HomeMy WebLinkAbout2008-00115 - plumbing R •
CITY OF ORONO PERMIT NO.: 2008-00115
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE Iss[1En: 08/06/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 575 FERNDALE RD N
PIN : 36-118-23-14-0001
LEGAL DESC : LJNPLATTED 36 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE:
BATHROOM FIXTURES: (1)WATER CLOSET,(2)LAVATORIES,(1)BATHTUB,(1)SHOWER
VALUATION OF PLUMBING 6200
APPLICANT PLUMBING FIXTURE FEE 77.50
FRANK MOTZKO PLUMBING STATE SURCHARGE PLBG(VALUATION) 3.10
4201 ZARTHAN TOTAL 80.60
MN 55416-
(952)929-6048
Minnesota State License#: 058694-PJ
OWNER
DAYTON,JAMES&MEGAN
575 FERNDALE RD N
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this perrnit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and [he
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is no[
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked�y time for due cause.
`` ���..��� �'� � � a� �� �"�D�� D�'
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Applicant Permitee Signature Date s ed By Signature Date
SEPARATE PERMITS REQUIRED FOR WO K OTHER THAN DESCRIBED ABOVE.
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FOI2 CTTY USE O!VLY '
��� City of Orono
P.O.Box 66 Date Received: Permit#
+/�,;:; � 2750 kelley Parkway
�� ��j' *s'� Crystal Bay,MN 55323 Approved By: Amount$:
'�''�rv�°r��}. � (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved bv the Building Official or Inspector)
GENERAL INFORMATION
L 1"ou may apply for plumbing pernlits by mail or in person at the City offices. Applications 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 UNTIL YOU RECENE 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 ho�r notice required)
TYPE OF PERMIT
Check All That A I
�Residential ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78,Article N)
Job Site /Owner Information:
Site Address: S7� ��o�f,,E}L I) � e`7
Owner:�,n�.�14�u /�a��s.,� Mailing Address: �7'� �����.�J��2�� IV
City: � 3Zvn�c'� Zip: ��"�.��5 G�
Home Phone: �2- Y�-�- /S"S 3 Alternate Phone:
Contractor Information:
Contractor: (•��,�� r ; « (�g� Contact Person: �o� Vh�zu:o
Address: -l/�� ��.2���A-.a At9s State Bond #: ,�o�9�(� P/Y(
City: �:Ld�� P,R�e Zip:�� Expiration Date: /� -3% 'n8
Phone: ��Z-Q2�'loC7!'�i' Alternate Phone: ��'s?�/7�24ic�
❑ Insurance-Current:
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� � .: � �,, ����� .,� `��� PL�C:�B��i; ..� ��� ���� �°S BEIN���f'�T��,�7����� � ��:F,��«�
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1' 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet � Floor Drains
Lavatory � Sewer Ejector
�- / Laundry Tray
8�t� T�r3 �
Shower � Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
�� PERMIT �EE CALCULATION(S) � �
BASED nFF - 2002 S'T'ATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
]. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine 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 Permit $ l 5.00
State Surcharge $ .50
Mail-In Fee(If Applicabie) $ 1.50
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
, , ,
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$35.00)
t�
��(�:�.� c x.0125 $
(contract price) (minimum$35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Appiications) $ 1.50
� 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
estimated cost or contract price for permit 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 Building Department at(952)249-4600 for the price.
PLUMBING PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City far 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: �� ���1�-������ Date: �,��U�
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