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Home My WebLink About2009-00187 - plumbing � � CITY OF ORONO PERMIT NO.: 2009-00187 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEu: 04/29/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 2565 DUNWOODY AVE PI IV : 20-117-23-21-0031 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 000 BLOCK 008 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : F[XTURES- MULTIPLE NOTE: (1)WAT�R HEATER AND(1)BIDET VALUATION OF PLUMBING 4592 APPLICANT PLUMBING FIXTURE FEE 57.40 CITY VIEW PLUMBING& HEATING STATE SURCHARGE PLBG (VALUATION) 2.30 1880 WAYZATA BLVD W TOTAL 59J0 P.O. BOX 150 LONG LAKE, MN 55356 (952)473-8793 OWNER WELLS, ELLEN 2565 DUNWOODY AVE P.O. BOX 351 WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permi[is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. "Chis permit is for only the work described and does not grant permission for additional or related work which requires separate permits. Ali provisions of laws and ordinances goveming this rype of work shall be compied with whe[her or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in�e�t#aqrnance with the State Building Code.This permit may be revo� at any time for due cause. �__ :� `� �� a� � 2� a Applicant Permitee Signatur Date Iss e y Signature Date SEPARATE PERMITS REQUIRED FOR WORK HER THAN DESCR[BED ABOVE. � � � FOR CITY E ONLY City of Orono t/Z f0 em,it# o�ODq- ��7 ,O¢��O P.O.Box 66 Date Received: 2750 Kelley Parkway a r,''�• � Crystal Bay,MN 55323 Approved By: Amount$: � • � � '��.`':.t,o`- (952)249-4600 �tt�xoe�` CITY OF ORONO-PLUMBING PERMIT (All Commeroial 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. 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 A 1 �Residential ❑Commercial(Approval Required) ❑New [�Additional ❑Repairs ❑ Replace ❑ In Accessory Structure? *You will need prior approval and may need('l )'.(Per Orono City Code,Chapter 78,Article N) Job Site/Owner Information: Site Address: �� ,�) �'�� l�lU P� Owner: �� l�i� ��,��=-�� Mailing Address: �1�� k ,,�,� � City: � C (� �� Zip: S5 j� � � Home Phone: �5 a-�y I�a(� Alternate Phone: Contractor Information: Contractor:�--� ��r� �I < -� �, Contact Person: Qv��r n�Cc�� ►��c3,,,/ Address: �.�•; �n X �.�� State Bond#: �'-�S�J�� . City: L�r c Lvi � Zip:S j (, Expiration Date: �� J I �� Phone: �� ; l 3`7��.� Alternate Phone: ��1:� b�5 _��-'+ ❑ Insurance-Current: ��.�; 1 � � PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER 7'YPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathroom Laundry Tray Shower Washer Kitchen Sink Water Heater � Disposal Water Softener Dishwasher Wet Bar Sillcocks Misc llaneous / �� PERMIT FEE CALCULATION(S) 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;excluding 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 $ .50 Mail-In Fee(Lf Applicable) $ 1.50 Total Permit Fee S (Permit Fees Continued On Next Page) 2 , PERMIT FEE CALCULATION S —JOBS OVER$500.00 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) ^ r)!� �-{j�I� `- x.0125$ (contract price) (minimum$35.00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of 5.50) �� {��-V x.0005 $ (contract price) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT 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 SURCHARGE 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 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• ��' �� Date: L n Reset Form 3