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Home My WebLink About2010-01208 - plumbing CITY OF ORONO PERMIT NO.: 2010-01208 � 2750 KELLEY PARKWAY ORONO, MN 55356- DA7'E �ssUE�: 12/27/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1690 CONCORDIA ST PIN : 17-117-23-22-0031 LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK : LOT 029 BLOCK 000 PERMIT TYPE : PLUMBING (<$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 NORBLOM PLUMBING CO. STATE SURCHARGE PLBG (<$500) 5.00 2905 GARFIELD AVENUE S. MINNEAPOLIS, MN 55408- MA1L-IN FEE 2.00 (612) 827-4033 TOTAL 22.00 OWNER PALM, RICHARD& KIRSTEN 1690 CONCORDIA ST _ _ . . _ WAYZATA, MN �5391 AGREEMENT AND SWORN STATEMENT _...._ _.___ _.. _ _.__.. _ fhe��ork for�chich this permit is issued shall be perlormed according to the approved plans and speci�ications.applicable City approv�ilS,and the .. _. . .. State Building Code. 'I'his permit is for only the work described and does �� " � � � - --� not�rant pennission for�dditional or related work which requires separate pennits. All provisions of laws and ordinances goveming this type uf work � � — � shall be compied�vith��hether or not specified herein.This permit will � expire and become null and void i�fconstruction auth,prized is not commenced within 180 days of the date of issuance,or if construction is "" � suspended for a period of 180 days at any time after work has commenced. The applicant is responsible�for assuri�ig all required inspections are requested in conionnance��ith the State l3uilding Code.This pennit may be revoked at any time for due cause. , �_i�� i/l� / / � Applicant Permitce Signature Datc Issued By.'i ❑ature SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED ABO FOR CITY USE ONLY r O,�p�O City of Orono P.O.Box 66 DateReceived: Permit# �y� 2750 Kelley Parkway � � � ?�,�� Crysta]Bay,MN 55323 Approved By: Amount$: � �`��i;�o�o (952)249-4600 CITY OF ORONO —PLUMBING PERMIT (All Commercial permits must be approved by the Bui]ding Official or Inspector) GENERAL INFORMATION 1. You may apply for plumbing pemiits by mail or in person at the City offices. Applications will be reviewed and a pernut 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 RECEIVE A PERMIT. WORK n7UST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pernuts may be issued ONLY to licensed plumbin�contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved, a separate building pernut 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) ❑ New ❑Additional ❑Repairs ❑Replace ❑ In Accessory Structure? *You will need prior approva(and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/ Owner Information: Site Address: Richard Palm Owner:_ 1690 Concordia Street ing Address: Orono, MN 55391 City: _ 9524710028 Home Phone: Alternate Phone: Contractor Information: Contractor: i�Qr��b�Y}� ��,�� Contact Person: � Address: 2�� a�'�) '�� '�IV Sm. State Bond #: O� �� City: � �S Zip��b� Expiration Date: I � �� 1 Phone: ��2�$�'�� d�3 Alternate Phone: � ^ � Insurance—Current: 1 � � ��;. ` �� '.- `: PLUMBING FIXTURES BEING 1NSTALLED A�" ' ' FIXTURE BSMT 1'2"� OTHER FIXTURE BSMT 1' 2'� OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater � — _— —- - ------ - Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous ` PERI�IIT FEE'CALCULATION(S) : �' B ASED OFF - 2002 STATE STATUE '' ❑ Yes,this section applies The replacement of a Residential fixture or a�pliance that meets all three of the following requirements: 1. Does not require modification to elech-ical or gas service. 2. Has a total cost of$5�0.00�:;ess, excludin�the cost of ihe fixture or appliancc: 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 l�Text Page) � . • .;°��£,,.� PERMIT FEE:CALCULATIQI�(S) ;—:JOBS OVER$500 00 ` � If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) x .0005 $ (contract price) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged far the pernutted 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 pernut 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�kw��.��;,�; :PLLTIVIBING PERMIT APPLICA°'��ON AGREEME��`�'�x� �`��4,�_j; 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: Date: 12 � � 3