HomeMy WebLinkAbout1998-010644 - plumbing PERMIT
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� 2750 Kelley Parkway- P.O. Box 66 Permit Number: t_��r_�;=,�.��
Crystal Bay, Minnesota 55323 _
(612) 473-7357 Date Issued: ;;;;f����;•�:�;_;
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATUR
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CITY OF URONO APPLICATION FOR PLUMBING PERNIIT
}�oY h6 (2750 Kelley Parkway)
Crystal Bay, NIN 55323
GENERAL INFORMATION .
1. You may apply for plumbing pe=mits by mail or in person at the City offices.
2. Permit cazds will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
LTITIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
� POST�D 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 construction or remodeling is involved, a sepazate 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 before it is covered. Ca11473-7357. 24-hour notice required.
Instructiai�� Coazplet? all items on ttus application. Compute the permit fee. Sign and date
the certificatioii. INCO��PLET� APPLICATIONS WILL NOT BE PROCFSSED. If you have
questions, call 473-7357.
Please check one: New Addition Repair Replace
�Residential Commercial
JOB SITE: v�6 SD �i�de,e� � �� Zip: �35-6
Owner'sName: �" TelephoneNumber. �(y���6�
Mailing Address: 5,�,,.,� City: -- Zip: —
�l�9.�3 Contract��r'sName: �',�w�%, �yjtiNr v.� TelephoneNwnber: y73- 76s/
MailingA.ddress: City: / �k Zip: Ss��Y/
PLUMBING FIXTURE SCHEDULE
FIXTUR.E BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL � TYPE FL FL
Water Closet /� Floor Drains
Lavatory � Sewer Ejector
Bathtub � Laundry Tray
Shower (/! Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishw;sher Wet Bar �/
Sillcocks Misc (list)
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
. x .0125 $ �SDO.°�
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x :0005 $
(contract price)
or $.50, whichever is greater
3. Posta�e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* 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 work done. If any material, equipment, labor,or installation aze furnished by the owner,
� tenant or an}+ 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 Cicy 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: �.�i�- Date: �/91�
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