HomeMy WebLinkAbout1998-010650 - vacuum breaker PERMIT
E CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 P L t SMB t N6
Crystal Bay, Minnesota 55323 Permit Number: t i 10650
)650
(612)473-7357 Date Issued: 0:3/ 0 ;8
SITE ADDRESS:
2.520 THOROUGHBRED LA
:H
04-117-23-11-0015
DESCRIPTION:
VACUUM UM BREAKER
Plumbing Permit Type VACUUM BREAKER
Plumbing Work Type RESIDENCE
REMARKS:
FEE SUMMARY:
VALUATION $500
Base Few $�- -'� • -00
Total Fee
CONTRACTOR: - Applicant - OWNER:
DAY HAROLD E h SON 24735349 E I DEN TON
410 NIAGARA LA N 2520 TH►�ROt GH6 ED LA
PLYMOUTH MN SS441 ORONO MN S_3S6
(F 12) 473-5349
THE CINDEI`SI ;NE® HEREBY, RE4EST : � ., � JEMETS
FEC Z F i ED AND AGREES "TO p0 1 G [F't:; � 4 I C ' OF '
L_ i�,C� �� C+FiCII+IAhIC STATE .CF kUl � :CE tEQtI � S".
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APPLICANT/PERMITEE SIGN RE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (27 50 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for plumbing permits.by mail or in person at the City offices.
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 PEI MIT CARD IS
POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property lowners residing
in the dwelling.
4. When any new construction or remodeling is involved, a separate building permit must lbe 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.
Instructions Complete all items on this application. Compute the permit fee. Sign and date
the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSE If you have
questions, call 473-7357.
Please check one: New Addition Repair Replace
— Residential Commercial
JOB SITE: 02
TNDclAZip:
Owner's Name: Vqephone Number:
Mailing Address: City: Zip:
Contractor'sName: p/U Tele honeNumber: ZJ,37
Mailing Address: ,v City: Zip:
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT IST 2ND OTHER FIXTURE BSMT IST IND OTHER
TYPE FL FL TYPE FL VL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishws,sher Wet Bar
Sillcocks77 Mis (list))
�� l I
I
I
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
.5-00'W- x .0125 $ S
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Postage and Handling (Only mail-in applications) $ __50-
4. TOTAL PERNIIT FEE (Add lines 1-3 above) $ ,?2,5--
* fr-
CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged 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 material, equipment, labor,or installation are furnished 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 Department of Inspectional 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: