HomeMy WebLinkAbout2001-P04542 - water heater PERMIT
CIT'.•."► OF ORONO Permit Number:
27�0 Kelley Parkway - PO Box 66 P04542
Crystal Bay, Minnesota 55323 Permit Type: F�XtUres
(952) 249-4600 Date Issued: �oi2a�2oot
SITE ADDRESS: 2765 Ethel Ave
Wayzata, NW 55391
PID: 20-117-23-24-0018
DESCRIPTION:
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Permit Class: Plumbing
Permit Type: Fixtures Per►nit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 400.00
State Surcharge Fee: $ 0.50
Misc. Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Norblom Plumbing Co. OWNER: Donna L Lile
2905 Garfield Avenue S. 2765 Ethel Ave.
Minneapolis, MN 55408 Orono,MN 55391
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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PPLI ANT P I EE NATURE UED BY SIGNATURE �
Cop►es: 1-File(Signitures Required), ]-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City o�ces.
2. Permit cards will be sent by retum 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 pemuts 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 the State Code requirements. �
6: All work must be inspected and air tested before it is covered. Call 249-4600. 24-hour notice required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date
the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 249-4600.
Please check one: New Addition Repair x Replace
Residential Commercial
LILE, DONNA
JOB S�: 2765 ETHEL AVENUE Zlp:
Owner's Name: ORONO, MN 55391 Telephone Number:
Mailing Address: (g52)471-3203 City: Zip:
Contractor's Name: b/ Co. Telephone Number: (,�1 -�27.. yo 3 3
Mailing Address: �9c�s Cjar��/�( A�vlc. o. CitY: �1�(,%_ ZiP. 55yv8
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND 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 Misc (list)
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PERMIT TEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee 35.00
�� X .oi2s $ 35. o0
(contract price)
2. State Surchar�e. ** Add the State Buildin Code Division
Surcharge to each permit. ���1�
x .0005 $ . 5 O
(ontract price)
or $.50, whichever is greater �
3. Postage and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE � (Add lines 1-3 above) $ 37. 00 ,
* 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 chazged to the
customer for the work done. If any material, equipment, labor,or installation are furnished by the owner,
ter.ar_t or any �fher p�ny the re?cn�3h1� ;�2,Sket value of such item� must �s adde� to the ectian�ted cast
or contract price for pemut 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 Department of Jnspectional Services 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.
Applicant's Signature: Date: ���C�l �l