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HomeMy WebLinkAbout2008-P11811 - water heater ' ' PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: p11811 Crystal Bay, Minnesota 55323 Permit Type: Fixtures (952) 249-4600 Date Issued: 1/16/2008 SITE ADDRESS: 2824 Casco Pt Rd Unit# Wayzata,MN 55391 P��� 20-117-23-32-0006 DESCRIPTION: Proposed Use: Residential Permit Class: Plumbing Permit Type: Fixtures Permit Sub-type(s): Water Heater DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PernutFee: $ 15.00 va�uation: $ 0.00 State Surcharge Fee: $ 0.50 Misc.Fee: $ 1.50 TOTAL FEE: $ 17.00 APPLICANT: Champion Plumbing LLC OWNER: David&Emily Shepherd 3670 Dodd Road- Suite 100 2824 Casco Pt Rd Egan,MN 55123 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. C_I�����(.� v V � APPLICANT PERMITEG SIGNATURE I SUED BY SIGNATURE Copies: 1-File(SignaturesReguired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1 � ' � r CITY OF ORONO APPLICATION FOR PLLTNIBING PERMIT Box 66 (2750 Kelley Parkway) Crystal Bay, 11�1N ��323 GENERAL IIVFORl�tATION 1. You may apply for plumbing permits by mail or in person at the City ofhces. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL � � �'OU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON � THE JOB SITF. 3. Plumbinb 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. �. All work mus[ be done in accordance with the State Code requiremen[s. 6. All work must be inspected and air tested before it is covered. Call (9�2) 249-4600. 24-hour notice required. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call (952) 249-4600. Please check one: New Addition Repair '�Replace _� Residential Commercial JOB SITE: v�<'� �`� C��i 5��l f t ���-� . Zip: � 5.�y � O«�ner's Name: �X'�✓��� S h�.' �> �-�C( Telephone Number: ���:�- y� ��- �30� Nlailing Address: j�;rn ' City: Zip: Contractor's Name: ampion Te lep hone Num ber: i�lailing Address: 3670 I�1XId Rd #100 City: Zip: Eagan, MN 55123-1339 FLUiVIBIl�TG FIXTLTRE SCHEDULE FI�iTURE BSIv1T 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL FL TYPE FL FL Wa��r Close< < Floor Drains Lavato � Sewer E ector Bathrub Laund Tra Shower Washer Iii�chen Sink Water Heater � Dis osal Water Softener Dishwasher Wet Bar Sillcocks Misc (list) �..��;�'U,� �� � 1 � v PERMIT FEE CALCULATION(S) 2002 State Statute � Yes, This Section Applies The replacement of a Residential fixture or appliance that meets all three of the followin� requirements: 1) Does not require modification to electrical or gas service. r 2) Has a total cost of$500.00 or less; excludin� the cost of the fixture or appliance: and 3) Is improved, installed or replaced by the homeowner or licenced c�ntractor. Skip next section; Cost of Permit $ 15.00 State Surcharge $ .50 Mail In Fee $ 1.50 If above does not apply, follow guidelines below: l. Contract Price* is .0125 % of job with a Minimum Fee of ($35 00) x .0125 $ (contract price) (minimum $35.00) 2. State Surcharge. ** Add the State Building Code Division a (I�Iinimum Fee of $ .50) x .0005 $ (contract price) (minimum $ .50) 3. Postage and Handlin� (Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ i ��'�G1 * 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[he customer for the work done. If any material, equipment, labor, or installation are furnished by che 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$1,000,000 or $.50 - whichever is greater. For valuations over $1,000,000 call the Department of Inspection Services for the price. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on'this application are complete, true and conect. �.�.�....._... Applicant's Si�nature: �_ �-_.,,.,�'"` Date: � -G��� � J � � } t�t�NNE5!:�"I'A DEP.IRTMENT U�' . LABUR & tNDUSTRY P�umbing Bond & Insurance Certificate � Construction Codes and l.icensing Di�ision Licensing and Certification Services 443 Lafayette Road N St Paul,MN 55155 Websi#e: www.doli.state.mn.us E-mail: DLLLicense(a�state.mn.us Telephone: 651-2845080 Thfs is to certify that the ceRiffcate holder is in compliance with Minnesota Statutes§32G:40,Subd.2 for calendar year 2008 and may engage in the plumbing trade in all areas of the state of Minnesota. JAMES G MEYER License: 61770-PM (PM006430) CHAMPION PLUMBING LLC 3670 DODD RD STE 100 EAGAN, MN 55123 �0 0$ Bond ID: 077723 66319916 Liability Insurance ID: CCX0512146 AUTO OWNERS INSURANCE COMPANY GENERAL CASUALTY INSURANCE COMPANY : :kTE OF Paii•,VCSOTA +:A�;ER PLUs�:iER �'+�+FST�% ,��.,�::.��. � �;::�nse# f� �1770-Nhi = .�, .::iration C :i�a 12/31/t008 �����'`j �° �r��...:���' (;�i,�inal Iss�;��d Date 04/�7/2007 - ,is�;,: JAM�S 6 ME`!�R 452 EIGHTN r�VEtvUt SDUTHWEST LOt3SDALE, i��t 55046