HomeMy WebLinkAbout2004-P08316 - plumbing ��'�`OF R N PERMIT
�' � � � Permit Number:
2750 Kelley Parkway- PO Box 66 P08316
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: i2i2�i2ooa
SITE ADDRESS: 380 Silver Meadow Dr
Long Lake,MN 55356
P I D: 33-118-23-42-0005
DESCRIPTION:
Proposed Use: Kesidennai
Permit Class: Plumbing
Pernut Type: Fixtures Permit Sub-type(s): Water Heater
DETAILS:
Approved per resolurion#:
Separate perxnits required:
NOTICES/REMARKS:
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. �WNER: Shawn&Ann Cadwallader
2905 Garfield Avenue S. 380 Silver Meadow Dr
Minneapolis,MN 55408 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE D BY SIGNATURE `�'����
Covies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323 � '
. , :
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City of�ces. ' '
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 ro properry 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 inspected and air tested befere it is covered, Ca�l (952) 249-4600. 24-hour natice
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
_/�tesidential Commercial
.T�B SITE:. CADWALLADER,SHAWN _
� � 380 SILVER MEADOW DRIVE - - ' Zlp: `
Qtvner's Name: . .�...�
ORONO, MN 55356 TeIePt10118 NUIl1bCT.
Mailing Address: ' (952)938-2998 Clt�c_. �ip;.;
Contractor's Name: '` � c � Telephone Number: (���2��2�
Mailing Address: zqOS e,�✓ .so. . City:_��/S Zip: SS��`�'
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL I
Water Closet Floor Drains
Lavato Sewer E'ector
Ba��b Laund Tra
Shower Washer
Kitchen Sink Water Heater �
Dis osal Water Sofcener -
_ ..
bishwasher . ..
Wet B�r _
Sillcocks Misc (list)
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PERMIT FEE CALCULATION(S1
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 ^.ext secticn; Cest af Perm�it � 15.OG
State Surcharge $ .SQ
Mail In Fee � 1.50
If above does not apply, follow guidelines below:
l. 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. Postage and Handlin� (Only mail-in applications) $ 1.50
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4. '1'�'rAi. Pr,�'cIViiIT r�E (Add iines 1-� abcve j � 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 $1,000,000 call the Department of Inspection Services for the price.
The undersigned hereby applies to the City for issuance of a Plumbing Pernut, 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: �2 15�_ .