HomeMy WebLinkAbout2004-P07272 - water heater .� ._� PERMIT
�TY OF ORONO Permit Number:
. 2'750 Kelle Parkwa - PO Box 66 Po�2�2
Y Y
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: 3ili2ooa
SITE ADDRESS: 1675 Shadywood Rd
WAYZATA,MN 55391
PID: i�-ii�-23-2i-0004
DESCRIPTION:
Proposed Use: Kesidential
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: $ 15.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT' Norblom Plumbing Co. OWNER: �CHARD O NORiJM&WIFE
� 2905 Garfield Avenue S. 1675 SHADYWOOD RD
Minneapolis,MN 55408 WAYZATA MN 55391
THE UNDIItSIGNID HIItEBY REQUESTS PERMISSION TO MAKE THE REAL IlVIPROVEMENTS SPECIFTED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE W1TH ALL CITY OF ORONO ORDINANCFS AND Sf ATE OF
MINNESOTA BUII,DING CODE REQUIREIVIII�ITS.
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Si�nitures Reauiredl. 1-Anvlican� 1-Monthlv Renorts. 1-Assessine, 1-Finance Page 1
a
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORNIATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit 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 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 (952) 249-4600. 24-hour notice
:eqnired.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the
certification. INCOMPLETE APPLICATTONS WILL NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: New Addition Repair I�eplace
��tesidential Commercial
JOB SIT'E:. NORUM, RICHARD
- ,. � , 1675 SHADYWOOD ROAD Zlp:
O�vner's Name:. ORONO, Mrv 553s� ' Telephone Number:
— �.
Mailing Ac�dress:^�952)471-7790 �it�: . Zi�;., �
Contractor'sName: ` � c TelephoneNumber: � (�►z,�'z�-y�3.�
Mailing Address: ZqOS G, e/✓ .so. City: /V)�/S Zip:' �'S�c��'
� PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND I OTHER
TYPE FL FL TYPE FL FL
�
Water Closet Floor Drains
Lavaro Sewer E'ector
Bathtub Laund Tra
Shower Washer
Kitchen Sink Water Heater �
; Dis osal Water Softener
Dishwasher .: Wet Bar
Sillcocks Misc (list)
�
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• �
PERMIT FEE CALCULATION(Sl
2002 State Statute (� Yes, This Section Applies
�]c
The replacement of a Residential fixture or appliance that meets all three 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 licenced contractor. �
Skip next section; Cost of Permit $ __ 15.00
State Surcharge $ .SQ
Mail In Fee $ 1.50
If above does not apply, follow guidelines below:
1. Contract Price* is .0125 % of job with a Minimum Fee of ($35.00�
x .0125 $
(contrac[price) (minimum$35.00)
2. State Surchar�e. *�` Add the State Building Code Division a (Minimum Fee of $ .50)
x .0005 $
(contracc price) (minimum $ .50)
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. i�T�iL I�i�u'�ii i FiE �Add iiiies i-3 n�uvc� $
* CONTRACT PRICE or JOB GOST 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, tenant or
any other party the reasonable market 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[he 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 Inspection 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. t
Applicant's Signature: Date: �23�� `