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Home My WebLink About2013-00071 - plumbing . CITY OF ORONO * z � 1 3 - 0 0 0 7 1 * � 2750 KELLEY PARKWAY DATE ISSUED: OU28/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 185 CYGNET PL PIN : 04-117-23-23-0011 LEGAL DESC : SWAN LAKE ADDN : LOT 008 BLOCK 001 PERMIT TYPE : PLUMBING (<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NOTE: WATGR SOFTF,NER APPLICANT PLUMBING FIXTURE FEE (<$500) 15.00 APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 12850 CHESTNUT BLVD SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 (952)445-4803 � TOTAL 22.00 Minnesota State License#: 057209PM OWNER EZELL, ROXANNE& ROGER 185 CYGNET�L _ LONG LAKE, MN 55�56- AGREEMENT AND-SW4RN-STATEMENT l�he work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City_approvals,and the State L3uilding Code. This permit is for only the�work described and docs not grant permission for additional or related work which requires separate permils All provisions oflaws and ordinances goveniing 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 commenccd within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer 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 time for due cause. � � / /2�/�� // a3 � / Applicant Permitec Si� • re Date I,s d E3y Signaturc Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBGD ABOVE. _ FQ CIT SE ONLY O¢��O City of Orono 1 ��3� 7 • P.O.Box 66 Date Received: �Permit# 2750 Kelley Parkway � �� Crystal Bay,MN 55323 Approved By: Amount S: �- ��O (952)249-4600 0 CITY OF ORONO—PLUMBING PERMIT (Atl Commercial permits must be approved by the Building OfFicial or Inspector) GENERAL INFORMATION � - � 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. R�(+��VC� 2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE JAN 2 8 2013 PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owner��OF ORONO residing in the dwelling. . 4. When any new construction or remodeling is involved,a sepazate building permit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. Ali work must be inspected and air tested before it is covered. Call(952)249-4600. � (24-48 hour ootice required) TYPE OF PERMIT Check All That A 1 � [.�-Residential ❑Commercial(Approval Required) ❑ New ❑Additional ❑Rep�jrs �eplace ❑ In Accessory Structure? *You will need arior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: 1�� L.y��(r\�fi�1 Owner: I��er c 2� ,� Mailing Address: 1�S� c��,v�et- PI �� City: ��( �Y�� Zip: ��!7�, �lt, Home Phone: `��"`��"�' ?�:�� Alternate Phone: Contractor Information: ! ' Contractor: ContactPerson: ��t« I��Pt'�=, . Appliance Connections Inc. Address: State Bond#: ��]�-�i f�Nl Shakopee, MN 55�79 City: a��g��: Expiration Date: i�� Z3 "1 3� __ � Phone: � Alternate Phone: ' �'•' ' �� Insurance—Current: -'�� ( � 3� �� _ l � � �� FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains , , � Lavatory Sewer Ejector Bathtub Laundry Ttay Shower Washer Kitchen Sink Water Heater � v Disposal Water Softener � Dishwasher Wet Bar Sillcocks , Miscellaneous ,��PE�tMIT,FEE;CAL�CULATION(S) � ��"5 �� '��BASED.OFF``-2002 STATE STATUE ��`' ❑ 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;excludin¢the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 " � State Surcharge $ 5.00 � Mail-[n Fee(If Applicable) $ 2.00 Total Permit Fee $ i-1-�OG � � � l � (Permit Fees Continued On Next Page� ' . , II 2 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) • x.0125$ (conVact price) (minunum$50.00) a 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 55.00) x.0005 $ (contract price) ' (minimum$ 5.00) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ '� ■ * CO?�ITRACT PRICE ar JOB COST means the acival or estimated dollaz 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 installations are fumished by the owner, tenant or any other party, the reasonable mazket 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$5.00—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. �+I Q ' `'£�'�xR�E '` , The undersigned hereby applies to the Ciry 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. Applicant's Signature: ��"�;u��'�- � ' � � Date: � ��13 � ✓ Reset Form� � . � � � .. � � .� , . , , - . � _ 3 �