HomeMy WebLinkAbout2012-00807 - plumbing � - ' CITY OF ORONO * 2 B 1 2 - 0 � 8 0 7 *
2750 KELLEY PARKWAY DATE ISSUED: 08/17/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 131 CHEVY CHASE DR
PIN : 36-118-23-41-0021
LEGAL DESC : HILL O'WAY MANOR
: LOT 016 BLOCK 001
PERMIT TYPE : PLUMBING (>$500)
• PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: REP[�ACG WATER HEATGR
VALUATION OF PLUMB[NG 1500
APPLICANT PLUMBING FIXTURE FEE 50.00
LEGACY MECH SERVICES STATE SURCHARGE PLBG (VALUATION) 0.75
9714 WOODCREST CT
MONTICELLO, MN 55362- MAIL-IN FEE 2.00
(763)219-8978 TOTAL 52.75
PAID WITH CC# 0723
OWNER
MOYNEUR, PATRICK
131 CHEVY CHASE DR
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The�vork 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 for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construc[ion 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 commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State E3uilding Code.This permit may be
revoked at any ti�ne for due cau e.
, 8�� 17 � 1 �- ��- �' l17 / l7-
Applicant Permitee Signa ure Date ssue y Signature Date
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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City of Orono ` `�� � ' ��7
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Cryslal Day.MN 55323 Approved'�3y„ , � �hipunt�:�� �
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�� � �952)249-4G(10—Main �,.,.,..; .. ,,,,;..... ., ,.,�... ••.•:
(952)249-4G 1 G—Hax
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approvecl b� the State Prior to City Approval)
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1_ You roay apply for plumbing permits by mail or in porsun fd tkte City offlces. Anplications will bc
revicwed and a perrnit will be is�ued wilhin lwo working days.
7.. Pcrmit carcls will bc scnt by cetum rn�il al�er a review is completed_ PERMITS ARE NOT
YAL1D UNT1L YOU R�Ck?�VF..A PF:I�MIT. WORK MUST NOT BEG[N UNT1L T11L
PERMIT CARD 1S POSTED ON'1'ICC:JOB S['T�.
3_ Plumbing pennits may be issued ONLY to licenscd plumbing contractors and w property owners
residing in thc dwclling.
4, Whcn any ncw c�nstrucliun ur remudeling is involved,a separate building permit must bc
obtained.
5. All work must bc donc in accurdancc with Slale Cocle requirements,
G. All work must be inspected and air tcstcd bcfo�c it is wvered. Call(952.)249-4600.
(24-48 hour notice required)
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[]Rcsidential ❑Commcrcial(Approval Rcquircd)
❑ New ❑ Addition�l ❑Repairs [J Mteplace
❑ ln Accessory Slruclure?
*You will need nrior apuroval and may need�.(Per Urono Ciry Code,Chapter 78,Article T�
�Jo�;Site/:'Ovviie'r Inforination':'�� ���^� "">; ,I
site ndaress: 131 CHEVY CHASE DR
���eC. LEAH M OY N E U R Mailing Address: 131 CHEVY CHASE DR
c;tY: ORONO 55391
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Home i��,one: �952) 473-3777 Alternate Phone: (612) 201-6588
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LEGACYMECMANICALSERVICES DUSTIN OR JAIME
Contractor. Contact Person: _
Address: 9714 WOODCREST CT St�t�sond�: PC644975
MONTICELL� . s53ea 12/31/13
City: --------------_____ 7ip:----- Expiralion Da��:
Phone: (763) 314-0877 Alternate Phone: �763) 314-0876
❑ l„surance—Cun•ent: YES
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FIXTi1RE RSMT ���� ZN� OTH1:12 L'1X'1'URL' DSM'1' l 2 6 OTM?R
7YPF. F1_, C'L TYP� PL I'L
Wa[er Closel Floor Drains
Lxvatory Sewer�jector
DathCub Laundry Tray
Sh�wcr W asher
Kilchcn Sink Water I•leater X
Disposal Water Softener
I)isf�wAsher Wet Bar
Sillcucks Miscellaneous
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❑ Yes,this section applies
'fhe replaccment of only qpe j�gsidential f xture or apgliance that meets al I tliree pf the fpllowinA
requirements;
l. Does n �require modefiet�tion to olectrical nr gas service.
2. Has a total co of$500.00 or lCss;oxcludin the cost of the fixture or applianee;and
3. Is improved,installed or replaced by the homcowner or licensed phimbing contractor.
Skip next scction,if this applies; Cosi of Permit $ 15_00
State Surcharge $ 5_O(1
M�il-!n Fee(!f Applicable) $_, 2.00
1'otal Permit Fee �
(Permit Fees(:qntinued On Next Page)
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If above clors not apply;toll�w guidclincs bclow:
l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
1,500.00 X.012s s 50.00
(contract price) (minlmum SS0.00)
Z. �TATE SURCHARGE �,500.0� x.UU05 $0.75
(controct pricc)
3. POSTAGE&HANp�,ING(Only on Mail-!n Applications) $ 2.00
4. TOTAL PEAMiT F'E�(Add I�ines 1-3 Above) $50,75 -� � • U U
■ � CONTRACT PRTCF. or JOB COST' means the acCUAI or esCimated dollar amount charged for the
pormitted work inciuding materials, labor, profi[, and other fixed custs. 1�is ttie amoun�to be eharged
to thc customer for the work done, if any m4terial, equipment, labor or installAtions are furnistied by
the uwner, tcnant or�ny other party,the reasonable market value of such items musc be added to the
estimated cust or wntract pricc for permit fee purposes. Tn the event tliat there is a dispute on the
amount of the jub eust, thc Cily may rcquest the submission of a signed copy of the act��al c�ntrack
The undersigned hereby applics to tk�e Cily for issuance of a Piumbing Permit, agrees to do all
work in stricc accurdance with the ordinrinccs of thc City and lhe rebulations of the State of
Minnesola, and certifies thAt afl statements macle on this application az•e complete, true and
correct.
Applicant's Signature: __ __�--�_ Date:__� /� /�
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