HomeMy WebLinkAbout2013-00247 - plumbing , . CITY OF ORONO * z 0 1 3 - P1 B 2 4 7 *
2750 KELLEY PARKWAY DATE ISSUED: 04/16/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2773 CASCO POINT RD
PIN : 20-117-23-23-0018
LEGAL DESC : SPRING PARK
: LOT 131 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES- MULTIPLE
NOTE: RECONNECT KITCHEN SINK, FAUCET AND DISHWASHER
VALUATION OF PLUMBING 1200
APPLICANT PLUMBING FIXTURE FEE 50.00
TONKA PLUMBING HEATING&COOL INC. STATE SURCHARGE PLBG(VALUATION) 0.60
265 CTY RD 110 NORTH
MOLJND, MN 55364 TOTAL 50.60
(952)472-9200 PAID WITH CC# 4708
Minnesota State License#: 060524-PM
OWNER
LARSON, REED
2773 CASCO POINT RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is Yor only the work described and does
no[grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified 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 construc[ion 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 Sta[e Building Code.This permit may be
rev ke at any time for e se.
� � � I � I /��� // /
Applican m� e Si na re Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE.
Iliticrosottt Word - Plumbing Permit - Updated 07-28-11.doc -... http://www.ci.orono.mn.us/vertical/Sites/{CBFC8FAF-C313...
FOR CI'IY USE O�LI'
Cit�•of Orono
��^IO�,\ P O Box 66 Date Recet�'ed: Pemut e ao�3- ���
` ?7>0 Kelley Pukway
' � Cn�stal Ba}�.NIN»3?3 Appro�'ed B}• Ainotmt 5:,:�
(9�')3�39--4600-Main
�� � � �� (95?)�49-�616 Faac
�', ,�(� `� CITY OF ORO�O-PLL"'�ZBIVG PERtiiIT
�'��'�!+t{�'�li (All Coimnercial Pe�Yuits Must be Appro�•ed b�•the State Prior to City Approval)
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GENERAL INFORMATION
1. You may apply for pliunbing perniits by mail or in person at the City offices. Applications��•ill be
re��iew�ed and a pennit��-i11 be issued v�-ithin h��o H�orkuie days.
2. Pemiit cards«-i11 be sent by rehuz�uiail after a re�-iet�-is coinpleted. PERMITS ARE NOT
VALID LTITIL YOL'RECEI`'E A PERhIIT. WORK VIL"SI'1�OT BEGI�U?�TIL THE
PERMIT CARD IS POSTED O\THE JOB SITE.
3. Pltunbing permits may be issued ONLY to licensed plumbing contractors and to property o�-ners
residing in the dw-elling.
4. VVhen any new constniction or remodeling is in��ol�-ed.a separate build'uig pemiit mtist be
obtauied.
S. All work nmst be done ui accordance witl�State Code requuements.
6. All v�rork must Ue uispected and air tested before it is co�•ered. Call(952)?49-4600.
(24-48 hour notice required)
TYPE OF PERMIT l
� _ (Clieck All That Apply) �
�Residential ❑Comntercial(Appro��al Reqiiired)
❑I�ew ❑Additiotial �Repan•s ❑Replace
❑ In Accessory Stnicture?
*You will ueed���or auaro��Al and may need CUP.(Per Orono City Code.Chapter 78,Article IV)
Job Site /Owner Infonnation:
�
Site Adciress: 2 ^11 ��tiSG,� }�ti►vh-�- �.pCLG�
O��ier: I�G� �:✓Si���-- Mailiiig Address: Z��I 3 Cc;SC� ���t.._�-�
c�ry: �Y'� n.t� z��: 5S 3�i 1
Home Phone: 4o1�--a-�l�' Z bS�� Alternate Pl�one:
Contractor Infonnation: ]
C'outractor:-��;�,�Le�-� ������i�tact Person: L���D�/���
�
Address: �-�v S LLj.l%1G� l 1,�!v State Bocid#: 'PG�4 C✓���I
City: �O w�-P� ZipS��' Expiration Date: ��I�j i`(�j
Phone: ���2'�'1�- ��2�t� Alternate Pl�one: ��,Z- ZC�D-R�--I�-
❑ Insurance-CiuY�ent: � �
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Ai�icrosoft Word - Plumbing Permit - Updated 07-28-11.doc -... http://www.ci.orono.mn.us/verticnl/Sites/{CBFC8FAF-C313...
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT l Z OTHER FIXTURE BSIvIT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drauis
La�•atory Sewer Ejector
Bathhib Laiuiciry Tray
Shower Wasl�er
Kitchen Sinl: Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcacks Miscellaneous
� �l� �-�,'�"S�1��..����t�` �C�t I,S v�u1L�
_ _ . _ �. _.... .
__ _.__.._. I
�' PERMIT FEE CALCULATION(S) ,
� _ B�SED OFF - 2002 ST�TE ST.ATLTE _ I
❑ Yes,diis section applies
The replacement of onh-one Resiciential fixhu�e or appliance that meets all three of the follo�nig
reqiiireineiits:
1. Does not requue modification to electrical or gas ser�•ice.
2. Has a total cost of$500.00 or less:excludinst the cost of the fixhu�e or appliance:and
3. Is impro�•ed, installed or replaced by the homeowl�er or licensed plwubing contractor.
Skip ne?:t section, if this applies: Cost of Perniit $ 15.00
State Surcharse � 5.00
Mail-In Fee(If ApplicaUle) � 2.00
Total Pe�luit Fee S
(Permit Fees Continued On l�ext PAge)
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PERNIIT FEE CALCULATION(S)—JOBS OVER$500.00
If abo�-e does not apply; follo�� gtiidelines belo���:
1. CONTR�►CT PRICE * is 1.25%of contract price with a(Minimum Fee of 550.00)
��Q� x.012i $
--------_ - ----_
(conuact price) (minimum S50.00)
2. STATE StiRCHARGE �
�L(S�O� x.0005 $
(conffac[pnce)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $_ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S
* CONTRACT PRICE or JOB CUST ctleazis the actual or estunated dollar ainount chareed for tlie
pennitted work including materials, labor,profit.and other fixed costs. It is die at7iotuit to be charged
to tl�e custoiner for the work doiie. If ury material, equipment, labor or uistallatioiis are fiuYiished by�
tlie owner, tenaiit or any otl�er party, the reasonable market��alue of such items must be added to the
estimated cost or contract price for penuit fee purposes. In the e��ent that diere is a dispute on the
aiuount of tlie job cost. tlie City uiay request the suUmission of a sigued copy of the achial couh�act.
PLUMBING PERMIT APPLICATION AGREEMENT
The iuidersigned hereby applies to the City for issua�ice of a Pliunburg Permit, agrees to do all
work iii strict accord�uice widi the orduiaiices of thc C:ity �uid the regulatioiis of il�c State of
Minnesota. and certifies tt'raT all statemerits made on this application are completc_ tnie and
coi7�ect.
Applicant's Signat�u-e: Date: � L��
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