HomeMy WebLinkAbout2015-00174 (water softener) � CITY OF ORONO
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� 2750 KELLEY PARKWAY DATE ISSUED: 02/10/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952 249-4616
ADDRESS : 2414 CARMAN ST
PIN : 20-117-23-12-0064
LEGAL DESC : N/A
: LOT MB BLOCK 001
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : IZESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG (<$500) 5.00
CULLIGAN SOFT WATER SERVICE CO. MA1L-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 22.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 22.00
OWNER
MERZ, MARCUS
2414 CARMAN STREET
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
'Che work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and thc
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit wili
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 Buildin�Code.This permit may be
revoked at any time for due cause.
� � �
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Applicant Permitee ign ure� Date Issued By Signature Date
02/09/2�15 14:35 FAX 9529335049 CULLIGAN MNTKA �005
I'OR CITY USE ONLY
,�` City of Or000
�'�`�' P.O.Box 66 Date Received: Permit#
�y,�,;.s„ Q 275a Kelley Psrkwsy
�� �}'?�:' Crysral Bay.MN 55323 Approved By: Amount 5:
�4'�;�+� (952)249�600
��ispa�'
CITY OF ORONO-PLUN�l3�NG�'E�T
(All Commercinl permits mus[be approved by the Building Offtcial or inspector)
GENER.AL INFORMATION
], You may apply for plumbing permits by mail or in person at the City offices. Applicarions will be
rcview�d and a permit will bc issued within two working days.
2. Permit cards will be sent by retum mail afrer a review is completed. PERMITS ARE NOT
VA.LIA 1JNTIL YOU R�'.CEIVE A PERMIT. WORK MUST NOT BEGXN�NTY�T�T�
PER'vtIT CARD IS POSTED ON THE JOS SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new constTuction or remodeling is involved,a scparatc building permit must be
obtained.
5, All work must be done in accordenct with 5ta[e Code requlrements.
6. All work must be inspected and air tested befo�e it is covered. CaII(952)249-4600.
(24-48 hour notice required)
� TYPE OF PERMZT
Check All That A 1
�]Residcntial ❑Commcrcial(Approval Required)
/ \
�New ❑Additional ❑Rcpairs ❑Replace
❑ Jn Accessory Structure?
*You will need nrior aaarova[and may need CUP.(Per Orono City Code,Ghapter 78,Articic IV)
Job Site/Owner Iz�formation;
Site Address: _,�y 1 W ��-�rr�v� �
Owner: I(Y�c.�e.a,,S Y�-e-( � Mailing Address:
City: Zip:
Home�'hone: ___�O l a_�� �_' J�b?�,, A[ternate Phone:
Contractor Tnformation:
�htt�9uN WATEF C�NDII�IONING Contact nerson: �I
8034 CIJLL.IGA,� WAY
Addt�$�N��ONKA, fV1N 55345 State Bond#:
(952) 933-7200
City: Zip: Expiration bate:
Phone; Alternate Phone: �S� � ��a � r1� ��
❑ Tnsuranc�-Current:
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02/09/2015 14:36 FAX 9529a35049 CULLIGAN �NTKA C�006
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FYXTURE BSMT 1 2 OTHER FIXTURE BSMT I 2 OTI�ER
TYPE FL FL TYPE FL FL
water Closet Floor Drains
Lavatory Sewer Ejector
BAthtub C�aundry Tray
Shower Washer
Kitchen Sinl: Water I�eater
Disposal Water 5ofrener �
bishwasher Wct Bar
Sillcocks Miscellaneous
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r, ' �.,1J ,I'�.l :ri:4 11"{ �� .�'� ..I� ,�y,�, „FJ ,� !`�4 p� .:7�.�r�
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� Yes,this section applies
The replacement of a Resideneial fixture or apnliance that meeu ali three of the following requirements:
1. Doas not require modification to electrical or gas service.
2. Has a total cost of$500.00 ar less;excludin�the cost of the fixture or appliance:and
3. Is improved,installed or repleeed by the homeowner or iicensed contractor.
Skip next sectipn,if this applies; Cost of Permit $ 15.00
State Surcharge � 5.00
Mail-In�'ee(Tf Applicable) $ 2.Op
Total Permit�'oo S
{Permit Fees Conrinued On Next Page)
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02/09/2015 14:a6 FAX 9529�a5049 CULLIGAN MNTKA f�007
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,�,1i���; ':�,;i).� �'�ti�,nr�L�� l�� '�7�fJ_'i��1��1�:51,:.r�l,����JnV,��,4T1',� ::�-f, �D�+�,i1J.c��C��iDS',�11.�.V,�,'�i1�d:r.y�4„-C.;����ir�6��t�,;' ,�n G
Tf ahove does not app[y;follow guidelines below:
I. CONTRACT XCE "is I.25%of contract price with a(Minimum�'ce of�SU.00)
x.0125�
(Contruct price) (minimum$50,40)
2. STATE SURCY�ARCE '�"Add the State Rldg Cod�Div_Surcharge(Minimum Fec of$5.00)
x.D005 �
(wntracrprice) (minimum$ 5.ao)
3. POSTAGE&HAN1aLING(Only on Mail•In Applications) $ 2.00
4. TOTAL r��MIT F'EE(Add Lines I-3 Abovc) $ p�a, u(�
■ '' CONTRACT PRICE or JOB COST means thc actual or estimat�d dollar a�noont charged for the
permiteed work including maeerials, labor,profit,and othcr fixed cosu. It is thc amount to be ehargcd
to the custAmer for the work done. If Any materiaJ, equipment, Iabor or installations arc furnished by
the own�r,tenant or an� olhcr party, thie rezsonable market value of sueh itcros rnust be added to the
estimated cost or contraet price for permit fee purposes. In the event that therc is a dispute on Chc
amount of the job cost, the City may requEst the submission of a signed copy of ihe aotual contract.
■ *'�The STATE SURCHARGE is.0005 ofthe eon�act price under$1,000,000 or$5.00—whiehever is
greater, For valuaClons over$1,OOO,b00 call th�Building DeparCment at(952)249-4600 for thc price.
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�fMs i���' d� r � � c 'i i � C 7 ,ia ,v,,r,,� �� �.�
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The undersi�r►ed hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accord�nee with the ordinances of the Ciry and the regulations of the State of
Minnesota, and certifi�s that all statements made on this appIicAtion are complete, true and
correct.
Applicant's Signature: Date: a"� ' �
,�;
y C'�G, Pv�'i:
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