HomeMy WebLinkAbout2018 - 00285 - plumbing CITY OF ORONO 1ll l l l l* 2 0 I g 0 0 2 8 5
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2750 KELLEY PARKWAY DATE ISSUED: 03/13/2018
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1186 WILDHURST TR
PIN : 07-117-23-24-0007
LEGAL DESC : REG. LAND SURVEY NO. 1116
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER
VALUATION OF PLUMBING 1000
•
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.50
ALL CITY PLUMBING TOTAL 50.50
8100 COUNTY ROAD 110 W
MOUND,MN 55364-
Payment(s)
(612)817-6731 CREDIT CARD 5083 50.50
Minnesota State License#:plbg-PC643613
OWNER
RASMUSSEN,BRIAN&SANDY
1186 WILDHURST TR
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.
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Applicant�ermitee Signa ure Date Issue, ty Signature Date
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'� City of Orono 11,TOR CITY USE O
trisiQ�Q P.O. Box BE Date Re = :d: .Q�)3/—�1
2750 Kelley Parkway Permit# JI, 4.O IS--cyo2 5
Crystal Bay,MN 55323
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� � (957)249 A600-Main Apprnve.k, w4 (952)249-4616-Fax i'i, v 5 0
Amount
CITY OF ORONO—PLUMBING PER I:
(All Commercial Permits Must be Approved by the State Pr' , o City Approval)
htt•://www.dIL.mn.•ov/CCLD/PDF/•e plumb•la. va• •.•df
GENERAL INFORMATION i!I'Il
1. You may apply for plumbing permits by mail or in pereon at the Cit til r, ices. 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�!l • ERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN U THE PERMIT CARD IS
POSTED ON THE JOB SITE. !
3. Plumbing permits may he issued ONLY to licensed plumbing contra i• •rs and to property owners
residing in the dwelling.
4. When any new construction or remodeling is involved, a separate W'= •ung permit must be obtained.
5. All work mub1 be done in accordance with State Code requirement
6. All work must be inspected and air tested before it is covered. Cal .,•2)249-4600.
(24-48 hour notice required) I ',
TYPE OF PERMIT(Check All That Ap.1,
HI
,Residential 17Commercial (Approval Required) [Ir`' L flow Device:❑AVB 0 PVB]
III
New ❑Additional ❑ Repairs 1, 1 (Replace
` 1
❑ In Accessory Structure? H'
`You will need Prior approval and may need CUP. (Per Orono Code, Chapter 78, Article IV)
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Job Site/Owner Information: f
Site Address: /15 Lt -^'_
Owner: Mailing Address:
City:
I
Zip: 5-535 L I9
,
Home Phone: Alternate Phone: 1'I'i _
1i;
Contractor Information: I I !�
Contractor: ll C t T`1 p(.y Nta IAiI� Contact Person:'` 'i ( • 14P M
`I
I
Address: . 8t 0 O Cyz- I+0 _W —State Bond #: I ,. C L/ f
IEx Expiration Date: la 31 )
City: c ✓t Zip: I'�'l� p / /
i
Phone: ,~ ( Alternate Phon I
Insurance–Current:
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Page I3i!
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fIf SIJs
l�Lt MBI,IVG FIXTURE BEING INS T'
FIXTURE BSMT 1sT 2N0 OTHER FIXTURE 1 !I MT 1s 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
- _
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer il;
ter--
Kitchen Sink Water Heater 14i'
Dispose! Water Softener 77
Dishwasher i Wet Bar
Slilcocks Miscellaneous tri
P liMIT;FE.OALCULAT1;ON
1. CONTRACT PRICE is 1.25% of contract price with a (Mi 1,1
urn Fee of$50.00)
l i e.)Ol2, UrJ x .0125: ' $
(contract price) i� (minimum$50.00)
7. STATE SURCHARGE
x .000 $�
(contract price)
3. POSTAGE& HANDLING (Only on Mail-In Applications) II i $_ 2.00
r
4. TOTAL PERMIT FEE (Md Lines 1-3 Above) � $
* CONTRACT PRICE or JOB COST means the actual or estimat� dollar amount charged for the
permitted worK Including rnalerials, labor, profit, and other fixed costsli I G is the amount to be charged to
the customer for the work done. If any material, equipment, labor oi;��l� stallations are furnished by the
owner, tenant or any other party, the reasonable market value of h items must be added to the
estimated cost or contract price for permit fee purposes. In the e , u that there is a dispute on the
amount of the job cost, the City may request the submission of a -,°1''ed copy of the actual contract.
PLUMBING PERMIT APPLI, ATIONSAG 111E IT
The undersigned hereby applies to the City for issuance of a Plumb!, `Permit, agrees to do all work in
strict accordance with the ordinances of the City and the regulatio 'I of the State of Minnesota, and
certifies that all statements made on this application are complete,tru` -nd correct.
; I
Applicant's Signature: 1 L Date: g' 9-/
Ii1
SII ,l
Date:
Building Official/ Inspector: 1I ,
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