HomeMy WebLinkAbout1994-006124 - re-roof/tearoff PERMIT
;CIT� OF ORONO PERMIT TYPE:
�2750�e11e Parkwa • P.O. Box 815 �;�_'�� ���`}{-
Orono. Mi nesota 55356-0815 Permit Number: ;_;�k�,3�y� ;
(612) 473-7357 Date Issued: -� -�
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� APPLICANT; MITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO - BQIZDZNG PERMIT APPLIC3TION
� �� 5�v � Date Received:
Total Fee: $ -
Date A�prove�: '
Entered Bv: �'�� Permit�: �o��T . - - _= -
- - ,
AT•T• INppgMATIUN MIIST B$ SZ7BMITTED IN I'IILI� BEFORE PI,AN REVSEW WIIS� BS S�`�T�----
(Sea Check-off List Enclosed)
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T�'iE APPLICAN
T IS: (circl.e one) OS�TNER o CONT.RACTOR �o )
ZIP: � �
JOB SITE ADDRBSS:
� (work)
^ � PSONE: (home) � /�—ld'Z�
N� OF OWNER:
MATI,ING ADDRESS: I'2SS T5 S
� �cz�: l� o u v► ��Z1P• -�5-3ti `�
PHONE:
CONTR��CTOR: V�
CITY: ZIP:
j�pTT ING ADDRESS:
ST�,TE ZICENSE: �
PHONE:
ARCHITECT/ENGINEERs
CITY: ZIP:
MAIZING ADDRESS:
REGISZ'�TION a
NAME:
Accessory Structure Move �
TYPE OF WORR: New Addition Land Alteration
De�o
Re.*nodel/Alteration Renovate
-F' u e
PROPOSED WORR (describe in detail) :
STORSES: S4- FEET OF EAC� FLOORs
NO. OF BEDROOMS:
��� gTAT,T•g. ATT. DET. _
�—
� la.nd) - $ �
ESTIMI3TED CDNSTRIICTION VALIIATION (eac3.ndinq
I hereby apply for a building permit ae work i17. be in conf rmancef with the
` above is complete and accurate; that th Code; that 2
� ordinances and codes of the Ci.ty and with the State Building e�it; and
� understand this is not a permit and work is not to start without a p
that the work wil 1 be ia accordance with the approved p laa. _ • -
� DATE s �/ "`��� /�
APPI�ICANT'S SIGNAT'ORE-
� . ..
. �
CTT� OF OKONO APPLICATION FOR PLUMSII�TGr PERMIT
Bo� 66 (2750 Kelley Parkway)
Cr�stal Bay, IVIN 55323
CiII�ATr INFORMA'r'YO1�I
I, 'You may apply for plumbing perm.iu by mail or in person at rhe Ciry offices.
2. Permit cazds will be sent by renun mail after a review is completed. P�I2MITS A.RE NOT VA,LTl�UN'I'IL
YOU REC$IVE A pETtMIT. wO�LK MUST NOT AEGIN TNTIT..TH13 PERMIT CARD 1S�'OSTED ON
TH�IOB Sr!'F_
3. Plumbing permiu may be issued ONLY to licensed plumbin�conuactors and to property owners residing
in the dwelling.
4, When any new construcdon or remodeling is�mvolved, a separa�e building permit mus�be obtaiaed.
5. All work must be done in accordance wi�h the: Stau Code requirements.
6. All work mus� be inspec�ed and air tested t,efore it is covered. Call (952) ?�9-4600. 24-hour norice
required.
Instructic►ns Complete a11 items on this application. Compute rhe permit fee. Sign and date the
certification. INCOi�IPLETE APPLICATTt1NS WII.L NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: �,'_ Ne�v _ Addidon Repair Replace
Residential Commercial
JOB SITE: I 2� ��? �u L t �'c� Zip:
Owner's Name: �c: r�=v►��� Telephone Number:
Mailirtg Address: City: Zip: -
Contractor'sName: CULLIGAi� WATER COND1Ti�NINC�'elephuneNumber:
Mailing Address: 6030 N Citp: Zip:
, .
PL�2�}����� sc�:n�rt.E
FI3LTURE BSMT 1ST 2ND OTH1:R �T.�CTURE BSA�IT 1ST 2NA OTFIER -
TypE FL FL TYP� FL PL
'Water Closec Floor Drains
Lavato Sewer �jector
Bathtub Laundrv Trav
Shower W asher -
TCitchea Sink Water Heacer .
Dis osal Water Softener I�
Dishwasher wet gaz
5illcocks Misc (list)
j , .
PERIVIY'T' �E CALC�7I,ATTON(S)
20 2 State Statute � Yes, This Section Applies
The replacernen[ of a �2esidential fixture or appliance that meets all three of che following
requirements:
1) Does not require modification t.o elecuical or aas service.
2) Has a cotal cost af$500.00 or less; excludinQ the cost of the �xture or appliance:
and
3) Is improved, installed or replac ed by the hameowner or licenced contractor.
Skip next secuon; Cost of Permit $ �5.00
� State Slircharge $ ._50
Mail Tn Fee $ 1.50
�f above does not apply, follow guidelines belo�v:
1. Contract price* is .0125 � of job with a 11�finimum Fee of ($3S.00)
x .0125 $
(contr;ict price) (minimum$35.00)
2, State �nrcharge. *� Add the State Building Code Division a (1Viinimum Fee of $ .50)
x ,OOOS $ �
(con��act price) (minimum$ .50)
3, Post��e and I�andlin� (Only mail-in applicarions) $ 1.50
4. TOTAY. pERNIIT F'�E (Add lines 1-3 above) $ (�; a�`
* CONTRACT PRICE or dOB COST means thE:actual or esuma�ed dollar amoun�charged for the permitted
work including materiais, labor,profic, and odier fixed costs. It is rhe amount to be charged to rhe customer
for the work done. If any material, equipmecu, labor, or installation are fttrnished by the owner, tenanc or
any other party tI�e reasonable market value cf sueh i[ems must be added to the estimated eost or contraec
� price for permi[fee purposes. In the event chac there is a dispute on che amoun�of the job eost, �he Ciry may
reqttest the submission of a signed copy ot thc actual contract.
** The STATE SURCHARG�is .0005 of the co�itracc price under 51,000,000 or 5.50 -whichever is greater.
For vatuaiions ovcr$1,Ob0,000 call the Departmen�of Inspeetion Services for the price. .
The undersigned hereby applies to the City f+�r issuance of a Plumbing Percnit, agrees to do all
work in strict accordance with the ordinanc�:s of the City and the regulations of ihe State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's SiDnature: � Date: � /lv�/