HomeMy WebLinkAbout1999-011751 - vacuum breaker � PERMIT �
t CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: - '-'`_'•"�``'"i'
Crystal Bay, Minnesota 55323 '.;�{. s:�:~�
(612)473-7357 Date Issued: ;
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT '
Box 66 (2750 Kelley Parkway) �
Crystal Bay, MN 55323 �
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GENERAL INFORMATION i
1. You may apply for plumbing permits by mail or in person at the City offices. i
2. Pemut cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID �
UNTIL YOU RECENE 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 pemut 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.
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Instructions Complete all items on this application. Compute the permit fee. Sign and date , i
the certification. INCOMPLETE APPLICATIONS WII.,L NOT BE PROCESSED. If you have �
questions, call 249-4600.
Please check one: New ddition Repair Replace
Resident' 1 Commercial
JOB SIT'E• v�;.�-U � C������ �-,1 �c`C�C� t���"t �..:z Zip: �'�..�.�G
Owner's Name: �f� �,e �e � o,�,� Telephone Number: Y Z l�'.f�
Mailing Address: �� o,��� �.J �J�;.� G,� City: U��'����e Zip: ��-�3,��
Contractor's Name: ����� ��� �G'�_ 6 r��� Telephone Number: Q�3�3 5``����
Mailing Address:;;?�,��-� Y�1,��,,�` ,�6<�� City: -< �;.,, Zip: �,-��3
P�,UMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 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
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Misc (list) � �. �;�4.h�'' v�Uv `
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PERMIT I�'EE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00) � �"
/ �� x .0125 $ :� �
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ S "
(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) $ �� S ��/ .
* 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 chazged to the
customer for the work done. If any material, equipment, labor,or installation are furnished by the owner,
tenant or any other party the reasonable mazket 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 Department of Jnspectional 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
Miruiesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: ,.�—� � Date: � l,3
C� D TE TIME
ITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED /6 � �30
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PERMIT NO. I 1"7.5I COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO. 93 3- SG�.3Cc
� DESCRIPTION , )
t� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/G DING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECT�ON
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEM - L 15 SEPTIC INSTALL. 22 FOLLOW-UP
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23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OW O MEET YOU:_YES_NO i
� COMMENTS: �1n l ALltIY�(�� OYf ' .S/�fe
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W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C�RRECT WORK,CALL FOR REINSPECTION TEMPORARY
ORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Ca11 for e next i tion 4 hours in advance.473-7357
Owner/Cont on s' e•
Inspector.
ite Copyllnspecto�'s File Canary Copy/Site Notice