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HomeMy WebLinkAbout1997-008672 - water heater � . PERMIT , , CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 ;�i�.i_i:�;y:;�;w_ Permit Number: ;�„_;,w;;�,�:�� Crystal Bay, Minnesota 55323 - (612) 473-7357 Date Issued: ,-�; .;t`,:-::;,=;::: SITE ADDRESS: � _:'=�ii_i i�;E�1��f,�:i_Ij�!,}�f-'� ��� L_;�,ii . . . �`� . . . _"�(. _ !'".�.. ...._.."'i_i[_ia-.s.... DESCRIPTION: i`1�11(itL�lt?°� i`Ht`iEtl�.� � Vr�°=' i' .�,�.� �?i�`.i'.'•�� �"�l.�if(iI_�i��'��� �n1f:i�F:; "11,�:it-: _ �.`��"''�...t?�.•t'. i'},_ : � T"ul-i i ����:���:!�'. �-��i�����{�; REMARKS: FEE SUMMARY: �:1(-�F f:F—;1 1 � E'.� C`'.:.l.i 3 t 1 . t._•'' _ "' ' ' ' `_i.^f�--•� , i''}� +'Ee,.i3:k ,l..��_1 I�t"�T�.... �I.i;� _.._.._._..��._ �'%s '�"1i_n) ��e...1?�Ci Sj.,��;, ._.._.__._.___ � r={i f i_�t ;1 �"'�'.� !•+;'i�;:�i1 =;i�%�;.��7..�? �'�,=;��f,�;t, CONTRACTOR: -- �"�:r-��°� �_:-a�it� --� OWNER: .,_, . — - — _;; -;,,j _ p:tM y i�a�� _ ._ ___�-. ?�'� :.�� ��. •°� :i: ��i =�: ,�_ — --- ,,<. . ; . .—. , ,.. . � .: : : � : , :.:_�•: - _. ...:_._,_. . ..=:,� ....�:;._:v,. -... .:., ... • _ '._ ._:,..: , P�•:�.!t.��:`�y: __.w _ _. t�f�:j-"r- i L�i_l,) G`�i��' _. 1 ;-,_,;_1 R,,:i_.:!''yi_:;,iFif,1 F F.�j �. i ''',�`;m=;�`�_��_i'�= �•�r•` _'_'�'_'�= ._. .�;����_! r:t�,t c:c,.'=���t - , ,.. . _ _.- - - _ . . . , . ,.- . - - - - : � '� '"� ' ' ' `�� - — � , , .. . . _.._ _ � .. .. .:. :.::.. : �,..... :.,,, ; �.: . . _ ... 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APPLICANT%PERMITEE SIGNATURF ISSUED BY:SIGNATURE em�s� ovw `sno���Nr��� Hlnos •�nv a�ai�a�� 5�s� £�Ob-LZ8 (Zl9) Sli3'1�0��NI�WR�I��^��18�lQN a8� (lsii) �s►y�I sx�o�tliS .�g laM .�aqs�:n�usiQ aauaa�os 1aa�M �esodsiQ fialeaH ialeM �Iuis uau�l[}I _iaqs�M ian�oyS �C�iZ tipunE� qnaql�g loa�afg .zan�as �o��n�-� sut;;.;� .�0013 aasu�� la1�M 'I3 "I3 �d1�.L 'Id 'Id �d�i.L 2I�H.LO QNZ .LSi .LWSS �2III.LXId 2I�H.LO QNZ .LSI ,LL�ISg ��2If1,LXI3 �zna�x�s �nsxi ���������a���s6sr H1 :d�Z :�c��� ,,.,,,.,�,��a� �aMei�a�ivi�^ ��pp��uiii�y�i �1' :aaqiunNaaoqdalaZ •0� �w��wt�,� �'�6�18�t0�w��s�.�o�����uo� ,�,� :diZ :�f�i� saaPPF��ui1i�y�I :.�aqwn�auoqdaial _ _ :aui��s�.�aun�p :dTZ _ , -,-``"�- — ,�. ��.r�s gor i�t�.zauiuzo� i�i�uapisag a��ida� � ai�da� uoiaippd maN :auo x�au� as�ald 'LS£L-£Lti il�� `suoi�sanb an�u no��I 'Q�SS��02Id�g.LON'I'IIt1A Sl�IOI,Ld�I'Iddd 3.L�'IdGUO�I�II 'uoia��t3i�a�ati� a��p pu� u�is •aa� �iuuad aq� a�nduzo� •uoi���iidd� siq� uo sura�i Ji� a�ajdu:o� s��ioi;�na�suI •paimba.z a�iaou.cnoq-�Z 'LS£L-£L� IIE� •paiano�si �i aio3aq pa�sa��i� pue pal�adsut aq lsnm xlo,�IIb' '9 �sauauzalmbai apo� a1eaS aq� q�rm a�u�pio��� ui auop aq asnui xion� Itd 'S •pauieaqo aq lsnui �iiuiad �u►pimq aaei�das e `panionu► s► �u►iapoival lo uocl�ru�suo� n�au �iu� uaqM '�, •�utijan�p aqa u► �uipisa.z siaurt�o,Caiado.�d oa pu� s1ol�Eiluo��utqtunid pasua�ri oi�Z�p panssi aq �C�tu satuiiad�uiqcunld '£ '�.LIS gOf �H.L I�IO Q3.LSOd SI Q2Id� ,LIY�I2I�d �H.L 'II.LI�Ifl 1�IIJ�g .LOI�I .LSf1W }I2IOM '.LIW2I�d N �AI���2I f10A 'II.LI�Ifl QI'IdA .LOI�I �2I�' S.LIYII?I�d 'paaaidmo� si matnai e ia13e tt�uc usniai ,Cq �uas aq jtinn sp.��� �iuuad 'Z •sa�i o �Ci►� aql 1� uos.�ad ui io Iieui �Cq sltuizad �u►quznid io3 �Cidde �CBui no� •i �t��J� � N�� I�IOI,L�'I^I2I031�II 'Id?I�I�I�� £Z£SS I�iL11 `��g I��s,�a� (�C�nn�.��d �a[Ia?I OSLZ) 99 X�II .LIY�I?I�d�I�IIgWII'Id 2I03I�IOI,L��I'Idd� OI�I07I0 �O 1�.LI� Y ♦ , PERMIT FEE CALCULATION 1. 1.25% of Contract Price* or Minimum Fee 35.00 2 ' �� x .0125 $ J� � (contract price) 2. State Surcharge. ** Add the State Building Code Division Surcharge to each permit. ��r' x .0005 $ � ��U (contract price) or $.50, whichever is greater 3. Postage and Handlin� (Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3�-G� * 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 installation are furnished by the owner, tenant or any othe: party th� reasona�le 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 Department of lnspectional Services for the price. 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. A licant's Si nature: � Date: PP g