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Home My WebLink About2011-00387 - plumbing � CITY OF ORONO PERMIT NO.: 2011-00387 } � 2750 KELLEY PARKWAY i � ORONO,MN 55356- DATE ISSUED: OS/24/2011 _ ; 952 249-4600 FAX: 952 249-4616 ADDRESS : 3472 SHORELINE DR PIN : 17-117-23-43-0094 LEGAL DESC : NAVARRE HEIGHTS : LOT 018 BLOCK 006 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: 1 WC, 1 LAV, 1 KITCHEN SINK, 1 LAUNDRY TRAY VALUATION OF PLUMBING 500 � 4 1 APPLICANT PLUMBING FIXTURE FEE 50.00 DAVE DEMPSEY PLUMBING INC. STATE SURCHARGE PLBG(VALUATION) 0.25 17264 165TH SE TOTAL 50.25 ' BIG LAKE,MN 55309- Minnesota State License#: 058005 PM OWNER Bankunited FSB 7815 NW 148TH ST MIAMI LAKES,FL 33016-1554 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work - shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if consVuction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be rev at any ti r due cause. � S/o? l l/ l l Applicant Permitee Sign Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. � ,I . FOR CITY IISE-AIVUY � , �g��,� City of Orono � � P.O.Box 66 Date Received:' Petmit# 2750 Kelley Parkway � `� �'� Crystal Bay,MN 55323 Approved 8y: ' Amount$: . (952)249-4600—Main �rsa$y (952)249-4616—Fax CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://www.dli.mn.�ov/CCLD/PDF/ e lumb lanreva . df C'rENERAI,INFOItMATION ' 1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return 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 construcrion or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) ' TYPE C)F PERNSIT (Cheek All That A 1- ) �Residential ❑ Commercial(Approval Required) ❑ New ❑Additional �Repairs ❑Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article I� Job Site-%•Owner Information: Site Address: ,3 � 7Z J�"� c� Owner: Mailing Address: City: /��9v�t/1 Zip: Home Phone: Alternate Phone: Cor�t�actor Iriformation: Contractor: Q�i� jJ��r05�% �'L,(3j� Contact Person: �� 3 /l�ZO Address: I7�Z 6�/ /65 .s% 5� State Bond#: C City: ��`6 LAkc. Zip:S�309 Expiration Date: ��3/�// Phone: ��2"��0� �I-SO L Alternate Phone: �6 3` �Z Z'�S 7Z ❑ Insurance—Current: 1 \ . . / � FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet r Floor Drains Lavatory ( Sewer Ejector Bathtub Laundry Tray ! / Shower W asher Kitchen Sink n Water Heater � Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous ❑ Yes,this section applies The replacement of only one Residenrial fixture or ap hn 'ance that meets all three of the following requirements: 1. Does not require modificarion 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 improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next section,if this applies; Cost of Pernut $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 � • If above does not apply; follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) �00. od X.oi2s$ (contract price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 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 fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations 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 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: � 02�( � 3