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Home My WebLink About2010-00074 (plumbing) � CITY OF ORONO PERMIT NO.: 2010-00074 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 02/10/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3211 BAYSIDE RD PIN : OS-1 17-23-41-00 l 8 LEGAL DESC : STIELOWS ADDN : LOT O10 BLOCK 001 PERMIT TYPE : PLUMB[NG (<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(<$500) 0.50 3670 DODD ROAD-SUTTE 100 EAGAN, MN 55123- MAIL-IN FEE 2.00 O TOTAL 17.50 Minnesota State License#: 61770PM OWNER LUNDELL, JAMES&TRACEY 3211 BAYSIDE RD LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and ihe State Building Code. "l�his permit is for only the work described and does not grant pennission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied wi[h whether or not specified herein.This pennit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afier work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. `1�t�-i-( �-rt. / / / / Applicant Permitee Signature Date Issued By ig ure Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO ___ FOR CITY USE ONLY , %�"p�.� City of Orono P.O.Box 66 Date Received: Permit# �� ` 2750 Kelley Parkway � } �• :. ;�t Crysta]Bay,MN 55323 Approved By: Amount$: �} c (952)249-4600 `��t�r.,yi` �, „ 48H�A>�� CITY OF ORONO—PLUMBING PERMIT (Al]Commercia]permits must be approved by the Building Official or Inspector) GENERAL INFORMATION l. 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 hvo working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS 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 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 A 1 ) �Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs �f Replace � In Accessory Structure? *You will need prior aaproval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: �(� ( ��/Si�� ` Owner:��'E.-�S L►.i-i'1� �- � � Mailing Address: S C�-� C ity: ��Yl� Z ip; ;��40 Home Phone: ��2." �y"�"�' �y� Alternate Phone: Contractor Information: Contractor: �4��g Contact Person: �� #8'I��0-PM Address: 631-365-1340 State Bond#: 3670 Dodd Rd. i City: Eagan, MN��1.23 Expiration Date: I�-`�� Phone: Alternate Phone: � Insurance—Current: 1 ' n� �� 1/ PLUMBiNG FIXTURES B�1N��+TSTALLED FIXTLJRE BSMT 1 2 OTHER FIXTURE BSMT 1 2 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 Dishwasher Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) _ BASED QFF -2002 STATE STATUE � Yes,this section applies The replacement of a Residential fixture or appliance 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;excludine the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip neat section,if this applies; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ 11„� (Permit Fees Continued On Ne�et Page) 2 a PERMIT�'EE CALCULATI�N S -JOBS OVER$500.00 ,„�;: If above does not apply;follow guidelines below: 1. CONTRACT PWCE *is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50) x.0005 $ (contract price) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 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 installations 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 Building Department at(952)249-4600 for the price. 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 made on this application are complete, true and correct. Applicant's Signature: �'�� y ,,,,,/ ��.w-�-~�� Date: �`��- �� Reset Form � ' �� 3