HomeMy WebLinkAbout2011-00201 - water heater � • CITY OF ORONO PERMIT NO.: 20��-0020�
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 04/07/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 80 SMITH AVE
PIN : 02-117-23-21-0004
LEGAL DESC : ORONO ORCHARDS
: LOT 042 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
NORBLOM PLUMBING CO. STATE SURCHARGE PLBG(<$500) 5.00
2905 GARFIELD AVENUE S.
MINNEAPOLIS, MN 5540& MAIL-IN FEE 2.00
(612)827-4033 MISC FEE 0.00
TOTAL 22.00
OWNER
MCMILLAN,TAMMIS
80 SMITH AVE
WAYZATA,MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time aRer work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cau9e.
i�'3�'_Gtl.L !�L l l l l
_ Applicant Permitee Signature Date Issued By Si ture ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO
FOR CITX USE ONLY
^�' � ' O,�p�,O City of Orono A ;,
P.O.Box 66 Datc�ReceiHed: �'� Ferinit#
2750 Kelley Parkway ' ( '
., � � Crysta]Bay,MN 55323 ApproVed By , � ,Amount$:
L_ '$y (952)249-4600 � "
��is8� �� `�
CITY OF ORONO—PLUMBING PERMIT
(All Commercia]permits must be approved by the Building Official or Inspector)
;GENE�AI;INFORMATION
1. You may apply for plumbing pemuts by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON�THE JOB SITE
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construcrion or remodeling is involved,a separate building permit must be
obtained. -
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
� TYPE QF-PERNIIT'
' Check Ai1=T�iat A` pl
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs
❑Replace
❑ In Accessory Structure?
*You will need arior annroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
JobtSite/Qwner�nfvrmation4�-4 ,J� ",�� ,ur; ,�''',�:ti,; .
Site Address: Tammis Mcmillan
80 Smith Avenue
Owner: Orono, MN 55391 �ss:
6129610317
City:
Home Phone: Alternate Phone:
Contractor Inforination:. ' ;. .
Contractor: ��CV�bYY� pI�,V�� Contact Person:
Address: ���� �1ar'f1��d �V sti, State Bond#: ��.(� �5� �
City: �. �s Zip�d$ Expiration Date: I � v�/v 1
Phone: ��P�2�g�7- �fa33 ---
Alternate Phone:
� Insurance—Current:
1
� 4 `� �
+
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 I
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ 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; exciudine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $��
(Permit Fees Continued On Negt Page)
2
. � _ .
,
If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �2-.�
.�i
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
perxnitted 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 fiunished 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 Building Department at(952)249-4600 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: Date: � I'"f I I I
3