HomeMy WebLinkAbout2001-P04337 - plumbing CITY �F ORONO PERMIT
^ Permit Number:
2750 Alley Parkway - PO Box 66 P04337
Crystal Bay, Minnesota 55323 Permit Type: FiXn�reS
(952) 249-4600 Date Issued: 9i13i2ooi
SITE ADDRESS: 2477 Shadywood Rd
Excelsior,MN 55331
PID: 2o-i t�-23-t i-oo2�
DESCRIPTION:
Proposed Use: tcesidentiai
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Kitchen Sink
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 895.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Westonka Water& Sewer pWNER: Baywind Christian Church(Mr.&Mrs. Svoboda
6501 County Rd 15 2477 Shadywood Rd
Mound,MN 55364 Excelsior MN 55331
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�ILDING CODE REQUIREMENTS.
�
, �/ /il � �~___ Y`,� ^� - !' . 1 L.'• ' �
G ��/� � ��_` ;, �
` A PLICANT PERMITEE SIGNATURE ISSUEDBYSIGNATURE
Cooies; 1-File(SiQnitures Reauired). 1-Aonlicant, 1-Monthlv Reports, 1-Assessin�. 1-Finance Page 1
� �
CITY OF ORO\TO APPLICATION FOR PLLTi�SBI�i 1G PERMTT
Box 66 (2750 Kelley Parkway)
Crystal Bay, l��' S5323 �
�
GENERAL INFOR��TION
1. You may apply for plumbing permits by mail or in person at the City o�ces.
2. Permi[ cards will be sent by retum mail after a review is completed. PERl�1ITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTII., THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. P1L•nbing permiu 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 in.c�cted and air tested before it is covered. Call 249-4600. 24-hour notice required.
Instructions Complete all items on this application. Compute the pemut fee. Sign and date
the certification. I'iVCONIPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 249-4600.
Please check one: � New Addition Repair Replace
ay Residential � Commercial
JOB STTE: � , Zip: 5 s 3 3 l
Owner's Name: �' \ Telephone Number:
l�lailing Address: City: Zip:
Contractor's name: , � �, _ Tele hone l�umber: �-{'�-�-�{C(SC�
Mailing Addreas: _ � City: �i Zip: '
PLUVIBING FIXTURE SCHEDULE
FIXTURE BS�iT iST 2ND OTHER FIXTURE BS�iT 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)
;
;;
� �
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
��1�•(� � x .0125 $
(contract price)
2. State Surchar�e. ** Add the State Buildin; Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Posta�e and Handlin; (Only 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 permitted
work including materials, labor, profit, and other fized costs. It is the amount to be charged to the
customer for the work done. If any material, equipment, labor, or installation are fumished 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 Ciry may request the submission of a signed copy of tbe actual contract.
�
** The STATE SURCHARGE is .0005 of the contract price under $1,0OO,OQO or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional 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 stateme ts made on this application are complete, true and
correct. � �
�
;
Applicant's Signature � " Date: ,3 (�
.
I
, r