HomeMy WebLinkAbout2002-P05285 - gas line inspection PERMIT
C I�:! O F O RO N O Permit Number:
2?50 Kelley Parkway- PO Box 66 Pos2gs
Crystal Bay, Minnesota 55323 Permit Type: FiX�es
(952) 249-4600 Date Issued: 6ilo�2o02
SITE ADDRESS: 3050 Sixth Ave N
LONG LAKE,MN 55356
P I D: 28-118-23-32-0015
DESCRIPTION:
Proposed Use: Kesiclential
Permit Class: Plumbing
Pernut Type: Fixtures Pernut Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate pernuts required: Other-(gas line to dryer)
NOTICES/REMARKS:
FEE SUMMARY: Pemut Fee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc. Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Tim's Quality Plumbing OWNER: M L KEZAR&M A MCDONALD
P.O.Box 292 3050 SIXTH AVE N
Osseo,MN 55369 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 PERM[TEE SIGNATURE IS UEDJ SIGNATURE �
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
C1TY OF URONO APPLICATION FOR PLUMBING PERMIT
�los b6 (27�0 Kelley Parkway)
Crystal Bay, MN 55323
• GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cazds 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 PERMTT 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.
Instruction� Complete all items on this application. Compute the permit fee. Sign and date
the certificatioii. INC0119PLET� APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, ca11473-7357.
Please check one: �_ New Addition Repair Replace
Residential Commercial
JOB SITE: 3oso G�u� Road (o Zip: x3S�
Owner'sName: pv,v, ��e�u-�c�r TelephoneNumber. �q�a�u�3�ba3s
Mailing A ddress: �o�o C1�u.r-�y„�.vc�4 c� City: OVcrn� Zip: �3 5�
Contractur'sName:T�rn�s ('�uU-t►f-y P�u-uv'b�v�r� TelephoneNumber. �a�a�4�3•oc�ss
MailingA.ddress: 5a3 Cu�tvc�.l P�e,vu,�.� City: Oss� Zip: ��3�q
PLUMBING FII�TURE SCHEDULE
FIXTURE 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 ► �D
Disposal Water Softener
Dishw:+sher Wet Baz
Sillcocks Misc (list)
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
3 3 O � x .0125 $ 35•o0
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
• Surcharge to each permit. x .0005 $ •50 _
(contract price)
or $.50, whichever is greater
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3Z•oo
* CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount chuged 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 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 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: �.0 cl,�, ,r� Date: (� 5 0