HomeMy WebLinkAbout1992-004679 - water heater � . � ��'�r�1Y11�
CITY OF ORONO
13 3 5 BROWN RD s , Box 66 �ERMIT TYPE: F't�����,�.��i� �
CRYSTAL BAY, MN 55323 'ermit Number:
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473-7357 Date Issued: i�7���°�'��=��
SITE ADDRESS:
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE �.,�J
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� • Crystal Bay, MN 55323
�, ************************************************************�**************
General Instructions
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fees shown below.
Permit cards will be sent by return ma3.1 the same day the application is received.
3. Permits are not valid until you receive a permit card. �
4. Work must not begin unless the permit card is available on the job site.
5. Plumbing permits may be 3.ssued to licensed contractors only.
6. When any new construction or remodeling is involved, a separate building permit must
be obtained.
7. All work must be done in accordance with State Code requirements. -
8. All work must be inspected before it is covered. Call 473-7357.
24 honr notice required.
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JOB SITE ADDRESS: �9�? ���j� �('t.(�'j7�hYqQ WC� h'
Occupancy Type: � Reside tial Commercial
OWNER'S NAME: (�� (�.�p��irr✓ Phone No. : ��/-����
Mailing Address: ���,�� City:
CONTRACTOR'S NAME: BL16. TTn. ; ��'""�j/�-�'�; -�
� Mailing Address: � � � City: ���_ Zip: �:�`;t���'
Master Plumber's tate License No: City�Cert. No. :
************************************** ************************************
PLUMBING FIXTORE SCAEDULE
(Show number of fixtures of each ty�e on each floor)
FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER
------------- --- �----- ----r----- ------ ------------- ---- ----•---- --------- -----
Water Closet Sewer E ector _
------------- ---- -------- ---- ---- ------ -------]----- ---- --- -'t--- --------- - ,--
Lavatory Laundry Tray
Bathtub Washer
------------- -----�-------- ------ ---- ----------- -�-1 --^--- ------- ----
Shower Water Heater 7�
--------------�----- --•----- -------- ------ ------------- -�\ ---•----- -----_--- -----
Kitchen Sink ' Water Softner OCT 6+ `'�. �
-------------�---- --�----- -------- ------ ------------ --- --�---- -----�� ----
Disposal I_ Wet Bar
-------------1 --- ----- ----- ---- ----------- -- --•---- -------- ----
Dishwasher __ I- Sum Pum
----------- 1 --- --- -- ---- -- ---- --p----P--- -- ------ -------- ----
Sillcocks �_ ______ Misc. (List)
------------- ---- ---•--- --------- ---------- ---- ------- ---------- -----
Floor Drains_i_ 1_ .�_ .1_ 1_ 1____1____ �_ �_
------------ 1 ---- --�---- -------- ----- ------------ ---- --------- ---- -
*******************************,t******************************************* --
1. Fixture Fee The minimum �ermit fee is $30 .00 $ �(� •�?��
Compute number of fixtures x $8/fixture �
x $5/fixture reset
2. State Surcharge $ .50 �
3. Postage � Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above} $ 3 � � C���
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The undersigned hereby applies to the City of Orono 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.
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Signature of l�pplicant: /��� , Date: /Q-%—q�