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Home My WebLink About2009-00329 - plumbing CITY OF ORONO PERMIT NO.: 2009-00329 � 2750 KELLEY PARKWAY � ORONO, MN 55356- �ATE IssuEv: 06/17/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 101 CHEVY CHASE DR PIN : 36-118-23-41-0006 LEGAL DESC : HILL O'WAY MANOR : LOT 001 BLOCK 001 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NOTE: CONNECT BACK FLOW TO LAWN IRRIGATION APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 LEON DUDA PLUMBING STATE SURCHARGE PLBG(<$500) 0.50 208 l 7TH AVE N TOTAL 15.50 HOPKINS,MN 55343 (952)933-5636 PAID WITH CC# 8018 OWNER ESTHER,ALBERT 101 CHEVY CHASE DR WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which[his permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for onl the work described and does not grant permission for additional or rel work which requires separate permits. All provisions of laws and ord ces governing this type of work shall be compied wit the r not cified herein.This permit will expire and become d d if c truction authorized is not commenced with a f the e of issuance,or if construction is suspended for a e d 8 day any time after work has commenced. The applicant r o le for a ring all required inspections are �� requested in nf ce ith t State Building Code.This permit may be revoked at y ti e cau e. j �_. � � � � � ��-- � (� � ( � � L_t G�"�}'1�� 1't / / Applicant Per ee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. -r � FOR CITY USE ONL1' ' ,�p�� City of Orono � � P.O.Box 66 Date Received: Permit# ; ��,i,� ��i 2750KelleyParkway ��a ��(,,�,'-". ��i Crystal Bay,MN 55323 Approved By: Amount$: 's�' ,'�a!`1�vr�t,o~� (9�2)249-4C00 �ell�� a� d6Ap0 CITY OF ORONO -PLUMBING PERMIT (All Commercial permits mustbe approved b��the Building Oflicial or Inspector) GENERAL INFORMATION 1. 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. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UIvTIL 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 buildinb 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) ❑ �e�' ❑Additional ❑Repairs ❑ Replace ❑ In Accessory Structure? *You will need prior anprovai and may need CUP. (Per Orono City Code, Chapter 78,Article IV) Job Site/ Owner Information: Site Address: I Q � �1e�� f��}J-.� ,I�� Owner: ��(� �S�i�.2 Mailing Address: _� '� � C �-�✓-� G�„�--�L � City: (�l� J �J � Zip: SS�3 �'� Home Phone: Alternate Phone: �P ��y/ -� y�s Contractor Information: Lc=�.� ,�) Contractor: �vJ� ��cS� S�'�S Contact Person: /" 1�- �� Address: � �� ` � �� 'tC /" State Bond #: �(� U� � � City: � � ��'� Zip:S �7�j? Expiration Date: /Z�3i �J � Phone: %S� ��3 � �.-�� Alternate Phone: lr�� / �`��/�i � Insurance- Current: 1 � . , PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT I 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower W asher Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous �J�l'12 C�� UL ��J c:-� T U ( f�i—� � /`�', ('/J��,l'9�l� �� , PERMIT FEE CALCULATION(S) '�� , BASED OFF - 2002�STATE STATUE � �� ❑ Yes; this section applies The replacement of a Residential fixture or apvliance that meets all three of the following requirements: 1. Does not require mod�cation to electrical or gas service. 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 licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 � t�` � , , PERMI'�� CALCTJLA`�'�t7N S '—TO�S O�R$500:00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) `� vU x.0125 $ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) a.0005 $ (contractprice) (minimum� .SOj 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 perniitCed 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 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 $1,000,000 or �.50—whichever is greater. For valuations over$1,000,000 call tbe Building Department at(952) 249-4600 for the price. ` PLUMBING PERMIT APPLTCATION AGREEMENT ° - �.�� The undersigned hereby applies to the City for issua e of a Plumbing Permit, agrees to do all work in strict accardance with t ord' c s of City and the regulations of the State of Minnesota, and certifies that al ta nts a n this application are complete, true and correct. Applicant's Signature: Date: �� 3