HomeMy WebLinkAbout2006-P10331 - vacuum breaker � PERMIT
CITY OF ORONO
�750 Kelley Parkway- PO Box 66 Permit Number: p1o331
Crystal Bay, Minnesota 55323 Permit Type: Vacuum Breaker
(952)249-4600 Date Issued:
9/19/2006
SITE ADDRESS: Common Area-Stonebay Unit#
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PID: 33-118-23-12-0030
DESCRIPTION:
Proposed Use: Other
Pernvt Class: Plumbing
Permit Type:
Vacuum Breaker Pernut Sub-type(s): Vacuum Breaker
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 1,000.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Roger Wiley Inc. OWNER: O.T.Development,LLC
4935 155th Lane 10300 lOth Avenue N#101
Ramsey,MN 55303 Plymouth,MN 55441
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.
/ �
APPLICANT PE SI ISSLTED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page I
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� FOR C[TY USE ONLY
City of Orono C'
��'� P.O.Box 66 Date Received: �y� ���Permit# �� -���
• �4; � 2750 Kelley Parkway � ,
'�? '� � Crys[al Bay,MN 55323 Approved By: Amount$:�
����..a (952)249-4600
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CITY OF ORONO-PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
3'3- iI -�- I� C�C sC�
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. Pernut cards will be sent by retlun mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE ��t
PERMIT CARD IS POSTED ON THE JOB SITE. �5(
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners �I
residing in the dwelling.
4. When any new construction or remodeling is involved,a separate building pernut must be
obtained.
5. All work must be done in accordance with State Code requuements.
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 pl )
❑ Residential �Commercial(Approval Required)
�..New ❑Additional ❑Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
Job-Site/ Owner Information:
Site Address: S���U�- ��Y G(�C v�V�S �3'2J�
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ���� " .�✓l�_ Contact Person: ���
Address: ��35 I J�J � � L�� State Bond#: i� L 1 51���
City: ��M�Y Zip:55�j Expiration Date: i'�. �31 '06
r� Phone: � �j( z'�b�� ���'t7 Alternate Phone: �j5 -� "2.U� -�5 2�
❑ Insurance- Current:
1
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PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
Q?Z_
PERMIT FEE'CALCULATION(S)
BASED 4FF -2002 STATE STATUE �
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
l. 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 contractor.
Skip next section,if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
, ,
� PERMIT FEE CALCULATION S -JOBS OVER"$500:00
If above does 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 535.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
���� x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pernutted 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 pernut fee putposes. 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.
' � PLUNIBING PERNIIT APPLICATION AGREEMENT '
The undersigned hereby applies to the City for issuance of a Plumbing Pertnit, 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: Q j K I ��'
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