HomeMy WebLinkAbout1998-009951 (Plumbing) 1' . _ _
PERMIT
CITY OF ORONO PERMIT �rPE:
�750 Kelley Parkway- P.O. Box 66 Permit Number: �'L`�E�$�!G .
Crystal Bay, Minnesota 55323
(612)473-7357 Date Issued: �:+C�`�'��1
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: _ ���������,� _ OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATU E
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CITY OF URONO `='�����_�d'�_$�����'� APPLICATION FOR PLUMBING PERMIT
�lox bb (2750 Kelley Parkway)
Crystal Say, 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. PERMTTS ARE NOT VALID
UNTIL YOU RECENE 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 sepazate 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.
Instruction� Coalplete all items on this application. Compute the permit fee. Sign and date
, the certification. INCOA�?LET� APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 473-7357.
Please check one: New Addition Repair � Replace
� Residential Commercial
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JOB SITE: l �.5 f�t��l�. `�,�''1" P ��63Z.�
Owner's Name: !����� Telephone Number:�f 7��- �%��'
MaiIing,.Addressi " ��P�-t��" � - � - � City: � Zip:
Contract��r'sName: �ORBL�AII ai �nn��tic� c�n TelephoneNumber:
MailingA.ddress��A VENTCO/APPLIAt�CE IN5'fA�.L��� City: Zip:
290�5 �ARFIELD AiiE. SOU�'H �
MINN ' J�. URE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishw��sher Wet Baz
Sillcocks Misc (list)
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PERMIT FEE CALCiJLATION
1. 1.25% of Contract Price* or Mitimum Fee ($35.U0)
. x .0�25 $ �
(contract price) ; �, �
2. State Surcharge. ** Add the State Building Code Division
� Surcharge to each permit. � � x .0005 $
� (contract price) �
or $.50, whichever is greater
3. Postage and Handlin� (Only mail-in application$) $ 1.50
4. TOTAL PERNIIT FEE (Add lines 1-3 above) $ ��'7. Of�
k * 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 are fumished bq the owner,
—
tenanf or any other party the reasonable market value ofsuch items must be adde,d�o the esrima�ed cost
�, or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ciry may request the submission of a signed copy of the actual contract. ,
** The STATE SURCHARGE is .0�5 of the contract price trnder $1,000,�0 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�Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the Cit�'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: —
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