HomeMy WebLinkAbout2016-00355 (Plumbing) - � CITY OF ORONO * 2 0 1 6 - 0 0 3 5 5 *
2750 KELLEY PARKWAY DATE ISSUED: 04/08/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1295 ARBOR ST
PIN : 10-117-23-31-0035
LEGAL DESC : CRYSTAL BAY MINNETONKA
: LOT 000 BLOCK 002
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: (1)WATER CLOSET
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
J&J MECHANICAL INC(MAIL DIFF) MAIL-IN FEE 2.00
452 8TH AVENUE SW
LONSDALE,MN 55046- TOTAL 52.25
(651)7240973 Payment(s)
CREDIT CARD 0479 52.25
OWNER
Twelve Oaks Properties LLC
PERRY,CHRISTOPHER
1125 HUNTER DR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized 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 assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any[ime for due cause. 1
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Applicant Permitee Signature Date Issued By gnature Date
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C1TY aF ORONO— PLUM�ING PERMIT
(All Commercial Permits Must be App�'oved by the State Prior to City Approval)
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1. You may apply for plumbing permits by mail or in pers�n at the Ciry affices. Applicativns will be
reviewed and a permit will be issued within two warking days.
2_ Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VAL.ID
UNTIL,YQU RECEIVE A PERMiT. WORK MUST NOT BEGIN UN71L TWE P�RM(T CARD IS
POS7�D ON THE JOB SITE.
3. Plumbing permits may be issued QNI�Y tv licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construction or remodeling is invalved, a separa#e building permit must be obtained.
5. All work must be done in aecordance with State Gode requirements.
6. All work mu5t be inspected and air tesEed before it is covered. Call (952) 2a9-46b0.
(24r48 hour notice required)
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�Residential ❑ Commercial (Approval Required) [Backflow Device: ❑,t1,VB [�PVB]
❑ New ❑ Additional ❑ Repairs � Replace
❑ In Accessory Structure?
'�You wili need prior apprayal.and may need CUP. (Per Orono City Code, Chapter 78, A�ticle IV)
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Site Address: �2��J �Ckx�C Sk -
Qwner: �J f1v �e_r�r.i ___Mailing Address:
Cify: �s�r�c> zip� �53 1
Home Phane: a 3�j���• �►a'�°I Alternate Phone:
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Contractor: ,� f, � '�Cc_h Qv�i��l �ri�. C�ntact Person: �1�.�
Address: �1��+ �"� �Ve. SV�! State Bond #: ��at-el�
City: 1� Zip: ���4 Expiration Date: �1 �
Phone� �P�J1• 12-N• C�°1�13 Alternate Phone:
[� Insurance — Current: f .� � G1,�L7
Page 7
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FIXTIJR� BSMT 1sr 2N� C7THER F(XTUR� BSMT 1�' 2�dD OTHER
TYP� Flaor Floor TYPE Floor Floor
Water Closet � Floor Drains
Lavatory , Sewer Ejector
Bathtub � Laundry Tray
Shower � Washer
Kitchen Sink Water Heater
Disposal I Water Softener �
Dishwasher Wet Bar
Silicocks i Mlscellaneous I
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1. C�NTRACT PRICE * is 1_25% of contract price with a (Minimum Fee of$50.00)
V�a��.��o� �� X .0,�5 �
(contract price) (minimum $50_Op)
2. STATE SURCHARGE
x .000� �
(contrac�t price)
3. POSTAGE & HANDLING (Onfy on Mail-In Appiic�tions) $ 2.00
per�}hp►'�
4. TOTAL PERMIT FEE (Add �.ines 1-3 Above) $ ��• �� ,T, lQ��
" CONTRACT PRICE or J4B COST means the actual or estimated doilar amount charged for the
permitted work including materials, labor, pro�it, and ather fixed costs. It is the amo�mt to be charged to
the customer for the work done. If any material, equipment, labor or installations are fumished by the
owner, tenant or any ather party, the reasonable market value of such items must be added ta th�
estimated cost or cantract price far permit fee purposes. In the event that there is a dispute on the
amount of the job cost, the City may r�qu�st the submission of a signed copy of the actual cantract.
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
strict accorclance with the ordinances of the City and the regulations of the State of Minneso#a, and
certifies that all statements made on this application are complete, true and correct.
Applicant's Signature: ' Date: �/�o
Buifding Official/Inspector: Date:
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