HomeMy WebLinkAbout2011-00165 (plumbing-fixtures) CITY OF ORONO PERM[T NO.: 20ll-00165
� 2750 KELLEY PARKWAY
' ' ORONO, MN 55356- DATE ►ssuEn: 03/18/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2715 CAROLINE AVE
PIN : 20-117-23-24-0007
LEGAL DESC : CASCO HEIGHTS
: LOT 000 BLOCK 002
PERMIT TYPE : PLUMBING (>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES - MULTIPLE
N07'E: 1 ST FLOOR: l WC,2 LAV, 1 TUI3
VALUATION OF PLUMBING 1595
APPL[CANT PLUMBING FIXTURE FEE 50.00
THOMPSON PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.00
15001 MINNETONKA IND RD
MINNETONKA, MN 55345 MAIL-IN FEE 2.00
(952)933-7717 MISC FEE 0.00
TOTAL 57.00
OWNER
REJZER, MR. & MRS.
2715 CAROLINE AVE
WAYZATA, MN 55391-
ACREEMENT AND SWORN STATEMENT
The work for w°hich lhis permit is issued shall be perfonned according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission lor additional or related work which requires separate
pennits. All provisions of laws and ordinances governing this t��pe of work
shall be compicd���ith whelher or not specitied herein."I'his pennit will
� expire and become null and void if construction auUiorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
� The applicant is responsible for assuring all required inspections are
rcqucsted in conformance with the State I3uildin�Code.This permit may be
rcvoked at any time for due cause.
/ / / /
Applicant Permitec Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
FOR CITY L"SE OnLI'
O���O CttV Of 000110 —
Y.O.13ox 66 Datz Raczt�'zd_ Pemiit�
2750 Kellev Park�cay
� .+ F Cn•slal B�iy.nii�5�323 :lppro�zd}3�: ;lmount$:
_..._.._.. _- -__..
���Aaexo��c` (952)249-�4G00
CITY OF ORONO - PLLINIBING PERNIIT
(All Commcrcial Perniits Must be Approved by the State Prior to Cit}-Approval)
GENERAL INFORMATION
1. You ma� �pply for plumbuig permits b�� mail or in person at the Cita off'ices. Applications�vill be
re��ie«-ed and a pennit�vill be issued�i-itlun t«o«�orking da��s.
2. Pernut cards«ill be sent by retum n�il after a revie�� is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. VVORK MUST NOT BECIN UNT1L THE
PERMIT CARD iS POSTED ON TAE JOB SITE.
3. Phimbing permits m:,i� be issued ONLY to licensed ph►inbing contractors and to properh�o�vners
residing vi the d«elling.
-�. When anj�ne�� coi�stn�ction or remodeling is involved,a separate building pznnit must be
obtained.
�. All��ork must be done ui accordance��-ith State Code requirements.
6. All��ork imist be inspected and air tested before it is co��ered. Call(952)249-4600.
(2�-:18 h��ur noticc rcyuircd)
TYPE OF PERMIT
(Ch�ck All That Apply)
❑Residential ❑Conunercial(Appro��al Required}
❑ Ne��� [�Additioi�l ❑Repairs ❑ Replace
❑ In Accessory Slnicture'?
*You v��ill need urior auproval and may nced C[:P. (Pcr Orono City Codc,Chaptcr 78.Ariicic 1V)
Job Site/Owner Information:
/"7
Site Address: ���S (- ��G�����
Owner: . , �s'� Mailing Address: a 7/S C���G2�i�� ��
City: `�����1t�Q: Zip: JS�cl�
Home Phone: Alternate Phone:
Contractor Information:
/
Contracto ��K Contact Person:
Address: 15�00 ����. � State Bond#:
�
City: Zip:.� Expiration Date:
Phone: GS�, � 33'7717 Alternate Phone:
�nsurance— Current: ���
�
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 2� OTHER FI�'TL)RE BSMT ls 2- OTHER
TYPE FL FL TYPE FL FL
Water Closet l Floor Drains
La`�atan� � Se«�er E jector
Bathtub Laundcti Tra��
� - -
Sho«�er Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Ivliscellaneous
PERI�'IIT FEE CALCUL,ATION(S)
BaSED OFF - 2002 STATE STATUE
❑ Ycs_ this scction applics
The replacement of on1�-onc Residential fixture or anpliance tlut meets all tlu�ee of the follo«ing
requirements:
1. Does not require modification to electrical or gas sen-ice.
2. Has a total cost of$SOO.OI)or less:eacludin�;flie cost of the filture or appliance: and
3. ls impro��ed.installed or replaced b` the homeo���ner or licensed plumbing contractor.
Skip ne�t section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee S
(Permit Fc�es Continued On Nest Page)
�
PERMIT FEE CALCULAT[�N(S)—JOBS OVER $500.00
If abovc docs not appl}; follo��•guidclincs bclo��:
L CONTRACT PRiCE � is 1.2�%oT contract price�i�ith a(Minimum Fee of�+50.00}
l�ls. °�' . .o�?s � S(� �i
(contraet prica) (minimum$>0.00)
2. STATE SURCHARGE ** Add ttie Stale Bldg Code Div. Surcl�arge(Minimum Fee ot'$5.00)
�
t .000s � S. `
(conlr�ct price) (minimum$ 5.00)
3. POSTAGE cY�,HANDLING(Onl} on Mail-in Applications} $ 2.00
4. TOTAL PERMIT FEE(Add Lines l-3 Abo�c) S � ���—
■ * CONTRACT PRICE or JOB COST means lhe actual or es[ilnaied dollar an�ount charged for the
pennitted«ork includ'uig materials, labor, profit, and other fised cosis. It is tl�e amowit to be charged
to the customer for the���ork done. lf anv material, equipmeut. labor or installations are furnished b}�
the o«i1er, tenant or am� otl�er part}�. flie reasonable market value of such items must be added to the
estin�ted cost or contract price for pennit fee ptuposes. In the e��ent that there is a dispute on the
amount of the job cost. the City nu}� request the subnussion of a signed cop�� of the ac[ual contract.
■ ** The STATE SURCHARGE is .000>of the contract price under$1,OQ0,000 or$>.00–«luche`�er is
greater. For�-aluatioi�s o��er$L000,000 call flie Building Departinent at(952)2�9-�600 for the price.
PLCiMBING PERMIT APPLICATION AGREEMENT
The Lmdcrsigned hereby applics to thc Cin for issuancc of a Plumbing Pernlit, agrccs to do all
�tiork in strict accordance �tith the ordinances of the Cit�- and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
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Applicasrt's Signatlirc: i � Datc: �7�����
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