HomeMy WebLinkAbout2002-P05055 - plumbing � � PERMIT
Cfl TYi O F O RO N O Permit Number:
2 7 5 0 K e l l e y P�r k w a y - P O B o x 6 6 P O 5 0 5 5
Crystal Bay, Minnesota 55323 Permit Type: FiXcures
(952) 249-4600 Date Issued: 4�i��2oo2
SITE ADDRESS: 795 Ferndale Rd N
Wayzata,MN 55391
P I D: 3 6-118-23-12-0014
DESCRIPTION:
Proposed Use: xesidential
Permit Class: Plumbing
Permit Sub-type(s):
Permit Type: Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Backflow Preventoer for Residential Springler System
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 500.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Randy Lane&Sons Plumbing&Heating OWNER: Catherine&James Blazier
1501 West Broadway 795 Ferndale Rd N
Minneapolis,MN 55411 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPUCANT PERMITEE SIGNATURE UED BY S(GNATURE
Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthlv Renorts. 1-AssessinQ, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Pemut 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 THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Plumbing peruuts 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 the State Code requirements.
6: All work must be inspected and air tested before it is covered. Call 249-4600. 24-hour notice required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date
the certification. INCOMPLETE APPLICATTONS WILL NOT BE PROCESSED. If you have
questions, call 249-4600.
Please check one: �/; New Addition Repair Replace
�,/ Residential Commercial
JOB SITE: '�1��' � �Z� ��-� t�.�"�.: Zip:
Owner's Name: � Telep ne Number:%`�;j�--�C"�'
i��ailing Address: City: Zip:
Contractor's Name• ` �� � ;,�: ; Telephone Number:(�/,,,1 S�2/-���.�-
l�lailing Address: - . .ea� .�f City: /�n,�.�v Zip: ,S�'�-'//
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BS:�iT 1ST 2ND 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 Misc (list)
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00) y��
S L�p .�� x .0125 $ �,�-.V
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ . `S�
(contrac� price)
or $.50, whichever is greater
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ��7,�O
* 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 chazged to the
customer for the work done. If any material, equipment, labor,or installation are furnished by the owner,
tenant or any other party the reasonable mazket �•alue of such items must be added to the estimated cost
or contract price for pemut fee purposes. In the e��ent that there is a dispute on the amount of the job cost,
the Ciiy 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
correct.
Applicant's Signature: Date:
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