HomeMy WebLinkAbout1995-007515 - plumbing � . PERMIT
' CiT�1( OF ORONO PERMIT TYPE:
2750 Ke�ley Parkway- P.O. Box 66 ._.
Crystal Bay, Minnesota 55323 Permit Number: _
(612) 473-7357 Date Issued: _ -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: '°"'' � '``� OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE .
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APPLICATION FOR PLUMBI�OPERMIT
rkway) �
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piumbing permits by mail or in person at the City offices.
� sent by retum mail after a review is completed. PERMITS ARE NOT VALID
:IVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
JOB SITE.
ay be issued ONLY to licensed plumbing contractors and to property owners residing
cruction or remodeling is involved, a separate building permit must be obtained.
�ne in accordance with the Stace Code requirem��ts.
�pected and air tested before it is covered. Call 473-7357. 24-hour notice required.
all items on this application. Compute the permit fee. Sign and date
✓IPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
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New Addition Repair � Replace
� Residential Commercial
�7 E,�S�-�%1���'�4�', �G'� Zip:
��� TelephoneNumber: ���,�- G��
City: Zip:
e� �, TelephoneNumber: ,3'�y/�1..��
fZ City: Zip: .5�5����
PLUMBING FIXTURE SCHEDULE
1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
FL FL TYPE FL FL
Floor Drains
Sewer Ejector
Laundry Tray
W asher
.,
Water Heater
Water Softener
Wet Bar
Misc (list)
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
�j��, �-�) x .0125 $
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ � 7� G'C�
* 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. ic is the amoun� to be chargen to tne
customer for the work done. If any material, equipment, labor, or installation 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.
** 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 Inspectional 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
,r,n_ri'P�r,
� /� Date: /l�� � ''
Applicant's Signature: �� -?���+9�'�1��