HomeMy WebLinkAbout1999-011185 - water softner r PER IT
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CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �-�?�_��°������a��
Crystal Bay, Minnesota 55323 Permit Number: ,_,� �{ , :;,�
(612)473-7357 Date Issued: _ _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: _ �;�;:�,� ��_.,;-;�;. _ OWNER:
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APPLICANT/PERMITEE SIGNATURE li ISSUED BY:SIGNATUR
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CITY OF URONO APP ICATION FOR PLUMBING PERMIT
�ox bb (2750 Kelley Parkway) �
Crystal Say, MN 55323
` GENERAL INFORM.�TION �
1. You may apply for plumbing permits by mail or in pe on at the City offices.
2. Permit cards vuill be sent by return mail after a revie is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON xHE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed pl bing contractors and to property owners residing
in the dwelling.
4. When any new construction or remodeling is involved, a sepazate building permit must be obtained.
5. All work must be done in accordance with the State C de requirements.
6. All�vork must pe inspect�d and air tesied'uefore it is c ered. Caii 473-73�7. i4-hour notice required.
Instruction� Coa�p�etP all items on this application. Compute the permit fee. Sign and date
the certificatioii. IN�011'1�LET� APPLICATIONS LL NOT BE PROCFSSED. If you have
questions, ca11473-'�357.
Please check one: � New Addition Repair Replace
� Residential C mmercial �
JOB SI1'E: oZ- 1 1� Zip: v,- � _
Owner's Name:� Q ,j�g��_ elephone Number: 5q j.Q$c/od-
Mailing Address: City: Zip:
Contractor'sN WA7ER CO�VDITt N TelephoneNumber:
MailingA.ddress: 30 CU�LIGAN WA City: Zip:
lVIINiVETONKA, MN 5
S�A�XTURE CHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIX URE BSMT 1ST 2ND OTHER
TYPE FL FL T E FL FL
Water Closet rlo Drains
Lavatory Sew r Ejector
Bathtub La dry Tray �
Shower Was er
Kitchen Sink Wat r Heater
Disposal Wat r Softener �
Dishw:�sher Wet ar
_ Sillcocks Mis (list)
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00) -
��D x .0125 $ ����
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
� Surcharge to each permit. � x .0005 $ � �0 �
� (contract price)
or $.50, whichever is greater
3. Postag,e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERNIIT FEE (Add lines 1-3 above) $ `�� _c7 c7
* CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount chazged for the permitted
work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the
customer for the woric done. If any materiai, equipmeni, iab�r,ar i�;staL'atian are f.imis�ed�y the ow�ner,
tenant or any other pariy 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 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 Inspecdonal Services for the price.
The undersigned hereby applies to the Ciry 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 tlus application are complete, true and
correct. �
Applicant's Signa e: � Date: � �