HomeMy WebLinkAbout2014-01408 - plumbing � ' CITY OF ORONO * 2 0 1 4 - 0 1 4 0 8 *
2750 KELLEY PARKWAY DATE ISSUED: 12/08/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2805 CASCO POINT RD � � � �
PIN : 20-1 17-23-32-0015 -�,e d �� /
LEGAL DESC : SPRING PARK ��� � � �
: LOT 125 BLOCK 000
PERMIT TYPE : PLUMBWG(> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES- MULTIP[.E
NOTE: WATER SOFTENGR
VALUATION OF PLUMBING 1600
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.80
BENJAMIN FRANKL[N PLUMBING MAIL-IN FEE 2.00
1424 3RD STREET N
MINNEAPOI,IS, MN 55411- TOTAL 52.80
(763)755-6468 Payment(s)
CHECK 22539 52.80
OWNER
FROMMEL�, ROGGR
2805 CASCO PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
I�he�+�ork for���hich this permit is issued shall be performed according to
the approved plans and specifieations,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant perniission lor additional or related work which requires separate
permits. All provisions of laws and ordinances governing[his type of work
shall be compied with whether or not specitied herein.This permit�ill
expire and become null and void it�eonstruction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenccd.
Thc applicant is responsible ti>r assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. � � ��
� � � �-
��� 'L� � ��� ������ �( ���'�Z'� ��� �� i �� i �
Ap licant Permitee Signat, ate Iss e By Signature Date
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��.� � a . �� �oP�#� 3� � aa� �6��.�5D-���
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� � FOR CITY USE ONLY ��A
''�� City of Orono �+ `;�� �`
'� �� p p �oX��� Date Received: Permit# ? �-
2750 Rellcy Parkway �'��.�
Crystal I3ay,MN 5�323 Approved[3y: Amount$: _ �j�.'��`�
(952)249-�F600—Main
� �. (952)249-4616—Fax
�'��' c` CITY OF ORONO— PLUMBING PERMIT
�
qKfs}a��� (All Commercial Pennits Must be Approved by the State Prior to City Approval)
- � 9idt_s:1,'�,�r�����.�11i.irr�►.x�}r 1C'C't,17,'F'l)�/ �k° }I�i�r��l����lzuire��si � �. i��1
GENERAL INFORMA"TION
l. You may apply for plumbing permits 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 MUST NOT BEGIN UN"TIL THE
PFRMIT CARD IS POS7'FD 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. Hil work must be done in accordance witn State Code requirements.
6. All work must bc inspected and air tested befare it is covered. Call (952)249-4600.
(24-48 hour notice required) ���',�Re,r��
TYPE OF PERMIT f.,F�; � ;; 2O 4
(Check All That A I
� �i�:�7�•.0�
�idential ❑ Commercial (Approval Required)
❑ New ❑ Additional ❑ Repairs Replace
❑ In Acccssory Structure?
*You will need prior anproval and may need CUP.(Per Orono City Code,Chapter 78, Article IV)
Job Site /Owner Information:
Site Address: � ��� � �� � D �d�� � ��
Owner: ( m :� \� Mailing Address: 5���
City: �o�C�,, �.�C�-- zip: � J �J� (
1 lome Phone: �'�J��� "�� � `����Alternate Phone: -
Contractor Information:
. �-�� � �
Contractor: Contact Person: �'1 bU
. �.��,��.
dha Benjamin Franklin Plumbing / 2,
Address: ���-���astn State Bond #: � 1.�� /��
�1+��:rht!c�7�
City: Zip: Expiration Date: ���ib ���
Phone: �„p�� .4� J�_I �'�� Alternate Phone:
❑ Insurance—Current: Q�if`�C f�S '(l�U{�n(,�
1
PLUMBING FIXTURES BEING INSTALLED `
FIXTURE I3SM�1� l�' Z"D O"1'IIER 1'1XTURE I�SMT l� 2 ° OTHEK
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
E3athtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
P,ispcsal '�'ater Soften�r
Dishwasher e
Sillcocks Miscellaneous
PERMIT F�E C LCULA�I'IOI�(S) � �
�__ � BASFD OFF - 20 2 STATE S"I"ATUr � � �� �
❑ Yes,this section applies
The replacement of only one Residential fixture ar a liance that meets all three of the following
requirements:
1. Does not require modification to electric 1 or gas service.
2. Has a total cost of$500.00 or less;exclu in the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the omeowner or licensed plumbing contractor.
Skip next section, if this applies; Cbst of Permit $ 15.00
St�te Surcharge $ 5.00
Ma�l-In Fee(lf Applicable) $ 2.00
TOtal Permit F'ee $
�1
(Permit Fees Continoed On Next Page)
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� � � � PERMIT FE� CALCULATInN(S)�-JOBS���OVER $500.00 � � �
If above docs not apply;iollow guidelines bclow:
1. CONTRAC7'PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
1 �' � o X .o�2s � c� rn�n c�
(contract price) (minimum$50.00)
2. STA7'E Sl1RCHARGE � �Q
V U x .0005 $ °
(contract price)
3. POSTAGE& HANDLING(Only on Mail-ln Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines l-3 Above) $ � a � � �
■ * CON7'RACT PR10E 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, labar or installations are furnished by
the owner, tenant ar 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.
PLUMBING PERMIT APPLICATION AGREEMENT ' '
The undersigned hereby applies to the City for issuance of a Plu�nbing 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: � ( �
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