The URL can be used to link to this page

Home My WebLink About2015-00286 - plumbing CITYOFORONO * 20 15 - 00286 * ,,.� 2750 KELLEY PARKWAY DATE ISSUED: 03/10/2015 , ORONO, MN 55356- 952) 249-4600 FAX: 952 249-4616 ADDRESS : 1165 FERNDALE RD W PIN : 02-117-23-43-0026 LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL COI�ISTRUCTION TYPE : FIXTURES- MULTIPLE NOTE: WATER SOFTENER IRON FILTER RF,VGRSE OSMOSIS VALUATION OF PLUMBING 3900 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 1.95 CLEARWATER SYSTEMS, INC. TOTAL 51.95 1519 148TH AVE NW Payment(s) ANDOVER, MN 55304 CHECK 34270 51.95 (763)434-0445 Minnesota State License#: plbg-61240 OWNER BROOK, ROBERT 1165 FERNDALE RD W WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 da s at any time after work has commenced. The applicant is responsibl r as uring all required inspections are requested in co f6'rman with t State Building Code.This permit may be revoked a y time r e c ( ' �. /� i�� /v � �� Lf '-�i /� � !S � icant i ee gnature Da Issu.e�d By Signature Date � � FOR ITY USE ONLY �� City of Orono � � �O�O P.O.Box 66 Date Received� �rmit�lS — 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: (952)249-4600—Main (952)249-4616—Fax �� j/� � �` CITY OF ORONO — PLUMBING PERMIT �✓ � " s� ��kEs H o��" (All Commercial Permits Must be Approved by the State Prior to C�ty Approval) htt :Uw�v��.ctli.n�n. o�>/CC:LD/PUF/�e �lumb �lanre��a � . d1' GENERAL 1NFORMATION 1. You may apply for plumbing permits 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 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 Apply) �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 IV) Job Site / Owner Information: Site Address: ll k�S ��!l . ��Z cYl�C�� Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor��Ir�tc�`b`-�` Sf9S. �'� Contact Person: !/1 1 � Address:�S/y�r� �� /tJt� State Bond #: City: ��1�V�;-�� Zip:�53�y Expiration Date: Phone: 7(�`j --`{.3�`o�f�S Alternate Phone: ❑ Insurance—Current: 1 � � PLUMBING FIXTURES BEING 1NSTALLED 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 Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscella(�neous .X "�.� Y-�� ` � . /� 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; excludin�the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed plumbing contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 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�50.00) �j�J�� x .0125 $ � (contract price) (minimum$50.00) 2. STATE SURCHARGE x .0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 0 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ �` � �v ■ * 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. lt is the amount to be charged to the customer far 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 Ciry may request the submission of a signed copy of the actual contract. PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City for issuance of a Plumbing Pennit, agrees to do all work i�� strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that al] statements made on this application are complete, true and correct. �,:-'� i�` � Applicant's Signature: 2 � Date� O � � 3