HomeMy WebLinkAbout2003-P06460 - water heater � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P06460
Crystal Bay, Minnesota 55323 Permit Type: FiXcures
(952) 249-4600 Date Issued: 6�2a�2oo3
SITE ADDRESS: 2780 Countryside Dr W
I.ong Lake,MN 55356
PID: 04-117-23-12-0010
DESCRIPTION:
Proposed Use: Kesidential
Pernut Class: Plumbing
Permit Type: Fixtures
Permit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 15.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc. Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: H.P. Pipeworks OWNER: Dewight&Lisa Seward
3670 Dodd Road Suite 100 2780 Countryside Dr W
Eagan,MN 55123 Long Lake MN 55356
THE UNDERSIGNED 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 BUILDING CODE REQUIREMENTS.
� .
��2-C�-(.X� •-fin% j�, " }� _���
APPLICANT PERMITEE SIGNATURE ,ISSUED BY SIGNATURE
Cooies: 1-File(Si,enitures Required), 1-Anolicant 1-Monthlv Reports, 1-Assessing. 1-Finance Page 1
�ui-ua-cw c ic:yup� FrortrClTY OF ORONO +85224g4616 T-590 P.001/�02 P-73�
�
��'I�'X �F 41201V'O A�'PI,��AT'YON�'QR PI,LT.�tlrTG��T
Box 66 (2750 i�ell�y parl�,ay)
Cry� ��y, MN 55323
G�.�v�RAL i1�iRc�R�re►�f*zn�
1- You may apply for p,tuuibing permics by mail ar in pers�n at che Cit�,o�es.
2. Permit cards will be sent t�+reU�nn m�zl a�fter a review is cormplenad. PERMITS Al2E NClT V'AL�UNi'IL
�o��c�vE����r. �vo�c Musr rra�r��c�nv,..��'��z.Y�'�s�,�os7'6D nN
T�70B 5,,,�TE_
3. Fh�ilbitig�mfts may be issued ONL'Y'to iicctued plumbimg coa�tr�ctars an.d.to properry rnvners residiug
m rhe dw�lling.
4. VVhen any new�oust�.ct�on az remodeling is invoived, a separate tx�i�diug germit must be obtazt�4d.
S. A1�wark ruust be dane in accordance vv�nc�13�State Code requ}semeacs.
6. All work mus� be i�pectecl and air c�sted before ft �S aovared. Cal� (�S2) 24�-46t)0. 24-hour saotice
requir�d.
Ynstr cu t�ons ���plete a11 items o�this applicauon, Gomp�t��permit fee. Si,gn and dat�'txt�
cercificatiQn. TNCCINIP�TE A�'PLI�ATIONS W�.L NOT BE P�FOCESS�,D, If yo�. have
questions, call (952) 249-�6Q0.
Pl�as� check on�: N'aw Addition Rep� �j T�,�lac�
� �teside�xi�l �W Coma��rcial
��?7�G, ._.�,
.ros s�`r�; � �. � ' ` �
� : , � �.,�� ��p, �a� -� ,
�ner's Name: � `` f �. . ��ephone Nwip�ber: � "' --
1VYailing A�dress; � y; � �� ����-'�
P�
��tractor's Narne: Telephone riru�nher: �
Mailin�Address: H.P. �IPEwnRK$ �ity; zip•
—�670 DODD ROAD
� �1'�� S�:�DUI.�
(6� 3 1340
�'�TC.JR� ��MT 1ST 2ND bTl��k FIXTURE BSMT 1�T 2Np OT#��g
TYk'E FL �.� T'YFE FL ��.
Water Closet Floor b�izts
Lavato Sewer E'ectoz
�azhtub L Tra
Shower W�sher
Kitchen Sink Wazcr Heat�r �
Dis psat Water SoPte�r
DishwasheF Wet Bar
SiSlccycks Misc �ist)
dul-D3-YOOY 12:50pm From-CITY OF ORONQ +9B224g4616 T-58U P.Q02/002 F-T30
s
rE�n�nm �E c�,��,.Trarr�,s�
�QQ2 h, t��tatute Yesr This SectSon Applies
T�e replacern�nt of a �'�. ia re��,j�� �t ���$ �� �.� o� � gallowi�.g
requir�rMe�,ts:
3) Doe� not require modificatia�,to�lectri,� or g�s service.
2) Has a o 1 o t o�$500.00 or 1ess; �xcludi�the co;� of th� �'ixtuxe or apgIzance�
and
3) Is i.mproved, instal�ed or replaced �iy the homsovvner ar licenc�d. c4,n.tra�ctor.
Skip ne�t section, Cost af P�rmit � `_. 1 pQ._ �
Stat� Surcharge $ ��,�a �
IvTail I�a Fee $ , 1,gQ
If above dQes nat ap�Iy, follow �uidelines helow:
1. �antract Fr��e* is .QX25 $o of job with � ��'n�num Y+'ee c►f r�3S Q(il
� x .A125 $
(conu;�et price) (mirumtut�$3S.Q0)
2. �� Surch,ar�. �� Add the St�te Huildin� CQd� ]�ivision a (1V�,'inirnum �''ee o[$ .54)
x .OQ05 �
{contract price) (mini�um$ .50)
3. Po�.�t ,�e and �nE (Qmly rnail-� agplicatic�ns) $ _ 1.50 ,_
4. �OTAY.�PERM�x�'EE {Add lina� �-3 abov�) $ ��L,.�'1
* C4N7'1�►CT PRIC�or JoB GQST means t�e Actual or estimated dollar amou,nt charg�d for th�permitted
wor}c i.ackadin�znacerials,lahar,prafit,�rud other fixed costs. It is the amou�t ta be cbar�ed co the custamer
for the wor�doae. IP any rngterial, equipmenc, labar, or installatioa ar�#i�rnished by the owner, cene�tt Qr
any ot�er pazty the reasor�a�l�markee value of such i��ma must be added ta the estia�at�d cost or conuact
price far permit fee�turp�ses. In�lt�event that ther�is a dispute on th�az�dunt of thc aob cast,the City aaay
requess i�e submassion of a sigAed copy of th�actual cou�tract.
*� The STATE SURCI3A�GB is .pQQS of t,rie cQntract price w�der$l,app,000 or $.�0-wtuGhever ia greate�c.
��ar valuations over$1,OOO,qCb call the D�partment Q�F Ins�ectxon Servfces for t3i�pricc.
?he undersig�ecl herehy a�pIies t4 the City for zssuanc� of a Plumbing Perm.it, �gree$ t�► d.o a�lI
work in sirict accordance with th� ardinan►c�s of the City an�i the xegulatioz�s of�,e State o�
Minzxesota., �nd certi�es �a j sta�e�uent r,y�.@e pm tIx�s �pplfaatiq�a are comgl.e�, true �.d
carrect. '
� �� �.�j/ / /' / `// '
Applicant s,SYgnatuxex � � � � pe,se; (y�