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Home My WebLink About2014-01040 - replace water heater • � CITY OF ORONO *� 4 — 0 1 0 4 0 * 2750 KELLEY PARKWAY nATE �ssuE�: 09/15/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2695 DEER RUN TR E PIN : 04-117-23-13-0012 LEGAL DESC : CRYSTAL BAY PRESERVE : LOT 005 BLOCK 001 PERM[T TYPE : PLUMBING (<�,500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NO"I'[,: R};PLACE WA�I�E:R EI1:A"I�I?R APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 STATE SURCHARGE PLBG (<$500) 5.00 APPLIANCE CONNECTIONS MAIL-IN FEE 2.00 12850 CHESTNUT BLVD SHAKOPEE, MN 55379 TOTAL 22.00 (952)445-4803 Payment(s) Minnesota State License#; cont-057209PM CHECK 5384 22.00 OWNER BERMAN, ARTHUR & KATHERINF. 2695 DEER RUN TR E LONG LAKF„ MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant pern�ission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced N�ithin 180 days of the date of issuance,or if construction is suspended fbr a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requcsted in conformance with the State Quilding Codc.This pemiit may be revoked at any time for due cause. C ,s � c� � is� � Applicant Permitee Signature ate Is ed By Signature Date FOR CiTY USE ONLY O¢��O City of Orono j , P.O.Box 66 Date Received: Petmit# _ � � 2750 Kellev Parkwav � C,�'x• Crystal Bay,MN 55323 Approved By: Aruount$:__� ''t '- : o� (952)249-4600—Main ��~�` (952)249-4616—Fax CITY OF ORONO —PLUMBING PERMIT (All Commercial Pcrmits Must be Approved by the State Prior to City Approval) �ii?�;" '�t\>.i:.<;:°.i3a:}.'e',frt'i i s.�`t ��::� '-t 3.�iYE 33�3i�il:;'�1.� D;). )t�� 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 wili be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMiTS ARE NOT VALia UNTIL YOU RECEIVE A PERMTT. 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 permit must be obtained. 5. All work must be done in accordance with State Code requirements. 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 (Check All,That Apply) (�]Residential ❑Commercial(Approval Required) `I� ❑ New ❑Additional ❑ Repairs ��Replace ❑ Tn Accessory Structure? *You will need prior approval and may need,(,l l['. (Per Orono City Code,Chapter 78,Article I� Job Site/Owner Information: Site Address: � �� , ( '�_�'�,{ �-1�_t"" t ` Owner: -� � . Mailing Address: City: __ Zip: Home Phone:�� - Q� � ��Q Alternate Phone: Contractor Information: Contractor: Contact Person: �, - 7Y1�^� � �'. ,2c�� ;�p iancE+�.�,>F . ., ions la?: � Address: �285C ��"` '� �=' "Z `'�.�¢} State Bond#: � � `,�. , ..A � ��Y .�Ti � ��'}-w , ._,�8�3 City: _ .. Zip: Expiration Date: Phone: Alternate Phone: RECEIVED ❑ Insurance-Cunent: SEP � ? .'�' 4 1 �„-..,,,��JROb� � ' � - < PLUMBING FIXTURES BEING 1NSTALLED � FIXTURE BSMT 15 2� OTHER FIXTURE BSMT 15 21VD 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 Dishwasher Wet Bar Sillcocks , Miscelianeous PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATL7E ❑ Yes,this section applies The replacement of onty one 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;cxcludin�the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If App(icable) $ 2.00 Total Permit Fee ��C�; f-. . 4 (Permit Fees Continued On Next Page) RECEi��;�� ` . , � ,� ��14 _ , r 2 . . . If above does not apply;follow guidelines below: 1. COPITRACT PRICE " is 1.25%of contract price with a(Minimum Fee of$50.00) , x.0125$ (contract price) . (minimum S50.00) ' � 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of S5.00) • x.0005 $ (conuact price) ' (minimum S 5.00) 3. POSTAGE&HANDLTNG(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMTT F`EE(Add Lines 1-3 Above) $ y • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charg,ed for the permitted svork including materials,labor,profit,and other fixed costs. It is the amount tobe charged to the customer for the work done. If any material,equipment, labor or installations are furnished by the owner,tenant or any o�er party�the reasonable market value of such items must be adc d to the estimated cost or conhact prict for permit fee purposes. In the event that there is a dispL:v on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. ■ **T'he STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is greater. For valuarions over$1,000,000 call the Building Department at(952)249-4600 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 that all statements made on this application are complete, true and correct. ' . `- �1 ��/ Applicant's Signature: . �` Date: I I .�!H, " . , . ` � � . ,.. l �' • '�. . .. ` � 1 �' f "�'CEI�.�p - . � �; �� . 3 _ . � � , a . 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