HomeMy WebLinkAbout2010-00979 - water softner , ti
CITY OF ORONO PERMIT NO.: 2010-00979
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 10/1U2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 430 BROWN RD S
PIN : 03-117-23-42-0011
LEGAL DESC : STRONGHOLD
: LOT 002 BLOCK 001
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: WATBR SOFTENF,R
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 5.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345 MAIL-IN FEE 2.00
(952)912-7379 TOTAL 22.00
PAID WITH CC# 0597
OWNER
BREHM, EDWARD& KRISTEN
430 BROWN RD S
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issucd shall be performed according to
the approved plans and specifications.applicable City approvals,and the
State Building Code. This permi[is for only the work described and does
not grant pennission for additional or related work which requires separate
pemiits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due ause.
G� /�� //� /� /� // ��D
A plicant Permitee Signature Date Issue y ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
10/11/2010 12:47 FAX 9529335049 CULLIGAN MNTKA C�002
FOR CIT USE ONLY
'�� City of OI'ono Date Received��� Permit# ab/D— 0 979
/ �' � P.O.Box 66
�0� �� 2750 Kelley Parkway
�fi�t Crystal Bay,MN 55323 Approved By: Amaunt$:��
������j �952)249-4600
��
CITY OF ORONO-PLUMBING PERMIT
(All Commercial pennits must be approved by the Building Of�icial or Inspector)
GENERAL TNFORMATION
1. You may apply for plumbing percnits 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 StTE.
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. Al)work must be done in accordance,with State Code requirements.
6. All work mvst be inspected and air tested before it is covered. Call(952)249-4b00.
(24-48 hour notice required)
TYPE OF PERMIT
Check All That A 1
�Residential ❑Commercial(Approval Required)
�New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure7
*You will need arior aparoval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Addrass: ,_ 43 0 ��°`-'�' � -S
Owner: �f�� 5 ���w� Mailing Address:
City: Zip:
�,
Home Phone: �15 a - a� � -- �U� I Alternate Phone;
Contractor Information:
��{�N VVA�fER CONDITIONING Contact Person:
6030 I AN WAY
Addre��N�ONKA, MN 55345 State Bond#:
(9
C�n,: Zip: Expiration Date:
Phone: Alternate Phone: q5a -9�d- 73 ��
❑ Insurance—Current:
1
10/11/2010 12:47 FAX 9529335049 CULLIGAN MNTKA [�003
�`i- ,�"� —:T�>��$�C"i�I�'1'�.�RE�S`,��,�'.x:��.�'�'1�►�.i�.�'� ;;s ''�.;;�� ��'
FIXTURE 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 I
Dishwasher Wet Bar
Sillcocks Miscellaneous
� 5 a�� a ,��ti I '�`r x �„ + �'�"fv'�'� �'�� "�".�''�,t'`'� Y��#'4 k
'� i �"� t r�`v'� ti'� j"��i`��''��'�����"��,�.,��.�.1���� � E 4, ��� F�x�� a�'� �sa�L`�
}�uw-:�r � ti� ���r�i+3�i� ��dV t r � � ':�,,,� 4�� �"� �t� �a �K��t�,r�:.y'�1'�i"l�"�'� ? r��
„�tbyt�il� �� ,t Y: rN4{'r v.�t ,��d �.a�t i .H Y-�'t i-� t��.�?���7��..�¢c�ra.,'
,� =z,��,� �,rr�� �W,x. �� A�F�] OFE-- 2002 STAT��. '���1''7'�� �,,,���_ �;
� Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not reguire modification to electrical or gas service.
2. Has a total cost of$500.00 or Iess;excludiae the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
5kip next section,if this applies; Cost of Permit $ I 5.00
Stata Surchazge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
10/11/2010 12:48 FAX 9529335049 CULLIGAN MNTKA 1�004
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..7! ".I:�..Clhi: l.t..� �,.fi �A`K� (� :cY. I� ��!'� !< �(�`%�il':<f_r::>�..I'�i':at
%:�..�::r'�' ���_��. .,li'. V' ,�' �,� :1�,�`;�1.. 7.i",,'�L,ii
,;r;�: ,'r:= =P��'.�`���.����i��'r'��T�T .f���.��� :��>04;: Q
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of 550.00)
x.O125 $
(contrect price) (minimum$50,00)
2. STATE SIJRCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee ofS5.00)
x,0005 $
(contract price) (minimum$ 5.�0)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �a ' �`�
■ * CONTRACT PR10E or IOB COST means the actual or estimated dollar amount charged for the
permitted work incfuding materials, labor,profit, and other fixed costs. lt is the amount to be charged
to the customer for the work done. If any material, equipment, fabor or installations aze 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 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$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
� �" �� ,�. s s, ..
.1{ ;I' _ ..2 .u .r I ''i
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: I u ' �I ' ��
F�eset,Fcirm
3