HomeMy WebLinkAbout1998-010247 - backflow preventer �'��1V�1�I,
�IT''r"OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �°i i_�3•s;=;s j��C:
Crystal Bay, Minnesota 55323 Permit Number: .
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Date Issued:
(612) 473-7357 d�`,�:�z_�:'`��w�
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLIC T P RMITEE SIGNATURE ISSUED BY:SIGNATURE
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C1TY OF UR.ONO APPLICATION FOR PLUMBING P�Ril�1IT
}Sr�x b6 (27�0 Kelley Parkway)
Crystal Sav, 1VIN 55323
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cazds 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 pernut 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 473-7357. 24-hour notice required.
Instructioii,� Co:nplete all items on this application. Compute the permit fee. Sign and date
the certificatioii. INCO:��PLET� APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 473-7357.
Please check one: 4. l�ew Addition Repair Replace
�Residential Commercial
JOB STTE: ` C�-�� ��� �✓: Zip: J'� .�3��
O�i�ner's l�tame: ..�,�i�-t��- �J���' elephone Number:
Mailing Address: � 2"/_'� �u ' � �-� City: -ve�,_; Zip: �5 3J��,
Contractor'sName: �v1v ' �, Tele honeNumber: �(�,.-���
Mailin A ddress: - � /� ��4- , ity:��' Yf G�� � Zip: �y-���
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PLUMBING FIXTURE SCHEDULE
FIXTUR.E� BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND 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
Dishwtsher Wet Bar
Sillcocks Misc (list) � Q /" ��-���
. •
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($3�.00)
�jd 0 � x .0125 $
(contract price)
2. State Surcharge. *" Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Posta�e 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 charged for the pemutted
work including materials, labor, profit, and other fixed costs. It is the amount to be chazged to the
customer for the work done. If any ma[erial, equipment, labor, or installation are furnished by the owner, 6
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 Ci[y 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 4
greater. For valuations over $1,000,000 call the Department of Inspectional 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 th t� all statements made on this application are complete, true and
correct.
Applicant's Signature: ' �ic Date: �Z6- %�
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