HomeMy WebLinkAbout2004-P07337 - plumbing CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po�33�
Crystal Bay, Minnesota 55323 Permit Type: FiXcures
(952)'249-4600 Date Issued: 4�12�2004
SITE ADDRESS: 2635 Countryside Dr w
I.ong Lake,MN 55356
P I D: 04-117-23-13-0007
DESCRI PTION:
Proposed Use: Kesidential
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PernutFee: $ 15.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 15.50
APPLICANT: Owner/Self OWNER: David&Teresa Gross
MN 2635 Counri-yside Dr W
Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TIIE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPL[C T PERMITEE SIGNATURG ISSUED BY SIGNATURE
Covies: 1-File(Sienitures Reouired), 1-Apvlicant, 1-Monthlv Reports. 1-Assessin�, 1-Finance Page 1
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,� p �337
� CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, NIl�T 55323
- GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL
YOU RECEIVE 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice
required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: New �/Addition Repair Replace
Residential Commercial
.
JOB SITE: 21.p o,� C' �u;.��.:,< � �'�_� . Zip: t-��
O w n e r's N a m e: ---T-�,�� (=�, r 6� Tele phone Number:���-,z� y��—�� �
Mailing Address: � . City: � Zip: yv��, s a '��fc
Contractor's Name: Telepho e Number:
Mailing Address: ' City: Zip:
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavato Sewer E'ector
Bathtub Laund Tra
Shower Washer
Kitchen Sink Water Heater
Dis osal Water Softener
Dishwasher Wet Bar �
Sillcocks Misc (list)
�
.
PERMIT FEE CALCULATION(S)
.
�
2002 State Statute � Yes, This Section Applies
The replacement of a Residential fixture or appliance that meets all three of the following
requirements:
1) Does not require modification to electrical or gas service.
2) Has a total cost of$500.00 or less; excluding the cost of the fi�ture or appliance:
and
3) Is improved, installed or replaced by the homeowner or licenced co�actor.
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Skip next section; Cost of Pernut $ ,'' � 1�.00 �
State Surcharge $� .50 % �
Mail In Fee $� 1.50
\
If above does not apply, follow guidelines below:
l. Contract Price* is .0125 % of job with a Minimum Fee of ($35.001
x .0125 $
(contract price) +--,inimum $35.00)
2. State Surcharge. ** Add the State Building Code Division a (Minimum Fee of$ .50)
x .0005 $
(contract price) i--�inimum $ .50)
3. Postage and Handling (Only 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 cha-=ed for the permitted
work including materials, labor, profit, and other fixed costs. It is the amount to be c:yr�ed co the customer
_ for the work done. If any material, equipment, labor, or installation are furnished b�-the oa�er, tenant or
any other party the reasonable market value of such items must be added to the estiL.ated cost or contract
price for permit fee purposes. In the event that there is a dispute on the amount of the:ob 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-whiche�-er is greater.
For valuations over$1,000,000 call the Department of Inspection Services for the p�ce.
The undersigned hereby applies to the Gity for issuance of a Plumbing Pernut. 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
conect.
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Applicant's Signature: Date: � � Q�
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