HomeMy WebLinkAbout2016-00600 - water softner CITY OF ORONO * 2 0 1 6 — 0 0 6 0 0 *
` 2750 KELLEY PARKWAY DATE ISSUED: 05/27/2016
� ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2060 SHORELINE DR
PIN : 15-117-23-21-0004
LEGAL DESC : HARTWOOD
: LOT 005 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: WATER SOFTENER
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 52.25
(952)912-7379 Payment(s)
CREDIT CARD 5107 52.25
OWNER
PETERSON,JAMES&NLIA
2060 SHORELINE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
1'he work for which this permit is issued shall be performed according to
the approved plans and specifications,applicabie 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 requves separate
permits. All provisions of laws and ordinances goveming 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 appiicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By i ature Date
05/26/2016 15:34 FAX 9529a35049 CtiLLIGAN MNTRA 1�002
_�5E ONI.Y
p City of Orono �
O� �O P�O��ox 66 T�au Receiv . permit# �� �
" 2750 Kellay Padcway
� i, ,•- L Crystal BaY,MN 55323 Approved By: Amoun�S:
���G� (95Z)2a9�600
CIT'Y OF ORONO—PLYI'MB�1VG PERMYT
(All Commerciat persnit5 mus[be approved hy the sujlding OQicinl or Inspectqr)
GENERAX,�1VI'ORMA'X`XON
1. You may appty for plumbing permits by mail or in person at the City offices. Applications will be
re�viewed and a peimit will be issued within two working days_
z. Permit cards will be sent by retum mail�er a review is complcted. PERMITS ARE NOT
VALYD UN'TII�YOU RECEIVE A P��', WORK MYJST NOT BEGIN UN'A'IL THE
PEYt11�T CARD IS PdSTED UN T��JOB STTE
3. Plumbing permits msy be issued ONLY to licensed plumbing contractors and to property owners
residing in t6e dwelling. �
4. When any new construction or remodeJing is involved,a separate building permit must bc
obtained.
5. All work must be done in accordanee with 5tate Code requirements,
6. AII wo1'k must be insp�ted and air tested before it is covered. Gall(952)249-4(00.
(24-48 f�our notice required)
TYPE OF PERMYT �
Check AIl That A 1
�Rtsidential ❑Commorcia](Approval}iequirCd)
�New ❑Addilaonal ❑Repairs []Rtplace
❑ In Accessory Structure? I
*You will need orior,aoorovul attd may nccd�.(Per Orono Ciry Code,Chapter 7$,Article IV)
�
Job Site/Owner Information: �
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Site Address; c��� s�►0 re.��� �J f Y
Owner� �r•-� I���r S�r� Mailing Address: �
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c��y: Z;p: �s3 9 �` �
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Home Phone: �S a �y q6 �9a.�a Alternate Phone: �
Contractor Xnformation P
�
Gontractor: Contact Person: � ;
`U1�L9U,qN WATER C�Nt]i�'IQNINC �
Addr��0 �ul�1G�lQ( ur��u State Bond#: '�
Ivi�fVN+�T��pKA, MN 55�45 �
City: (952) 93�-72�0 Zip: Expiration Date: i
;
phone� Alternat�Phone: ��7_1� - "�,3 I 7 �
. �
[] Insurance—Current:
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05/26/2016 15:34 FAX 9529335049 CtiLLIGAN MNTRA 1�003
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FIXTLTRE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTH�R
TYPE FL FL T'YPE FL FL
Water Ciosei Floor Drains
Lavatory Sewer Ejector
Bathtub La�mdry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener �
Dishwasher Wet Bar
Sil)cocks Miscellaneous
��I��,�1:1 n� ;li"' "i'id.,ry�A I; t���.Tt'•:,�ji•:i�:;iW"� �'1 �./Te'� � '�� .( J� `va�^•;`" .' �a�l'11r •r„..y�I.�p•�^C� a
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❑ Yes,this scction applies
T'he replacement of a Residential fixture or appliance that meers all three of thc following rcquirements:
1. Does not requue modification to electrical or gas service.
2. Has a total cost of$500_00 or less;excludine the cost of the fixture or appliance;and
3. Is iraproved,mstslled or replactd by the homcovmer or licensed con�actor.
Skip next section,if this applies; Cost of Permit $ 15•OQ
State 5iucharge � 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Perm�t Fee S
(1'ermit Fees Continued Qe Ncxt page)
2
05/26/2016 15:a4 FAX 8529335049 CULLIGAN MNTKA f�004
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lf above does not 8ppty;follow guidclines below:
1. CONTXtACT PRICE *is 1.25%of contract price with a(Mlnimnm Fee of$50.00)
x.0125$
(cpnp'act pricc) (minimum 5�,00)
2. STATE SURCHARGE *'�Add the State Bldg Code Div.Surcharge(A�iinimum Fcc cf55.00)
x.D005 $
(conhact prite) (minimum S 5.00}
3. P05TACy�&HANDLING(Only on Mail-In Applications) $ 2.00
4. 7'OTAL PERMTT FE�(Add Lines I-3 Above) $ �r� . a1 S
■ "` CONTRACT PRICE or 70B COST means thc actual or esrimated dollar amount charged for the
permitted wark including materials, labor,profiY,snd other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor or inscalIations sre fumished by
the owaer,'tenant or any other pany,the reasonable market value of such items must be added to the
estimated cpst or co�act price for permit fcc purposes. In the evcnt eItat there is a disputc on the
amo�u►t of the job eost,the City may request the submission of a signed copy of the actuAl contrac�
■ **The STATE SURCFIARGE is.0005 of the contraet price unde�r$1,000,000 or$5.00—whichevcr is
grcater. For valuations over S I,000,000 call the Baildin$Department at(952)249-4600 for the price.
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do al!
work in strict accordance with the ordinances of the Ciry and the regulations of the State of .
Minncsota, and certifies that a)1 statements made on this applieation are complete, true and
correct
Applicent's Signature: � pate: .S'o�b � ���_
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