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Home My WebLink About2016-00387 - water heater � � CITY OF ORONO * Z 0 1 6 - 0 0 3 8 7 * 2750 KELLEY PARKWAY DATE ISSUED: 04/18/2016 ORONO, MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 755 DICKEY LAKE DR PIN : 34-118-23-22-0009 LEGAL DESC : RINGERSWOOD : LOT 005 BLOCK 002 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER HEATER NOTE: WATER HEATER VALUATION OF PLUMBING 600 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 030 APPLIANCE CONNECTIONS, INC. MAIL-IN FEE 2.00 12850 CHESTNUT BLVD SHAKOPEE, MN 55379- TOTAL 52.30 (952)445-4803 Payment(s) Minnesota State License#: mech-MB004165 CHECK 7830 52.30 OWNER ESAU,TERRANCE&MARY 755 DICKEY LAKE DR LONG LAKE,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 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 wi[h the State Building Code.This permit may be revoked at any time for due cause. � "e � l � CJ / V Applicant Permitee Signature Date Issued B Si nature Date �p� City of Orono FOR CIT16 US ON Y O P.O. Box 66 Date Received:_��'�� 2750 Kelley Parkway � � Crystal Bay, MN 55323 ,� � �U�d Permit# �0�6 -�.3 � - �"1 �c? (952)249-4600—Main AYK A roved B KFSHOQ' (952)249-4616—Fax �� y' G�0�pRONO <Amo�nt$: 5 �. � :r CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the Si�ate Prior to City Approval) http://www.dli.mn.pov/CCLD/PDF/qe plumbqlanrevapp.pdf GE�IERAL INF0�=1U��4TiON _ 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. Permit 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 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) ✓ - ❑ New ❑ Additional ❑ Repairs ,�Replace i� ❑ In Accessory Structure? * *You will need prior anproval and may need CUP. (Per Orono City Code, Chapter 78, Article I� .��Ye�:O�er Inforrrfia#��art:'' . site Address: � '� �� .,� ,� 1�.�, .�✓' �5�5� �� --- Owner:fL'�'r i�1, -- C� � �Mailing Address: ` �� ►��--�' � ----�-- - - � City: ��d�� C% Zip: � �� 4emg Phone: ��- �5�� 3 Alternate Phone: �a�f�-actor.�n�orn�a#ifln: ; _ . �Contractor. Contact Person: � ' -� Appiisnce Can�tect�ons Inc �►� Address: _ ..,o�., �.,�,�� State Bond #: 5� (�� Shakopee, MN 55379 C�tY� - ��g�� Zip: Expiration Date: Phone: Alternate Phone: ❑ Insurance - Current: Page 1 FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sr 2ND OTHER TYPE Floor Floor TYPE Floor Floor Water Cioset Fioor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) x .0125 $ (contract price) (minimum $50.00) 2. STATE SURCHARGE x .0005 $ (contract price) 3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $��;j� * 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 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 m e on this application are complete, true and correct. Applicant's Signature: �, � Date: � Building Official/ Inspector: Date: Page 2