HomeMy WebLinkAbout2016 - 01573 - plumbing CITY OF ORONO 14 11 I I 1 II I I I 1 I II*
2750 KELLEY PARKWAY DATE ISSUED: 12/28/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2285 WEBBER HILLS RD
PIN : 03-117-23-33-0003
LEGAL DESC : WEBBER HILLS
: LOT 002 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: DISHWASHER
VALUATION OF PLUMBING 1000
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.50
ECOWATER MAIL-IN FEE 2.00
3208 FIRST STREET S
WAITE PARK,MN 56387- TOTAL 52.50
(320)251-2505 Payment(s)
Minnesota State License#:plbg-PC643402 CREDIT CARD 2893 52.50
OWNER
PEDERSON, D&K
2285 WEBBER HILLS RD
WAYZATA,MN 55391-
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.
Applicant Permitee Signature Date Issued Signature Date
2016-12-28 06:53 Ecowater systems 3202515566 >> 9522494616 P 1/2
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2760 Kahn Parkway
Crystal Bay,MN 56323 Permit* 0/0,
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(552)2404800-Main �,
•'4'4I11°. (i?62)2494ete-Fax raved
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CITY OF ORONO-PLUMBING PERMIT
(Ali Commercial Permits Must be Approved by the State Prior to City Approval)
A 11 ". ._. .&A A.i. +.,. it 1. F + a ,,.: •; 11 !•. nravacra.ro,g
GENERAL INFORMATIO —
I, You may apply for plumbing permits by mail or in person et the City offices, Appticatione will be
reviewed and s permit will be lowed within two working days.
2. Permit cards wilbe sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT, yWOIK MUST NOT SEQIN s : ,r -:.
POSTED ON.7NEusiSe SITS,
3, Plumbing permits may be Issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new conetruction or remodeling is involved,a separate building permit must be obtained,
6, All want must be done in accordance with Stats Code requirements.
8, All work must be inspected and air tested before it is covered, Call(982)2491-4800,
(24-48 hour notice required)
w.. .. TYPE OF PERMIT(Check All That Apply)
esidaniial ❑Commercial(Approval Required) jl3aaktrow Device;0 AVB PVB1
r New Q Additional [,,o)Repairs ,aRepiace
Q In Accessory Structure?
'You will need oricr approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner lnformaticn;
Site Address: > it t -
Owner;.ar.,.l;,i P>rr _Mailing Address: °2-2, ', - t Ad,
City: Qr°t .t?h- Zip: !!r "5 311
Home Phone: " !' iternate Phone:
Contractor Information:
Contractor: a c,..0 W Contact Person: .-- " " 4/ - W
Address: 3 2-ti r. '7" rt-e• Si State Sand#; L-t.3'.! o - '
. ,Z1p: 5.4 3 2' ....... Expiration Date: t '"4 l- 1 .?
Phone: ' 20 '" ?, ,— Alternate Phone:
j nsurance—Current >' 5
2016-12-28 06:54 Ecowater systems 3202515566 » 9522494616 P 2/2
faLU BINQ`FiU'EBIlw `iFJT�0.LLEG µ
,. FIXTURE Fi i rT 1 2 OTHER F7iTURE 1181 IST {?rwER
TYPE Floor Floor TYPE FIAor Floor
Water Closet Floor Drains
Lavatory Sower Elector
Bathtub �r_ .._... Laundry Tray.,,.,......._..-....y..., - ,... .
Shower Washer
Kitchen Sink Water Hueter
iisloaal Water Softener
Dishwasher I Wet Sar
Billhooks Miscellaneous
.__.,,.. q .�... PERM' p _ .;+ > ','TI a N .u..�._... .......,.......
1, CONTRACT PRICE "is 1.25° of contract price with a(Minimum Fee of$50.00)
iter 4125 $ e- CA)
(contract price) (minimum 550,00)
2. STATE SURCHARGE
.0005 $ 5
(contract price)
3. POSTAGE&HANDLING(Only on Mall-In Applications) $ 2,00
4. TOTAL PERMIT FEE(Add Linea 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 materiel, 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 eubrnieeion of a signed copy of the actual contract.
PL;. EIN4 P R i. t. CA' .a N AGi`E !VENT.: , _
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 Slgnature sate:, I . �!I+ .
Building Official/Inspector: ,. pate;
Papa 2