HomeMy WebLinkAbout2014-01360 - plumbing � ' CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 4 - 0 1 3 6 0 *
DATE ISSUED: 1U21/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2935 FARVIEW LA
PIN : 04-117-23-34-0009
LEGAL DESC : FARVIEW
: LOT 009 BLOCK 001
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
'JC)"I�E: WATF,R SOP'TI:N�;R
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CROIX CRYSTAL STATE SURCHARGE PLBG (<$500) 5.00
3440 YOERG DR MAIL-IN FEE 2.00
HUDSON, WI 54016- TOTAL 22.00
(715)386-8667 Payment(s)
CHECK 13086 22.00
OWNER
BILLIGMEIER, SHIRLEY
2935 FARVIEW LA
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. 'I'his permi[is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any timc a�tcr work has commenced.
The applicant is responsible for assuring all required inspections are
requcsted in conformance with the State E3uilding Code.This permi[ma��bc
revoked at any time for due cause.
�2 ,�
Applicant Permitee Sign� re D' c Issu� By Signature Date
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� � OR TY USE ONLY� ��� /�
Ci of Orono � U
�" �O� P.O.Box 66 Date Receiv d� � Permit# �0`
'� � `i 2750 Kelley Parkway �� r
�a � �; Crystal Bay,MN 55323 Approved By: Amount$:
�d�t } %o,_ (952)249-4600—Main
','�asxq8;` (952)249-4616—Fax
CITY OF ORONO-PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
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GENERAL INFORMATTON
L You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a peimit will be issued within two working days.
2. Pernut 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 TIIE
PERNIIT CARD IS POSTED ON THE JOB STTE.
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
ohtained.
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 �eplace
❑ In Accessory St�ucture?
*You will need prior approval and may need C'I�P. (Per Orono City Code,Chapter 78,Article I�
Job Site/Owner Information:
Site Address: �-�/ �`�� "� � � �[ l ��l [ l C� i U �� ��
Owner: �1� �� � �`L�j��,1Vlailing Address: ��-�1�7'7 �C�M�L 1 ������=�-� � �`�
�i�-� ���6Y1 L� 7.in: `� � ��J�,
y. _ —�
Home Phone: `�1��� �-��1� ��� �� Alternate Phone:
Contractor Information:
� � .
Contractor. �l L��l' � 1 L- ' � Contact Person: ��� �1�
Address: `�1�� ��L�' � k�£ l���� State Bond#:
�
City: ���1������ Zip:`�����'Expiration Date:
Phone: � � ���� �'��-1 Alternate Phone:
❑ Insurance—Current:
1
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.
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower W asher
Kitchen Sink Water Heater
Disposal �xlu;er Soften�r I
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
� Yes,this section applies
The replacement of only one 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 plutnbing contractor.
Skip ne�section,if this applies; Cost of Pemut $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $�Z'
(Permit Fees Continued On Negt Page)
2
'i .
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$50.00)
x.0125 $
(contract price) (minimum$50.00)
2. STATE SURCHARGE
r.0005 $
(contract price)
3. POSTAGE&IIE\NDLING(Only on Mail-In Applications) $ 2.00
=1. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � ' " "
■ * CONTRACT PRICE �r JOB COST mcans the acit�al or estimated doll�� 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 fumished 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 pernut 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.
PLUlV�1NG PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Plumbing Pemiit, agrees to do all
work in strict accordance with the ordinances of the City and the regularions of the State of
Minnesota, and certifies that all statetnents made on this application are complete, true aud
correct.
Applicant's Signature: � � �.- Date: �� � � � � � �
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