HomeMy WebLinkAbout2016-01435 - water heater ` CITY OF ORONO * 2 0 1 6 - 0 1 4 3 5 �
2750 KELLEY PARKWAY DATE ISSUED: 1U14/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 690 I3ROWN RD N
PIN : 34-118-23-12-0007
LEGAL DF,SC : t1NPLnTTED 34 118 23
: I,O'[' 000 BLOCK 000
PERMIT TYPI�: : 1'LlJME3[NG
PROPERTY Tl'1'I: : I:ESIDGNTIAL
CONSTRUC7'1O�' "1'YPE : �VAI�ERHEATER
NOTE: REPLACI'."��.�'I"I:R f ILA"I'GR
VALUATION (�I� ��� "`�113ING 1500
,�PPLICAN'1� PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUAT[ON) 1.00
APPLIANCE CO�"�:i:C"CIONS, [1�'C, MAIL-IN FEE 2.00
12850CHESTNI''; 13LVD
SHAKOPEE, I�1� ��79- TOTAL 53.00
(952)445-4803 Payment(s)
Minnesota State I i_��i�sc'i�: mech-NI[3004165 CHECK 8563 53.00
O�'VNI?1Z
LARSON, ERIC��� ��'I�RI;n
690 BRO�'�N iZ� �
LONG LAK E, �1� ��,�C-
AGREf�:i\I i_, i :�ND SW012N S7'ATEMENT
The work for ti�hich t��� ��crmit is issued sh;�Jl hc pertivmed aecording to
the approved pl;�n;:��.�, � :_ii'ications,appli�ablc Ciry�pprovals,and the
State[3uilding Codc �I��,i,pcnnit is for onl��thc�+�ork described and does
not grant permission !��:��.,!.litional or rclated���ork�chich requires separate
permits. All provisio r ���n��s a��:�l��rJii:;�naes governing this type of work
shall be compicd��i�.l � '�:r or nut�pc�il��,cd hercin.This permit will
expire and becom���n�'� � ��oid if conslruction authorized is not
commenced withi�i I �,of thc datc of i;suance,or ifeonstruction is
suspended for a perin.l��f I SO days at any timc aficr�vork has commenced.
The applicant is res;;;c��.:;.�i,r assurinn all rcquircd inspections are
requested in conf��nn�n�,�,���iih the Statc[3uildin��Code.This permit may be
revoked at any tinic I:�r,�-��.�,��ct�usc.
.
L �V l l �
Applicant Pcrni�.�.�. � � ����urr Uate Issued Signature Date
. , �pN City of Orono FOR CI US N
O 1 P.O. Box 66 Date Received: -1 �r�
� 2750 Kelley Parkway R�CEIVED �J
y � Crystal Bay, M N 55323 Permit# �c�`�o -O /��
�`1'rfSH��EG` �952)249-4600-Main ,, Approved By:
�s5z�24s-as�s—FaX NpV � � �_�71�a
Amount$: �
CITY OF ORON��PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.qov/CCLD/PDF/pe plumbalanrevapp ndf
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. Piurnbing permits may be issued ONLY to licensed piumbing 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)
�Residential ❑ Commercial (Approval Required)
❑ New ❑ Additional ❑ Repairs
Replace
❑ In Accessory Structure?
*You will need arior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information:
Site Address:_���I�� �r' .� yl. ��,� �,1
�
Owner:�YVtC��U. � ��SGr� Mailing Address: �' JGZ✓VLf� --
City: L� (.,-C�c Zip: j �j � ��,
Hq�e Phone: _ �'� `G�7�P �j�I�O Alternate Phone:
�
Contractor Information:
Contractor. Contact Person: �����_ ��,���
��,
Address: �� Connecnons tnc State Bc�nd #: �� c��9
City: S���� MN�55379
g��.�� Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance — Current:
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. PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT �sT 2ND OTHER FIXTURE BSMT 1ST ZND 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
PERMIT FEE CALCULATION
1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
x .0125 $
(contract price) (minimum $50.00)
2. STATE SURCHARGE
x .0005 $
(contract price)
3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $�����l
* 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 rrzaterial, equi�ment, labor or ir�staliations 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.
PLUMBING PERMIT APPLICATION AGREEMENT
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 ade on this application are complete, true and correct.
Applicant's Signature: � _ Date: _ � � � �
Building Official/ Inspector: Date:
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