HomeMy WebLinkAbout2010-01212 (water heater) CITY OF ORONO PERMIT NO.: 2010-01212
- 2750 KELLEY PARKWAY
' ORONO, MN 55356- DATE ISSUED: 12/30/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3231 CASCO CIR
PIN : 20-1 17-23-43-0016
LEGAL DESC : SPRING PARK
: LOT 021 BLOCK 000
PERMIT TYPE : PLUMBING (<$500)
�ROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
NORBLOM PLUMBING CO. STATE SURCHARGE PLBG (<$500) 5.00
2905 GARFIELD AVENUE S.
MINNEAPOLIS, MN 55408- MAIL-IN FEE 2.00
(612)827-4033 MISC FEE 0.00
TOTAL 22.00
OWNER
COOPER, MR. & MRS.
3231 CASCO CIR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
I'he work for which this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
� permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This pennit will
expire and become null and void if construction authorized is not
commenced within 180 days of U�c date ot�issuance,or if construction is
suspended for a period of 180 days at any time afler work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code."Chis permit may be
revoked at any time for due cause.
�� IiIL l l -Cg�'YLD�--� l l
Applicant Permitee Signature Date Issucd By S�g ature e
SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO
FOR CITY USE ONLY ' -
. 0,���0 City of Orono
P.O.Box 66 Date Received: PerTnit#
+�"y, 27�0 Kelley Parkway
• a `a�� Crystal Bay,MN 55323 Approved By: Amount$:
�. �������{,�y,c� (952)249-4600
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CITY OF ORONO —PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
:GENERAL INFORMATION
1. You may apply for plumbing pernuts 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 n7UST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing pernuts 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 buiiding permit must be
obtained. �
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
(Check All That Apply)
�Residential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78,Article IV)
Job Site/ Owner Information:
Site Address:
Jerome Cooper
Owner: 3231 Casco Circle .ddress:
Orono, MN 55391
City: 9524710895
Home Phone: Alternate Phone:
Contractor Information:
Contractor: i�i�r�✓�b� ��Lt,�'}����� Contact Person: �
Address: 2�05 �a�'�1�� � sti. State Bond #: O� ��� ��
City: � �S ZipS�b� Expiration Date: ( � v��� 1
Phone: ���2�$2�� �d�� Alternate Phone: �
� Insurance—Current:
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� "'� PLUNIBING FIXTURES BElNG Il�TSTALLED j
FIXTURE BSMT 1 2` � OTHER FIXTURE BSMT 1 2' OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater �
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
� PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATtTE
❑ Yes, this section applies
The replacement of a Residential fixture or a� lip ance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2 Has a total cast of$SOO.CO or less; excludin�the cost of the fixture or appliance: ar.d
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $_�2.,J00
Total Permit Fee $��
�
(Permit Fees Continued On Next Page)
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� F " �: ' �,;��;� P� ,;,RMIT,FE��CALGL7�AT:I�Q1�1(S);�r�JOSS�"O�ER$500.00 ` �` �
� If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$�0.00)
x.0125 $
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� ��
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pernutted 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 installations are funushed 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 pernut 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 Building Department at(952)249-4600 for the price.
��,,.�.���;�,�3�;;�����'LI.TIVIBINGPE � ' : ,APPLICA`���D F�;� GREEN.tE,�T�T������"�k�;�� �``'���
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: l ` �� � r O
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