HomeMy WebLinkAbout2007-P11711 - water heater PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P11711
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) ���9-4600 Date Issued: 11/27/2007
SITE ADDRESS: 160 Cygnet Pl Unit#
Long Lake, MN 55356
PID: 04-117-23-22-0020
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: Plumbing
Permit Type:
Fixtures Pcrmit Sub-type(s): Water Heater
DETAILS:
Approvcd per resolution#:
Separate permits 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: Norblom Plumbing Co. OWNER: Olson&Debernardi
2905 Garfield Avenue S. 160 Cygnet Pl
Minneapolis, MN 55408 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.
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APPLICANT PI:RMI'1'LE SIGI�ATURE � ISSUED BY SIGNATURB i
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, I-Assessing,(If Scptic, 1-Septic) Page 1
FOR C[TY L'SE ONLY
O���O City of Orono
P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
• .� � � Crvstal Bay,MN 5�323 Approved By: Amount�' i
`�� ' :yc` (9�2)249-4500
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial pennits 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.
2. Pe�mit 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 ;,c�� �u„struction or rerrtodeiing is invoived, a�eparate buiiding permit must be
obtained.
5. All work must be done in accordance with State Code requiremer:ts.
6. All work must be inspected and air tested before it is covered. Call (952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT i
(Check All That Apply) �
�esidential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑ Repairs �Replace
❑ In�ccessory Struct�re?
*You witl need prior aaproval.and may need CUP.(Per Orono City Code,Chapter 78, Article IV)
Job Site/Owner Information�
Site Address: _ paul Debernardi
160 Cygnet Place
Owner: Orono, MN 55356 �ss:
6513361394
City:
Home Phone: Alternate Phone:
Contractor Information:
Contracto�Q (� (�Aontact Person:
Address: 290� 827-4033 . SOState Bond#: S�CoS
C�ty: MINNEAP�LIS� �A�J 5540�Xpiration Date: _ o
Phone: Alternate Phone:
❑ Insurance—Current:
1
PLUMBING FIXTURES BEING INSTALLED
F[XTURE BSMT 1 2'�D , OTI�ER FIXTURE BSMT 1 2`° OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory. Sewer Ejector
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Bathroom Laundry Tray
Shower Washer
Kitchen Sink Water I-ieater �
I
Disposal Water Softener
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Dishwasher Wet Bar
Siilcocks Miscellaneous
PERMIT FEE CALCULATION(S)
� �ASED OF"r' - 2002 STATE STATUE
� Yes,this section applies
The repla�ement of a Residential fixture or appliance that meets all three of the following requirements:
l. Does not require modification to electrical or gas service. �
2. [ias a totai cost oi��UO.uU or iess;excludin�the cost of the tlxture 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 $ .�0
Mail-In Fee(If Applicable) $ 1.�0
Total Permit Fee $ /�.DO
(Permit Fees Continued On Next Page)
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• PERMIT FEE CALCULATION(S)-JOBS OVER $500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1?5%of contract price with a(Minimum Fee of$35.00) - -
x .0125 $
(contract price) (minimum$35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(�linimum Fee of�.50)
x .0005 $
(convact price) (minimum$ 50)
3. POSTAGE&HAN`DLING(Only on Mail-In Applications) $ 1.50
d. TOTAL YEIiMI"r FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar 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 furnished by
the owner, 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 City may request the submission of a signed copy of the actual contract.
■ ** The STATE SliRCHARGE is .0005 of the contract price under$1,000,000 or $.50--whichever is
greater. For valuations over$1�,000,000 call the Building Department at(952)249-4600 for the price.
PLUMBING PERMIT APPLICATION AGREEMENT -�
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do al]
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: Date:� ?O
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