HomeMy WebLinkAbout2008-P11918 - plumbing PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley F�rkway - PO Box 66 P11918
Crystal'Bay, Minnesota 55323 Permit Type: FiXtures
(952) 249-4600 Date Issued:
3/13/2008
SITE ADDRESS: 210 Big Island Unit#
Excelsior,MN 55331
PID: 23-117-23-23-0034
DESCRIPTION:
Proposed Usc: Residential
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 187.50 valuation: $ 15,000.00
State Surcharge Fee: $ 7.50
TOTAL FEE: $ 195.00
APPLICANT: Pavek Plumbing OWNER: 7ud Champlin
4550 County Rd 10 N 2643 Thoroughbred Lane
Watertown, MN 55388 Long Lake,MN 55356
THE UNDERSICNED 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 BUfLDING CODE REQUIREMENTS.
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ANPI,ICANT PERMITEF.SIGVATURE ISSUED BY SIGNATURE
Copies: ]-File(Sigiiatures Required), 1-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l
FOR CITY USE ONLY
,��� City of Orono �
P.O.Box 66 Date Received: Pennit#
� �y.€�.r_.. � 2750 Kelley Pazkway
�� j j'�..;�`: �i Crystal Bay,MN 55323 Approved By: Amo�nt$:
��'.�ti�>>�t=�o� (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building O�cial or Inspector)
GENERAL INFORMATION
L You may apply for plumbing permits by mail ar 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 RECENE 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 building permit must be
obtained.
5. All work must be done in accordance with State Code requirements.
6. All wark 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 A 1
�esidential ❑ Commercial(Approval Required)
❑ New ❑ Additional ❑ Repairs ❑Replace
❑ In Accessory Structure?
*You will need nrior approval and may need CUP. (Per Orono City Code,Chapter 78,Article I�
Job Site/Owner Information:'-::
Site Address: � �� �� t (.� �J�C/��
Owner: � �:�f� �Gi 4./�''!,%"� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ���/� �U, :��Contact Person: _� (,!�T ��C����
Address: yJ -JD GC3 '�,�I�C� State Bond #:
c�ry: ��T��Ta i.�� Zip S���Expiration Date:
Phone: ���- j 0 b `���� Alternate Phone: C J�v�� ��Sj,3���
❑ Insurance—Current:
1
���` . �'�'"��'����� �'�� '.�, .. y,;�;�TXTLTRES BEING INSTALLED .': r ,
� ,��� ���� .
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 ' 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet I I Floor Drains /-,
v
Lavatory i } Sewer Ejector
I
Bathroom l Laundry Tray
Shower , W asher
`
Kitchen Sink � Water Heater �
Disposal ' Water Sofrener
Dishwasher i Wet Bar
Sillcocks � Miscellaneous
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�
YERNIIT FF_,E CALCULATION(S) �
F3ASrD OFF - 2002 STATE STAT�UE � �
❑ Yes,this section applies
The replacement of a Residential fixture or anpliance that meets all three of the following requirements:
1. Does not reGuire modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine 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) $ l.50
Total Permit Fee $
(Permit Fees Continued On Next Page)
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, • y •�`� �i� �:� � � ,�'���"'.. � M �K�'u. ,��y'�.
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
1 �"oa X .o�25 $
(con ract price) (minimum$35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * 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 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 the Building Department at(952)249-4600 for the price.
Y �Z'` Y
�.�� ,��4 ��,� _ "j ' ��A°�'Z� `` ��MENT �,�`y����� '�
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
correct.
Applicant's Signature: �—
�i"�--- Date: � �� �
°�,� �� � ; �w� �.
__ �� Reset F �
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