcharge Fee: $ 1.26
TOTAL FEE: $ 36.26
APPLICANT: B&D Plumbing&Heating Inc. OWNER: Laura&Robb Hirschberg
4091 Maciver Avenue NE 2080 Salem Ct
St.Micheal,MN 55376 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSU D BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, I-Septic) Page 1
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FOR CITY USE ONLY
,�` City of Orono
+ O4O`�`O P.O.Box 66 Date Received: Permit#
�,;, 2750 Kelley Parkway
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� �j�!? ;r� � Crystal Bay,MN�5323 Approved By: Amount 5:
��; ,:,���';,�..�� (9�2)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Pernut cards will be sent by return 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 consriuction or remodeling is involved, a separate building perinit 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 ly)
�Residential ❑ Commercial(Approval Required)
[� New ❑Additional ❑Repairs [� Replace
❑ In Accessory Structure?
*You will need nrior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
�b Site/ Owner Information:
Site Address: � � �� �lE r� C `t
Owner: �'-����"�� Mailing Address:
City: U r� 'n� Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: g pD F'l``�6 � t�``+- Contact Person: �� ���C�'✓
Address: �-1U��l t�<��°y� N� State Bond#:
City: �t• rn•`-�`�'`l Zip: �5���Expiration Date:
Phone: ��-� `�Q���Zq� Alternate Phone: C�i2� 3z�s' -`�1�SCa
❑ Insurance— Current:
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PLUMBING FIXTURES BEING INSTALLED �
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FIXTURE BSMT 1 2' OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet � Floor Drains
Lavatory ..L Sewer Ejector
Bathtub Laundry Tray
Shower � Washer
Kitchen Sink � Water Heater
Disposal ( Water Softener
Dishwasher � Wet Bar
Sillcocks Miscellaneous
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�;� ,_ ,� �� 'PERMIT�FEE�CALCULATION(S) � � � �� �
' BASED OFF - 2002 STATE STATLTE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all tlu•ee of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed contractar.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee �
(Permit Fees Continued On Next Page)
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PERMIT FEE CALCULATION(S)-JOBS OVER$500.00
If aboye rloes not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00)
�� ��� x .0125 $
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Stu'charge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 1.50
4. TOTAL PERl�'IIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pemutted 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 ar contract price for permit fee puiposes. 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 conn�act.
� ** 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 far 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: � �� �t/Q� Date: l" Z 3-O�
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