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Home My WebLink About2009-00309 - plumbing , , CITY OF ORONO PERMIT NO.: 200�-00309 �� 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUEn: 06/1 U2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 2118 SHADYWOOD RD PIN : 17-117-23-42-0016 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 000 BLOCK 001 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER SOFTNER NOTE: WATER SOF'INER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 0.50 6030 CULLIGAN WAY MINNETONKA,MN 55345 MAIL-IN FEE 2.00 (952)933-7200 TOTAL 17.50 OWNER HANSSEN,PAUL&LEANN 2118 SHADYWOOD RD WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additional or related work which requires sepazate pertnits. AII provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance witl�i the State Building Code.This permit may be revoked at any time fQr due cause. `Z?4R.�� Li(. l � / � Applicant Permitee Signature Date Issued By ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHE THAN DESCRIBED A E. f ! ' . FOR CITY USE ONLY �� City of Orono �� P.O.Box 66 Date Received: Permit# � ' �''' 2750 Kelley Parkway a a`'�`•�� ;� Crystal Bay,MN 55323 Approved By: Amount$: ��'�� }:�o;;�r (952)249-4600 ,�R�o�.�:. 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 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. 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 pzrmit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. All wark 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 l �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: c� 1� � s��``( t„� 00 c� � 0� Owner: pG�� `�a hS �- v� Mailing Address: City: Zip: .55 3`� � Home Phone: `�� a `i � �' S5� 3 Alternate Phone: Contractor Information: C�'o�tt�t�',A�I � � �� Contact Person: �030 CULUGAN WAY Addre�kINNETONKA_ t�int ��e� State Bond #: � �ss2� ss3-�2o0 City: Zip: Expiration Date: Phone: Alternate Phone: �1�-�1� a- 13 1 � � Insurance—Current: 1 / � PLUMBING�FIXTURES BE1NG [NSTALLED � � �� FIXTURE BSMT IsT 2ND OTHER FIXTURE BSMT lsr 2"D 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 I Dishwasher Wet Bar Sillcocks Miscellaneous � PERIv1IT FEE CALCULATION(S} � � � i BASED OFF-2002 STATE�STATUE � � � Yes,this section applies 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;excluding 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 Permit $ I5.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 PERMIT F�E CALCULATI01�1 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$50.00) x .0125 $ (contract price) (minimum$50.00) 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) $ 2.00 4. TOTAL PERMI'I'FEE(Add Lines 1-3 Above) $ �7 �sv ■ * 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 charged to the customer for the work done. [f 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 permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may reyuest 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. PLUMBING PERMIT APPLICATION AGREEMENT 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. Applicant's Signature: Date: S ' a� ' uq Reset Form 3