HomeMy WebLinkAbout1993-005428 - plumbing PEI�MIT
��F�( OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: ������'iE�I tJ:�
Orona, Minnesota 55356-0815 Date Issued: `}`-'_`�•�'_�
(612) 473-7357 ��;_;:;�;_;���:�;
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF O�'�n\O APPLiCATIfl�FOR PLUI�IBL�G FERtiiTT
BoY b6 (?7�0 ;�elley Par'.cway)
Crystal Fav, �L'ti ���23 �,�"� � 2 �.'�93
GF:'.?'�aL L��'QRtiI=�i'i�'�
1. You may apply i�r�lumbin; permits by mail or in person at the City oi:ices.
2. Per�it c:uds wi_'. be sent by :etura mail afte: a review is corLpl�t�d. PER:'�IITS ARE NOT V:�LID
ti�iTIL YOL �.:C�IVE :� PER:tiIIT. �VOR�: I�tUST NOT BEGI`T UtiTIL THE PER�fIT CARD IS
i-OST�D C� i r:._ JOB SITE.
:. Plumbin�per4�its may be issuzd ONLY to ?iceased plumbing contractors a�d to properrv owne:s :esidin�
1P. [�'iZ C-' �IIlII�.
�. ti�'hea <:::y new :cr.s�r.�c:ion or remedeli�g is iavolve�, a se�ara::. buildin� pe.::it must be obtained.
_. �11 wor:t must �e �'�ne :n accordance wich t�� S'zie Code req�,::rements.
o. .�:' ;vor`.�m�st be :�pected a�d air tested 'oe:ore it is ccve:ed. Cui �73-;���. 24-ho�ur nctic� T2Guli�u.
Instructicns Come'e:e all items on �is appl�cation. Compute t�:e pe.-m.it fee. Sign ar.d �a��
t�e c�:�iiication. ��CO��IPLETE APFLiCATIONS WILL NOT BE PROCESSED. I���ou have
quest:ons, ca?1 473-7357.
Plea�e che�'.t one: �1ew �Addition Repair Re�iace
Resideni:ai Commz:ciai
.TL�t'� STTE: I 3 o S S�+a a� L �,., � 1.�2 Zip. 5 S 3 9 i
(�:,.-d�e�-'�'{;�nP' (,��iLLi;� �r, po PP �'el�'�i��;��2�iurnber:
1I;.;?ir.r,�_��t�r-:: _ �3os ,('HaRELi..� E ���. City�• W,�y Zip• ss3 ��
Conzractor's�a��e: T�„�.� U'lR A�,1 T�� �'�u.�,.,�g,,�ca T�lephonetiumber: �i � 3 - ��,s s-
�iailina_�ddress: P o B a X a y a City: o s s�� Zip• �S 3 G 5
Pi:L�!�;�its �I'i..'�E Sr�DL���
FL:T'.":: BS�1T � 1ST � 2�'D GTHER � FIXTURE BS1��IT 1ST =ND i OTHER
T`.":_ FL FL ( ; TYPE FL FL �
Wate: Cioset ��� � I � �� Se=Ner �.jector � 6 �
Lavator� 1 � � Laundrv Tray � ,
� �Bar.�tub � �' � V4'as�e: I
She�- I � I Wa�er Heater ( �
?::�c'r_en Sink j � I � Water Softeae: � � �
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uispos:z� ( � ( ( � �Vet $ar , � �
Dis+���...::::.ti: � � � � rioor Drains � � �
. __:;;� � � � � l�lisc (list) '
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
�.?. 07)a�cN x 1.25 $ .3 5. v o
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ • S�
(contract price)
3. Postage and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERNIIT FEE (Add lines 1-3 above) $ 3�-��
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
work including materials, labor, profit, aad other fixed costs. It is the amount to be charged to the
customer for the work done. If any material, equipment, labor,�or installaaon 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 fce 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 the contract price under $1,000,000 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 statements made on this application are complete, true and
correct.
Applicant's Signature: Date: i'°ly3
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