HomeMy WebLinkAbout2001-P03787 - plumbing PERMIT
CITY� C�r; ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3�g�
Crystal Bay, Minnesota 55323 Permit Type: FiXtures
(952) 249-4600 Date Issued: s�s�2ooi
SITE ADDRESS: 1212 Briar St
WAYZATA,MN 55391
P I D: 10-117-23-31-0075
DESCRIPTION:
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PtOpOSOCI USO: nc�iucii�iai
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Fixtures>3
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 37.50 Valuation: $ 3,000.00
State Surcharge Fee: $ 1.50
TOTAL FEE: $ 39.00
APPLICANT: Oak Grove Mechanical OWNER: R&J KIEMEN
Attn: Douglas Waller 1212 BRIAR ST
7236 Oak Grove Boulevard WAYZATA MN 55391
Richfield, MN 55423
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 REQU[REMENTS.
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A CANT PERMITEE SIGNATURE ISSUED BY SIGNATURE r.
Copies: City,Applicant,Assessor,Finance Page 1
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PERMIT £'EE CALCULATION
l. 1.25% of Contract Price* or Minimum Fee ($35.00)
.� e�-r� .. �� x .0125 $
- (contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
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 installation are fumished 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 pemut fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ci�y 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 tl�e 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: 3 �� i
. _Y .
CITY OF ORONO APPLICATION FOR PLUMBING PERMIT �
Box 66 (2750 Kelley Parkway)
. Crystal Ba��, MN 55323
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City o�ces.
2. Permit cards will be sent by retum 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 pemuts 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 buildin� 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 249-4600. 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 249-4600.
Please check one: 1/_New Addition Repair Replace
_�Residential Commercial
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JOB SITE: j Z %2- � r r'o�. .� J T; Zip:
Owner's Name: � ;��, �-�,��.,r,.,, Telephone Number:
Mailing Address: /� <L 13•-r �..�. City: v�-�.�� ZiP:
Contractor's Name: ��,�� �,,, ��.�,��: _ Telephone \umber: G�z -�cf_�S,t
Mailing Address: 7 z�.�K C�:,- .r3 c._-� City: ►� ��,a,�, ,,,�a Zip: J�r"y ��
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PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BS:�ST 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet j Floor Drains
Lavatory � Sewer Ejector
Bathtub Laundry Tray
Shower � Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
o Sillcocks Misc (list)