HomeMy WebLinkAbout1997-009152 - water heater PERMIT
4 CI�''Y OF ORONO PERMIT TYPE: - -�_ _
2750 Kelley Parkway- P.O. Box 66 '-�`'''='=`�"='
Crystal Bay, Minnesota 55323
Permit Number: �:��t'=�1�:;�
(612)473-7357 Date Issued: :�;�i t:a;��!��7
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE -��,
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'��'' R�CEIVE� � ���
JUL p 1 1997
CITY OF URONO APPLICATION F(��'��7��PERMIT
Bux 66 (2750 Kelley Parkway) . -
Crystal Bay, MN 55323
GENERAI.INFORMATION
l. You may apply for plumbing permits by mail or in person at the City offices.
2: Permit cazds�will be sent by return mail affer a revievir is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POS'T�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 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 before it is covered. Call 473-7357. 24-hour notice required.
Instructioii� Co�plete all items on this application.. Compute the pernut.fee. Sign and date
the certification. INCOA�PPLET� APPLICATIONS WILL NOT BE PROCFSSED. If you have
questions, call 473-7357.
. �.
Please check one: New Addition Repair Replace
Residential Commercial
JOB SITE: /9�0 ��'�T�J' �U� Zip: S'-r39/
Owner's Name: D/t.J �.+P�=A.� �. _ . .--- , Telephone Numb�r;.. Sl��- /a� a
Mailing.Address: ��City: � Zip: '
Contractor'sName:�'I2 ,eovT�-.e k.�,s`.�G- � -TelephorieNumber: s'-s'r� ass��
MailingA.ddress:ad'ao c�-:h,�r�1� �2 ���r� �/a City:Py�e�r.d � Zip: :ss��/
.
PLUMBING FII�TURE 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) ; .
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
_ �O , x .0125 $
(contract price) �
2. State Surchar� ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Posta�,e and Handlin� (Only mail-in applications) $ - 1.50 �
4. TOTAL PERNIIT 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 materiat, emaipment, la�or;or instalation are fur+Yishrd by the o«�ne*,
� 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 Tnspectional 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: Date: G—/U ' g�
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