HomeMy WebLinkAbout2010-01215 - plumbing CITY OF ORONO PERMIT NO.: 2010-01215
} '" 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 12/30/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2943 FARVIEW LA
PI N : 04-I 17-23-34-0008
LEGAL DESC : FARVIEW
: LOT 008 BLOCK 001
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOT'E: MISCELLANEOUS FIXTURE-REVERSIS OSMOSIS
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CLEARWATER SYSTEMS, INC. STATE SURCHARGE PLBG(<$500) 5.00
1519 148TH AVE NW TOTAL 20.00
ANDOVER, MN 55304
(763)434-0445
Minnesota State License#: 61240
OWNER
WILSON & TARA SULTON, GARY
2943 FARVIEW LA
LONG LAKE, MN 55356-
AGRF.EMENT AIYD SWORN STATEMENT
1'he work Ibr which this permit is issucd shall be performed according to
the approvcd plans and speci�ications,applicable City approvals,and the
S[ate Building Code. This permit is Cor only the work described and does
not grant permission for additional or related work���hich requires separate
permits. All pro��isions of la�vs and ordinances�oveming this type oCwork
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced���ithin l80 days of the date of issuanee,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant,is responsible for assuring all required inspections are
requesled i co mance wilh the Stale}3uilding Code.This permit may be
revo e t a ti��ic f�due cause.
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' plic 'ermitec Signature Date Issu y Signature Date
� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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FOR CITY USE ONLY
� �p� City of Orono l.� ]� �
. ' O4 `YO P.O.Box 66 Date Received:/L^�v�`PermiY':#�lG "d ��
�,;. 2750 Kelley Parkway
�'' Crystal Bay,MN 55323 A roved B Amount$: e�'�
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CITY OF ORONO— PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or lnspector)
GENERAL INFORMATION
1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be
reviewed and a pernut will be issued within two working days.
2. Pernut 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 annro��al and may need CUP. (Per Orono City Code, Chapter 78,Article IV)
Job Site/ Owner Information:
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Site Address:����� i 1��7�'c-'-' c_ C-�� �.��_'
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
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Contractor:'��-y�r�_�� ;��'i' �j����=1� ContactPerson: � '��
Address: /�%�/' /''� .gv' /t-� �-� State Bond #: ��1z' �'�?/�z`� �
Cit Zip:�`�z= �Expiration Date: !�J/�i/
y: ��'• )cl�:�:_ � -
Phone: T�>3 -�3��'S"/ S Alternate Phone:
❑ Insurance—Current:
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�, � .. . `�J�SBIl�G�FIXTURES BEING 1NSTALLED ' ;
FIXTURE BSMT 1' 2 OTHER FIhTURE BSMT 1' 2 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 Miscellaneous
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�� �PERMIT�FEE CALCU:LATIQN(S)� � z
__ r BASED OFF - 2002 STATE STATUE �� �
� Yes,this section applies
The replacement of a Residentia]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; excludin�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 Pemut $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
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` � ��� PERIvIIT FEE�CALCi7LATTON(S)-JOBS OVER �,�00 00 '"''` `'' �`
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If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
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_���J ` x.0125 $
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00)
x .0005 $
(contract price) (minimum$ 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 �
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
• * COI`'TRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pemutted 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 pnce 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$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
���' REEIVIENT'
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
wark in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statemerrts made on this application are complete, true and
correct.
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Applicant's Signatur • ����''� i �'— Date:f "�� ��'
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