HomeMy WebLinkAbout2017-01157 - water heater � - ' •
CITY OF ORONO �
2750 KELLEY PARKWAY * � 0 1 7 - 0 1 1 5 7 *
DATE ISSUED: 09/19/2017
' ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3160 SUSSEX RD
PIN : 04-117-23-32-0008
LEGAL DESC : FOX BEND
: LOT 002 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYP : RESIDENTIAL
CONSTRUCTIO TYPE : WATER HEATER
VALUATION : $ 3,468.00
NOTE: WATER HE TER REPLACEMENT
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I APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.73
HEATING&COO ING TWO INC. TOTAL 51.73
18550 COUNTY R AD 81
MAPLE GROVE, 55369- Payment(s)
(763)428-3677 CREDIT CARD 4334 51.73
OWNER
CHENITZ, RICHAI�D&PATRICIA
3160 SUSSEX RD �
LONG LAKE,MN�5356-
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AGREEME T AND SWORN STATEMENT
The work for which this ermit is issued shall be performed according ro
the approved plans and s ecifications,applicable City approvals,and the
State Building Code. Th s permit is for only the work described and does
not grant permission for dditional or related work which requires separate
permits. All provisions laws and ordinances goveming this type of work
shall be compied with w ether or not specified herein.This permit will
expire and become null a d void if construction authorized is not
commenced within 180 ys of the date of issuance,or if construction is
suspended for a period o 180 days at any time afrer work has commenced.
The applicant is responsi le for assuring all required inspections are
requested in conformanc with the State Building Code.This permit may be
revoked at any time for d e cause. • �
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C%Y � L �'C/(� �l ( �/ O �
Appli ant Permitee Si ature Date Issued By ' ature Date
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p City of Orono ` � ITY EQ�?� /
��� P_0.Box 66 � Date ReceivQ�6-� � �"°'�f�:
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� 2750 Keliey Parkway � - . .. _ .
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" Crystal Bay,MN 55323 Pet'rpat# ���� ;�r�-:
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exx�,.� (g52)24914616--Fax Appraved By
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� CITY OF ORONO- PLUMBING PERMIT �
(All Commercial Permits Must lie Approved by the State Prior to City Approval)
http:/Iwww.dli.mn.qov/CCl.QlPDFIpe plumbplanrevapp pdf
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. You may apply for plumbing permits by maii or in person at the City o�ces. Applications will be
reviewed and a permit will be issued within two working days.
. Permit cards wiil be sent by return mail after a review is completed. PERMfTS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTiL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
. Plumb�ng permits may be issued ONLY to licensed plumbing contractors and to property owner5
residing in the dwelling.
When any new construction or remodeling is involved, a separa#e building permit must be ob#ained.
All work must be done in accordance with State Code requirements.
6 All work must be inspected and air tested before it is covered. Cal! (952)249-4600.
(24-48 hour notice required)
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❑ esidential ❑ Commercial (Appraval Required) [Backflow Device:Q AVB ❑PVB]
❑ ew ❑Additional ❑ Repairs �Replace
❑ n Accessory Structure?
*You wi(I need prior approval and may need CUP. (Per Orono City Code, Chapter 78,Artide iV)
Jes�_.. ���1 QQ�r�er:tr�forrr��icir�....: � �:
Site ddress: ,3��0 �c-�S F��Q�,Q
Own r��h o ���Mailing Address: ��co d ��v���l�p��
City: �2� Zip: ��J`� �o
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Hom Phone: �-9��8��c� Alternafe Phone: ���- `?n �'" ��Z✓
�c��rf ���r'--�r�fo�rr����o�t ....;- ...._. ..
Contr ctor: 9�� p ',{/ G�CJ Contact Person: Li��,� �d��j
Addr ss:�$ � � State Bond #:
City: � /' �, Zi�: Jr5�c0 Expiration Date:
Phon : ` �� �d --��� �� Alternate Phone:
❑ Ins rance-Current:
Page�
Y � ~ Fr m Heating and Cooling Two 1.763.428.3682 Tue Sep 19 10:56:26 2017 MDT Page 2 of 2
, FI . llRE BSMT 1sT 2ND OTHER FIXTURE BSMT 4ST 2"D OTHER.
PE Floor Fioor TYPE Floor Ffoor
Wate Cioset Floor Drams
Lavat ry Sawer Ejector
8atht b Laundry Tray
Show r Washer
Kitche Sink Water Heater �
Dispo al Water Softener
Dishw sher Wet Bar
Sificoc s Miscellaneous
1. CONTRACT PRICE k is 1.25%of contract price with a (Minimum Fee of$50.00)
`�"c�fl` � x .0125 $ � ✓�'�J
(contract price) (minimum $50.00)
2. STATE SURCHARGE
r�'-3�{��� x .ao�s $__ �� ��
(cantract price)
. POSTAGE&HANDLING (Onty on Nlail-In Applications) $ 2.00
. TOTAL PERMI'�FEE (Add Lines 1-3 Above) $ �� ��
" CON RACT PR(CE or JOB COST means the actual or estimated dollar amount charged for the
permitt d work including materials, labor, proft, and other fixed costs. It is the amount to be charged to
the cus. mer for the work done. If any material, equipment, labor or installations are fumished by #he
owner, enant or any other parfy, the reasonable market value of such items must be added to the
estimat d cost or contract price for permit fee purposes. In the event that there is a dispute on the
amount f the job cost, the City may request the submission of a signed copy of the actual contract.
The und rsigned hereby appiies to the City for issuance of a Plurnbing Permit, agrees to do all work in
strict ac ordance with the ordinances f the City and the regulations of the State of Minnesota, and
certifes at ail statements de on application ar complete, true and correct.
Applican 's Signature: � Date: �� ��(�,��
8uilding fficial/Inspector: Date:
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