HomeMy WebLinkAbout2009-00886 - plumbing . ,
CITY OF ORONO PERMIT NO.: 2009-00886
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 12/09/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2545 DUNWOODY AVE
PIN : 20-117-23-21-0030
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT O10 BLOCK 008
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : F[XTURES- MULTIPLE
NOTE: ALL FIXTURES ARE REPLACEMEN'I'ONLY:
(2)WATER CLOSETS AND(2)LAVA'I'ORIES
(1)EACH: BATHTUB,SHOWER,KI'I�CHEN SINK.DISPOSAL,DISHWASIIER AND WA�I�ER SOPTGNGR
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
NORDL[E, JAMES STATE SURCHARGE PLBG (<$500) 0.50
2545 DUNWOODY AVE
WAYZATA, MN 55391- TOTAL 15.50
OWNER
NORDLIE,JAMES
2545 DUNWOODY AVE
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifica[ions,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not gran[permission for additional or related work which requires separate
pemtits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
reques[ed in conformance with the State Buiiding Code.This permit may be
rev � d at any ti e f du c se.
� k�-- / `� �C>c1 �� / �
Applican Permitee Signature Date Issu y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK O HER THAN DESCRIBED ABOVE.
s, . .. _'�r
FO�t C Y SE ONLY �
,�p�, City of Orono / D � aD� ¢ �j
P.O.Box 66 Date Received: rmit# U
��;ys,; � 2750 Kelley Parkway
� �����1. h Crystal Bay,MN 55323 Approved By: Amount$:��
�d' '!+�'`�i14.Gf (952)249-4600
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CITY OF ORONO–PLUMBING PERMIT
(All 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. Applicarions 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 ilI�TTIL 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
obtazned.
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 notice required)
TYPE OF PERMIT
(Check All That Apply)
�Residential ❑ Commercial(Approval Required)
❑ New ❑Additional �Repairs ❑ Replace
❑ In Accessory Structw-e?
*You wili need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Arricle IV)
Job Site/ Owner Infornlation:
Site Address: -�-�`-1� d �11 �c'w q y AcVI�, W �`12f4i`l� �l��l.- �'S 3� �
Owner: � Ir�� f�� ���e�, �-o►�a i.�r� Mailin� Address: �-S�b ��►�V, ��d y �'��'-
City: t�.t r�.2�-;� , k.��.1- zip: ���� i
Home Phone: 9�� – � � �—`�`s`t(o Alternate Phone:
Contractor Information:
Contractor: Contact Person:
Address: State Bond #:
City: Zip: Expiration Date:
Phone: Alternate Phoiie:
❑ Insurance– Current:
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PLUMBING FIXTURES BEING 1NSTALLED ,
FIXTURE BSMT 1' 2' OTHER FIXTURE BSMT 1 2' OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
.Z
Lavatory � Sewer Ejector
Bathtub ( Laundry Tray
Shower ' Washer
Kitchen Sink � Water Heater
Disposal i Water Softener `
Dishwasher ` Wet Bar
Sillcocks Miscellaneous
�� 1 l�IMS /� � I�f� � �-I��-�6'��N.1 C� V�t �-�l�
PERMIT FEE CALCULATION(S) ��
BASED OFF - 2002 STATE STATUE
� Yes,this section applies
The replacement of a Residentia] fixture or a� liance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2. ?-Ias z tota]cost of�,500.00 cr less, exc?udin�the c�,st;�f il;c fi,.ture or appiiznce: ar.d
3. Is improved,installed or replaced by the homeowner ar licensed contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $ ��j, S'Q
(Permit Fees Continued On Next Page)
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PERMIT FEE CALCULATION(S —30B5 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$50.00)
x.0125 $
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
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
esrimated cost or contract price for permit fee puiposes. 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 tbe price.
PLIJMBING 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 Si�,mature: \t��-� Date: � I��, , R . .2_DUc1
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