HomeMy WebLinkAbout1997-008739 (plumbing- fixtures) PERMIT
r �,1TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 =��; �,;;.a�-,t i•��;
Crystal Bay, Minnesota 55323 Permit Number: __+;:_:�;;,•'�;•�!
(612)473-7357 Date Issued: r.;:_�;��;;=,,:r�;�:
SITE ADDRESS:
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FEE SUMMARY:
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APPUCANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �,
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C1TY OF URONO APPLICATIO R��,�$IBING P�RMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323 �s a�' �������
GENERAL INI�ORMATION
1. You may apply for plumbing permits by mail or in person at [he City offices.
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 SITE.
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. 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 473-7357. 24-hour notice required.
Instructioii,� Co:nplete all items on this application. Compute the permit fee. Sign and date
the certification. INCOM?LETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 473-7357.
Please check one: New Addition Repair � Replace
Residential Commercial
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JOB SIT� _�.� , :���rrs �;'��,���.� _ ` Zip:
Owner's Namc ->>�;r����r, , Mrt r�.����� Telephone Number:
Mailing Addrf ;� .,�-_�+'��_ �, _ _ � ���;�'>,��!I�' City: Zip.
Contractar'sName: I�.P,L� Lz��p,l/�"(� TelephoneNumber:. �7- 33
MailingA.ddress:d1�05 �Fl� Al��- � . City: /�'(�C_.,S Zip•.����
PLUMBING �'IXTURE SCHEDULE
FIXTURIs BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower W asher
Kitchen Sink
Disposal Water Softener
Dishw.�sher Wet Bar
Sillcocks Misc (list)
1�80RE3L(���9 F'L.11l�PVk3;."!.P'a ��. �lOROL���1 f°�l1MB!"!^a �O,
�1gpe liERlTCOlAFPLIAtdCE �iSSTALLEFiS �BA �iENTCO/ARPLIANC� AP35T'ALL�RS
(6�2) 827-4033 (6t2) �27-4A33
�5�15 �ARFIELD AVE. SOUTH �505 �3ARFI�LD �4VE. SOIS��
i�ii�NE/�F'OLIS, M8V 554p8 AAOMN��WRJLIs, 1�1�D 55��
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00) n�
e����;�.,�r�: x .0125 $ �� �v
� (contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ '��
(contract price)
or $.50, whichever is greater
3. Postage 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 furnished 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 $I,000,000 or $.50 - whichever is
F greater. For valuations over $1,000,000 call the Department of Jnspectional Services for the 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
rycorrect. �
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' Applicant's Signature: Date:
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