The URL can be used to link to this page

Home My WebLink About2013-00841 - plumbing � , CITY OF ORONO * 2 0 1 3 - 0 0 B 4 1 * 2750 KELLEY PARKWAY DATE ISSUED: 08/22/2013 ORONO, MN 55356- � (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3515 SIXTH AVE N PIN : 29-118-23-43-0002 LEGAL DESC : UNPLATTED 29 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)SHOWER,(1)KITCHEN SINK,(1)DISPOSAL AND(1)DISHWASHER VALUATION OF PLUMBING 4000 APPLICANT PLUMBING FIXTURE FEE 50.00 MANATEE PLUMBING STATE SURCHARGE PLBG(VALUATION) 2.00 11525 199TH CIRCLE TOTAL 52.00 SILVER LAKE, MN 55381- (612)756-1172 Minnesota State License#: 005923PM OWNER PETERSON, DALE&DIANE 3515 SIXTH AVE N LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be rev ed at any time for due use. � � � � U �l Ap icant Per ee Signature Date Issue y ' nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � j, � FOR CTTY USE ONLY � City of Orono ' �-��O P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway ` Crystal Bay,MN 55323 Approved By: Amount$: (952)249-4600—Main (952)249-4616—Fax y�' c,` CITY OF ORONO—PLUMBING PERMIT tqKFSHo��' (All Commercial Permits Must be Approved by the State Prior to City Approval) htt :I/www.dli.mn. ov/CCLD/PDF/ e lumb lanreva . df GENERAL INFORMATION 1. You may apply for plumbing permits 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 construction 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 OF PERMIT (Check Al1 That A ly) �Residential ❑ Commercial(Approval Required) ❑ New �Additional ❑ Repairs �eplace ❑ In Accessory Structwe? *You will need arior aparoval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/:Owner Information: Site Address: �� Owner:,L �.t,I� t� -I�'�r 5�_ Mailing Address: City: �V �� Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: md`�� OY�� ContactPerson: �� Address: ��C) rC�� State Bond#: City: 'S1 �U Zip�� f Expiration Date: Phone: Cq��7 5�0 -l�7a Alternate Phone: ❑ Insurance—Current: 1 � � :� � . ,�. �� . . •�r'� ' E�F,,:, �� .�� . , k ,. ...�. ..� . � � .. : t e:.�`�"i . ` t . ' •. • ._: ._ .,� , .,.,. ... , ,4. , �,. s�., .m .� , .,.1�...o- ..>_... _�eb.. " FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower � Washer Kitchen Sink � Water Heater Disposal I Water Softener Dishwasher Wet Baz Siilcocks Miscellaneous ❑ Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three of the following reGuirements: 1. Does not require 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 improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Totat Permit Fee $ (Permit Fees Continued On Next Page) 2 i r , � ��, � �' ��' , . � , ,� � . , _ .„ar, ' � ^2'�' �:1„ s;`�{r z � `.F �W ��v,.� �:�:�s�, If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) "1,b�0 x.0125$ (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. e . , , , ;- � U 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: ��--� l� �� 3