HomeMy WebLinkAbout1993-005744 (plumbing) . PERMIT
' CITY OF ORONO � �
I' PERMIT TYPE: �`� i<<`��.:�i=`��=�
2750 Kelley Parkway • P.O. Box 815 I' Permit Number: `-''-'�_`�`�'�T
Orono, Minnesota 55356-0815 G �� � �' �='`+�=��-�
(612) 473-7357 � Date Issued:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO APPL CATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway) '
,
Crystal Bay, MN 55323 t�a;;'v � _� ' �����
GENERAL INFORMATION
i. You may apply for plumbing permits by mail or in per n at the City offices.
2. Permit cards will be sent by retum mail after a revie is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERII�IT. WORK MUST OT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plu bing 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 C de requirements.
6. All work must be inspected and air tested beiore it is c vered. 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 LL NOT BE PROCESSED. If you have
questions, call 473-7357.
Please check one: New Additio Repair Replace
X Residential mmercial
JOB SITE• 4105 Bayside Road Zlp. 55323
Owner's Name: Telephone Number:
Mailing Address: City: Zip:
Contractor'sName• um �ng erv�ces, nc TelephoneNumber: -
MailingAddress• Wy • • i City: Mp1s Zip:
PLUMBING FIXTUR� SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER �XTURE BSMT 1ST 2ND OTHER
TYPE FL FL YPE FL FL
e Water Closet � 3 �ewer Ejector
Lavatory , aundry Tray
Bathtub asher
Shower Z ater Heater 1
Kitchen Sink A�Vater Softener
Disposal et Bar
Dishwasher � loor Drains
Sillcocks Misc (list)
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Min�� Fee 35.00) 219.92
�- x 1.25 $
(contract price)
2. State Surchar� ** Add the State Building Code Division
Surcharge to each permit. 17,594.00 x .0005 $ 8•79
(contract price)
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 230.21
* CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 furnished by the owner,
tenant or any othez party the reasonable mazket 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
conect.
Applicant's Signature: Date: 10/27/93