HomeMy WebLinkAbout2010-01023 - plumbing CITY OF ORONO PERMIT NO.: 2010-01023
' 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 10/19/2010
952 249-4600 FAX: 952 249-4616
ADDRESS 2525 THOROUGHBRED LA
PIN 04-117-23-11-0020
LEGAL DESC OLD CRYSTAL BAY ROAD 2ND ADDN
LOT 003 BLOCK 002
PERMIT TYPE PLUMBING(<$500)
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE WATER SOFTNER
NOTE: WATER SOFTENER
APPLICANT
PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345 MAIL-IN FEE 2.00
(952)912-7379 TOTAL 22.00
PAID WITH CC# 0597
-- _ OWNER
BAKKEN,BRADLEY&MARY
2525 THOROUGHBRED.LA
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 does
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 cuse.
/Di/9
Applicant Permitee Sigffl5iure Date
Issj�dpy Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
10/18/2010 13:32 FAX 9529335049 CULLIGAN MNTKA Q002
FOR CITY USE ONLY
UOL41, P.Box of OronoDate Receivedi9//�Permit#66
2750 Kelley ParkwayCrystal Bay,MN 55323Approved By: Amount S:
(952)249-4600
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
I. 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 return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED 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 State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
Check All That Apply)
Residential ❑Commercial(Approval Required)
�(J New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need prior approval and may need 02.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address:
Owner: ry o,!21 Mailing Address:
City: Zip:
Home Phone: 95a .4 1 L - 95 m 0 Alternate Phone:
Contractor Information:
Contractor: Contact Person:
GULLIGAN WATER CONDITIONING
AddA030 CULLIGAN WAY State Bond#:
LINNET 55345
City. (952) 933-7200 Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
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10/18/2010 13:32 FAX 9529335049 CULLIGAN NNTKA Q003
r.'ds`,+ :i •.' '8 ,'1C: `» 11-71FE%10 MID wil-M-M
�1r . r'7,'.•:ri i', •, ;irx:J
FIXTURE' BSMT IST 2 OTHER FIXTURE BSMT l 2NO 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
Dishwasher Wet Bar
Sillcocks Miscellaneous
Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1, Does no require modification to electrical or gas service.
2. Hasa total cost of$500.00 or less;e c udin the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section;if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee Of Applicable) $ 2.00
Total Permit Fee S
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(Permit Fees Continued On Next Page)
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10/18/2010 13:33 FAX 9529335049 CULLIGAN NNTKA Q004
i
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00)
x.0005 $
(contract price) (minimum$ 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ aa . V V
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials,labor,profit,and otter fixed costs. It is the amount to be charged
to the customer for the work done. If any material,equipment, labor or installations are fumished 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$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 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.
Date:
Applicant's Signature: l� d • 1�
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