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Home My WebLink About2011-00956 - water heater CITY OF ORONO rERMiT No.: 2011-00956 2750 KELLEY PARKWAY ` ORONO,MN 55356- DATE IssuEn: 08/29/2011 { 952 249-4600 FAX: 952 249-4616 ADDRESS : 585 STUBBS BAY RD N PIN : 32-118-23-24-0006 LEGAL DESC : UNPLATTED 32 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER NOTE: WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 1313 DANITA CR. SHAKOPEE,MN 55379 M.AIL-IN FEE 2.00 (952)445-4803 TOTAL 22.00 Minnesota State License#: 057209PM OWNER FORT,JOHN&KRISTIN 585 STUBBS BAY RD 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 dces not grant permission for additional or related work which requires separate 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 revoked at any time for due cause. ` � / / ` � / / Applicant Permitee Signature Date Issued By Si ture ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A . FOR C1TY USE ONLY O,�p�O City of Orono • P.O.Box 66 Date Received: Pennit# 2750 Kelley Parkway ' � r Crystal Bay,MN 55323 Approved By: Atnount S: ��d�- �9s2�za9-a600 CITY OF ORONO—PLUMBING PERMIT (All Commercial permiu must be approved by the Building Official or Inspector) GENERAL INFORMA'�'ION - � • � 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 retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POS1'ED 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 State Code requirements. , � 6. All work must be inspected and air tested before it is covered. Ca11(952)249-4600. l (24-48 hour notice required) TYPE OF PERMIT Check All That A 1 � �Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Rep�jrs �Replace � � ❑ In Accessory Structure? 'You will need urior a�uroval and may need�UP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: ^ � � Owner.��r 1(1 �� I Mailing Address: b�� Z� � � City: � t'�f 1 Zip: �J`J��(�_ Home Phone: ��- �1��(�� Alternate Phone: Contractor Information: ! ' Contractor• Contact Person: A YYl� J A�� l001S lLZ� Address: 1313 �."'�w�� .:e' State Bond#: , Shak4pe�, �,��'�4��'"� City: . o�'_.��,��„ Expiration Date: ' , , Phone: r Alternate Phone: � - ❑ . Insurance—Current: , * 1 � � If above does not apply;follow guidetines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee o!$50.00) • x.0125$ (contract price) (minimum 550.00) 2. STATE SURCHARGE �*Add the State Bldg Code Div.Surcharge(Minimum Fee of S5.00) , , ' x.0005 $ � (contract price) ' (minimum S 5.00) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � '� ■ * COIVTRACT PRICE or JOB COST means the actual or estimated dollar amount charg,ed for the permitted�vork including materials,Iabor,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,ttie 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$5.00—whichever is greater. For valaations over 51,000,000 call the Building Departrnent at(952)249-4600 for the price. T'he 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 a11 statements made on this application are complete, true and correct. � � �ApplicanYs Signa Date: � � ! !, . • � � � "� . • ,� � + � � . , * 3 . � � . • . FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains ; -� Lavatory Sewer Eje�tor Bathtub Laundry Ttay Shower Washer . Kitchen Sink Water Heater � Disposal Water Softener . Dishwasher Wet Bar Sillcocks , Miscellaneous ❑ Yes,this section applies ' > The replacement of a Residential fixture or aapliance that meets all three of the foltowing requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost df 5500.00 or less;excludin¢the cost of the fixhue or appliance:and 3. Is improved,installcd or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit a 15.00 " ► State Surchazge ' $ � Mail-In Fee(If Applicable� $ 2.00 Total Permit Fee � e � ._ � ' ... , . » (Permit Fees Continued On Neat Page� - . , * 2 �