HomeMy WebLinkAbout2013-00184 - plumbing � - CITY OF ORONO * 2 0 1 3 - 0 0 1 8 4 *
2750 KELLEY PARKWAY DATE ISSUED: 03/20/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4325 CHIPPEWA LA
PIN : 31-118-23-42-0009
LEGAL DESC : CHIPPEWA
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING(> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: PLUMBING FIXTURES:
(3)WATER CLOSETS,(4)LAVATORIES,(2)BATHTUBS,(1 EACH)SHOWER,KITCHEN SINK, DISPOSAL,DISHWASHER,
WATER H�ATER AND WATER SOFTENER
VALUATION OF PLUMBING 2000
APPLICANT PLUMBING FIXTURE FEE 50.00
B&D PLUMBING &HEATING INC. STATE SURCHARGE PLBG(VALUATION) 1.00
4145 MACKENZIE CT NE
ST MICHAEL, MN 55376- TOTAL 51.00
(763)497-2290
OWNER
RICHARDSON, DALE
4325 CHIPPEWA LA
ORONO,MN 55356-
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 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 no[specified hereia 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 construction is
suspended for a period of 180 days at any time afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoke at any time for due cause.
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pplicant r � ee Signature Date I s ed By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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. ` FOR CITl'L"SE O\ZY
O¢��O Cit�-of Orono —
P-O.Box 66 Date Reca�-ed Pecmit._
. ' 2'S0 Kdley Parkway
� i`'�:• t'� Crystal Bay:`vIlv 55323 Appro�-edBy: Amouat S:
�'�rj%i?�b`-�i� (952)2�9�3600–'.blain
'��� (952)2�9-�616–Fax
CITY OF ORONO -PLLTn�iBING PERl�iIT
(All Commercial Perniits:1lust be Appro��ed b��the State Prior to Ciry Approval)
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GENERAL Il�-FORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications v«ll be
re��iew�ed and a permit�s�ill be issued w•ithin t�vo��•orking days.
2. Petmit cards u-i11 be sent by return mail after a revieu-is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK�ZL'ST NOT BEGIl�'L?':�iTIL THE
PER'1'IIT CARD IS POSTED O:�T'HE JOB SITE.
3. Plumbing pennits may be issued O'_�TLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construction or remodeling is invoh•ed,a separate building permit must be
obtained.
S. All vvork must be done in accordance w�ith State Code requirements.
6. All work must be inspected and air tested before it is co��ered. Call(952)249-4600.
(24-48 hoar notice required)
TYPE OF PERATIT
_ (Check All That A�l )
�Residential ❑Commercial(Appro�•al Requiredj
❑Nevv ❑Additional �Repairs ❑Replace
❑ In Accessory Strocture?
*You�r-iU need arior aaaro�•al and may need CUP.(Per�rono City Code,Chapter 78,Article IV)
Job S ite/Owner Information:
Site Address: � 3�� � h,rn� w:, L��,�
Owner: ��:�� i�.c �.f��».-• Mailing Address: /�s 5'o.S- /Y ,�'�/�,, ��
Clty. ��v�`� ! f�c,` i� �� Zi `S� J J ��
P�
Home Phone: �/Z ?C'S' E>C�-S Alternate Phone: �' � 2 ' �� �"��'��!
_ --
Contractor Information:
PLUMBING, HEATING Contact Person:
&AIR CONDITIONING —
f3 4145 MacKenzie Ct. NE
St. Michael, MN 55376 — State Bond#:
Phone: 763-497-2290
_ • Expiration Date:
Phone: Alternate Phone:
❑ Insurance–Current:
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PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 2' OTHER FIXTURE BSMT 1 2' OTHER
TYPE FL FL TYPE FL FL
Water Closet / / / F1oorDrams �
!
Lavatory � / � Sev��er Ejedor
Bathtub � / Laundry Tray
l
Shower � W asher
Kitchen Sink ` �Vater Heater %
l
Disposal / VVater Softener
Dish�sasher Wet Bar
Sillcocks Miscellaneous
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PERI�4IT FEE CALCULATION(S)
BASED OFF -2002 STATE STATUE
❑ Yes,this section applies
The replacement of onh one Residential fixture or appliance 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;excludinst the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip next section,if this applies; Cost of Pern►it S 15.00
State Surcharge $ 5.00
h1ai1-In Fee(If Applicable) $ 2.00
Total PermitFee S
(Permit Fees Continued On Neat Page)
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� PERI�IIT FEE CALCULATION(S)—JOBS OVER$500.00 �
If above does not appl}•;follo«-guidelines belo��r:
1. C0ITRACT PRICE * is 1.25%of contract price with a(Minimum Fee of S50.00)
��'v x .01?SS
�coaerxt ptice) (miaimom 550.00)
2. STATE SL'RCHARGE
x .0005 �
(coatract price)
3. POSTAGE&HANDLING (Only on h1ai1-In Applications) $�__�_ 2.00
4. TOTAL PER'1�IIT FEE (Add Lines 1-3 Abrne) S
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted woiic including materials,labor,profit,and other fixed costs. It is the amount to be charged
to the customer for the w�ork done. If any material, equipment, labor or installations are fumished by
the o�ver,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 actnal contract.
PLUMBING PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Plumbing Perniit, agrees to do all
«�ork in strict accordance «�ith 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'sSignature: /�' �-� � `��-(��� Date: 3" z`'' �3
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