HomeMy WebLinkAbout1996 - 007806 - plumbing •
4 PERMIT
4 CITY OF ORONO PERMIT TYPE:
275t*KeIley Parkway- P.O. Box 66 PLUMBING
Permit Number: 007806
Crystal Bay, Minnesota 55323
Date Issued: 03/25/96
(612) 473-7357
SITE ADDRESS:
365 WILLOW DR N
CH
P . I N. ; :33-118-33-41-0012
DESCRIPTION:
FIXTURES
Plumbing Permit Type FIXTURES
Plumbing Work Type RFPLACE EXISTING
1 WATER HEATER 1 WATER SOFTNER
REMARKS:
FEE SUMMARY:
VALUATION $280
Base Fee $35 . 00 MAIL IN $1 . 50
Surcharge $-50 Total Fee $37 . 00
Subtotal $35 . 50
CONTRACTOR: - Applicant - OWNER:
CUSTOM Pi 8G INC 25410203 OSGOOD LARRY
12711 HILLOWAY RD 365 WILLOW DR N
MINNETONKA MN 55343 ORONO MN 55:356
(612) 541-0203 473-6354
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF
ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS .
APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE .
{ (1$°`°
CITY OF ORONO APPLICATION FO` PLIJ Bl41J%PERMIT
Box 66 (2750 Kelley Parkway) MMII��
Crystal Bay, MN 55323
GENERAL 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. 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call 473-7357. 24-hour notice required.
Instructions 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 473-7357.
Please check one: New Addition Repair X Replace
Residential Commercial
JOB SITE: ,3 6 S'- 19, lU �i zc -- (4-)L4_ , Zip:
Owner's Name: dotAA , � �Q Telephone Number: 47,E-- may
Mailing Address: City: Zip:
Contr TelephoneNumber: 4Q--o/7
CUSTOM PLUMBING INC.
Maili 2105 Daniels St. City: Zip:
P.O. Box 694
Long Lake, MN 55356-0694 JRE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet II Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater x
Disposal Water Softener X
Dishwasher Wet Bar
Sillcocks Misc (list),.,..-.
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
O. z) x .0125 $
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Postage and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3 7. O d
* 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 he charged to the
customer for the work done. If any material, equipment, labor,or installation 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 STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional 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: Date: /9�f,