HomeMy WebLinkAbout2016-01141 - water heater - CITY OF ORONO
* 2016 - 01141 *
2750 KELLEY PARKWAY DATE ISSUED: 09/19/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS 1300 VINE PL
PIN 07-117-23-42-0002
LEGAL DESC REG. LAND SURVEY NO.0488
LOT 000 BLOCK 000
PERMIT TYPE PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER
NOTE: WATER HEATER
VALUATION OF PLUMBING 3474
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.74
DEAN'S PROFESSIONAL PLUMBING MAIL-IN FEE 2.00
7400 KIRKWOOD CT
TOTAL 53.74
MAPLE GROVE,MN 55369-
Payment(s)
(612)817-0438
Minnesota State License#:BUIL-62187PM CHECK 9894 53.74
OWNER
STERLING,RICK&KRISTINE
1300 VINE PL
MOUND,MN 55364-
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 cause.
&:,="d ) 6 '�'M --a ` 1
Applicant Permitee Signature Date Issued B ignature Date
�0 City of Orono FOR CITY USE ONLY
O P.O. Box 66 Date Received:
2750 Kelley Parkway RECEIVES Permit#
s Crystal Bay MN 55323
F4 % (952)249-4600—Main p i 7�1 Approved By:
'rfSHO (952)249-4616—Fax
Amount$:
CITY OF ORONO
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dii.mn.gov/CCLD/PDF/pe plumbplanrevapp.pdf
GENERAL INFORMATION
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 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)
9 Residential [:] Commercial (Approval Required)
/❑ New ❑ Additional ❑ Repairs Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information:
Site Address: 1600 Vi'a P
Owner: ( h io Mailing Address: 1300 V) VI,Q P /
City: 0aw, U Zip: �55aey
Home Phone: Alternate Phone:
Contractor information:
Contractor: ,� 1'S ��1 /6�CL Contact Person:
Address: ` �U � od cf State Bond #: ' OV U�c39
City:4Zip: Expiration Date:
Phone: 4G,� y2g," 13Z l Alternate Phone:
14 Insurance — Current:
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1gling
FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
1. CONTRACT PRICE * is/1..225% of contract price with a (Minimum Fee of$50.00)
;1-1 7 l x .0125 $ ' 1, 6�
(contract price) (minimum $50.00)
2. STATE SURCHARGE q qd
x .0005 $ 1�
(contract price)
3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
* 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 installations 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 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 madp,on this application are complete, true and correct.
Applicant's Signature: _A& Date: - q -13-1te
Building Official/ Inspector: Date:
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