HomeMy WebLinkAbout2004-P07580 - water heater PERMIT
CITY, OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 Po�sso
Crystal Bay, Minnesota 55323 Permit Type: FiX�es
(952) 249-4600 Date Issued: 6iai2ooa
SITE ADDRESS: 2585 Shadywood Rd
EXCEISIOR,MN 55331
P I D: 21-117-23-22-0013
DESCRIPTION:
Proposed Use: Kesidenriai
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
Separate permits required:
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NOTICES/REMARKS:
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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: D M SCHULTZ ETAL
2905 Garfield Avenue S. 2585 SHADYWOOD RD
Minneapolis,MN 55408 EXCELSIOR MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRIGT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Apnlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
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GENERAL INFORMATION _
1. You may apply for plumbing permits by mail or in person at [he City offices. ' '
2. Permit cards will be sent by retum 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 i.nspected and air tested before it is covered. Call (952j 249-4600, 24-hour notice
required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: New Addition Repair Keplace
___�_/�Zesidential C'nmmercial
.T-�B SITE: SCHULTZ,DON
. : � , , 2585 SHADYWOOD ROAD ? Zlp: �
Otvrter's Name: . ORONO,MN 55331 lephone Number' '
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MdlI1T1g AU(Il'eS5: ' (952)471-9685 l�lt�s '`�ip:�, �- -�
Contractor's Name: ` � `
� TelephoneNumber: r (��2,y2�-y�.��
. Mailing Address: 2qOS e,�✓ .so. City:_�+42�/S Zip: s'��c��'
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER +
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavato Sewer E'ector
Bathtub Laund Tra
Shower Washer
Kitchen Sink Water Heater �
Dis osal Water Softener
; Dishwasher_. . Wet Bar ,,, _ .. _ . ;
Sillcocks Misc (list)
PERMIT FEE CALCLTI.ATION(S�
2002 State Statute � 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; excludin� the cost of the fixture or appliance:
and
3) Is improved, installed or replaced by the homeowner or licenced contractor.
Skip next section; C.�ost of�Fermit � 1�.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 $
(contract price) (minimum $35.00)
2. State Surchar�e. ** Add the State Building Code Division a (Minimum Fee of $ .50)
x .0005 $
(contract price) (minimum $ .50)
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
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4. TOTAL PERMIT FEE (Add lines 1-3 above) $ � C �
* 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. 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 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 che contract price under$1,000,000 or $.50 - whichever is greater.
For valuations over $1,040,000 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
Nlinnesota, and certifies that all statements made on this application are complete, true and
correct.
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Applicant's Signature: Date:
Se-�" i V
CITY OF ORONO LLED IN
6DA� TIME
INSPECTION NOTIC SCHEDULED 6�� ��
PERMIT NO. O COMPLETED
ADDRESS 5 5 C�G�.-
OWNER CONTR. DY�� �i�t-�-
TELEPHONE NO. 9�Z- 7��/ 9��5 /�ZLDDyt.S�`-�"Z
� DESCRIPTION W��l TT l��l�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAI 36 FOUNDATION/REMOVAL
� OWNERICONTFiACTOH TO MEET YOU:_YES_NO
v�, COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPEC710N REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the n t inspection 2a hours in advance. (952) 249-4600
OwnerlContr on e:
Inspector. �
White Copyllnspector's File Canary CopylSlte Notice