HomeMy WebLinkAbout2004 - P07858 - plumbing PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P07858
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued:
8/18/2004
SITE ADDRESS: 4505 West Branch Rd Unit#
Mound,MN 55364
PID: 07-117-23-21-0014
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Fixtures Permit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
•
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 15.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: H.P.Pipeworks OWNER: David Levy
3670 Dodd Road Suite 100 4505 West Branch Rd
Eagan,MN 55123 Mound Mn 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO M KE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE W TH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
403
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
PERMIT
CITI, OF ORONO Permit Number:
275(JKelley Parkway- PO Box 66 P07858
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: 8/18/2004
SITE ADDRESS: 4505 West Branch Rd
Mound,MN 55364
PID: 07-117-23-21-0002
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 15.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: H.P.Pipeworks OWNER: Harriet Morgart
3670 Dodd Road Suite 100 4505 West Branch Rd
Eagan,MN 55123 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
WLe`�- � i G� 'a
APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Siinitures Required). 1-Applicant, 1-Monthly Reports, 1-AssessinE, 1-Finance Page 1
I 4-tuuz 12:50pm From-CITY OF ORONO +9522494616 T-580 P.001/002 F-730
CI1 Y OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GEL 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. . O• .�� T s - B e NIL LEP: _ :.: ' ?. ' EO
THE lop 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice
required.
InstrjIctions Complete all items on this application, Compute the permit fee. Sign and date the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
•
Please check one: ew Addition Repair ✓ Replace
residential Commercial
.IOB SITE: 4 15 _ if- 9fp. 3
Owner's Name: Q,u Cel 0 -e.-c)-c. Telephone Nwuber: D
Mailing Address: A/5'65 ua 7te 74t, City: y 700. Zip: _5'651,--,/
Contractor's Name: `fid y° 47404,0{t-t_12.4) Telephone Number:
Mailing Address: ,3610 3r,- Q City: X -49/Yin.Zip; .2.3
PLTJMAING FIXTURE $CIIEDLTLB
FIXTURE BSMT 1ST 2ND 1 OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE t FL FL TYPE FL FL
Water Closet Floor Drains .._.
Lavatory _ Sewer Ejector -. -—
Bathtub _ Lau. Tra
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener _____._--
Dishwasher Wet Bar
Sillcocks Mise(list) —
4/ 9, ot)
41u1-U3-2002 12:50pa Frora-CITY OF ORONO +9522494616 T-680 P.Q02/002 F-780
PERMIT'' EEE CAI.CI.ILATTON(S)
2002 Vote Statute 2 Yes, This Section Applies
The replacement of a Residential fixture or valance that meets all three of the following
requirements:
1) Does not require modification to electrical or gas service.
2) Has a total cost of$500,00 or less; xi g the cost of the fixture or appliance:
and
3) Is improved, installed or replaced by the homeowner or licenced contractor.
Skip next section; Cost of Permit $ T 15.00
State Surcharge $
Mail In Fee $ 1,SQ
If above does not apply, follow guidelines below:
1. Contract Price* is ,0125 % of job with a Mini nun Fee of($3SAO)
.� x .0125 $ —
(contract price) (minimum$35.00)
2. State Surcharge, ** Add the State Building Code Division a (Minimum Fee of$ .50)
x .0105 $ ._.
(contract price) (in'ni ,uni$ .50)
3. pest ge and%I ndling (Only mail-in. applications) $ - 1,50
4. TOTAL PERMIT FEE (Add lines l-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 installation art 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 $.$0-whichever is greater.
For valuations over$1,000,000 call the Department of Inspection 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: ,Aitir ,; ;,L��._ • _ Date: IZ/jlg