HomeMy WebLinkAbout2007-P10894 - plumbing PERMIT
CITY ��F ORONO
27�� Kelley Parkway- PO Box 66 Permit Number: p1o894
Cryst�l Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: 4/17/2007
SITE ADDRESS: 1640 Fox St Unit#
Wayzata,MN 55391
PID: 03-117-23-14-0002
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Fixtures Permit Sub-type(s): Plumbing Undefined
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Drinking Filter
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 600.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Clear Water Systems Inc. OWNER: Conley&Carol Brooks
1519 148th Ave NW 1640 Fox St
Andover,MN 55304 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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P MITEE SIGNA ISSUED B SIGNATURE
Copies: 1-File(Sig�zatures Reguired), l-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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� 1��)R C1��Y I:SE OVLY
. ��j�� City of Orono
P.O.I3ox GG �Dafe Received: Permit#
��;,;..,,� � 27�0 ICelley Parl:way
`� �Il�'�A�.';;�_ �, Ciystal Aay,MN�i323 Approvcd I�y: An�ount S:
�'"�(t'�j�r;��o� (952)249-4600
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CITY OF ORONO -PLUMI3ING PERIVIIT
(All Commercial permit�must Uc approved Uy the E3uilding Ol'ficial or Inspcctor)
GENERAL INFORMATION
1. You may apply for plumbin�pem�its by mail or in person at the City offices. Applications will be
reviewed and a pernut will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERIVIITS ARL;�IOT
VALID UNTIL YOU RECEIVE A PERMIT. �VORK MUST NOT BEGIN UNTIL THE
PT1Zi17IT CAI2.D IS POSTED ON THE JOB SITE.
3. Plumbing permits inay be issued ONLY to licensed plumbi�lg contractors and to property owuers
residing in the dwelliilg.
4. When any new constniction or remodeling is involved, a separate building permit must be
obtaiued.
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►•equired)
TYPE OF PERMIT
(Check All That Apply)
�] Re�sidential ❑ Conu7�ercial(Approval Required)
❑ N�w ❑ AddiYional ❑Repairs ❑ Replace
❑ In Accessory Sri-uchire'?
"'l�011 Pri[i iii;i;ti jii i(iC :lj3j�f'v'r'iil ilI1C1 i11a�/il(;l;U Cv C. �t"CI'liiUIlO�.1Ly' C,OCiC� �,�i£L�7l�.i 7u�Hl'iiC�lt L V)
Job Site/ Owner:tnfonnation: _ �
Site Address: L�O�(� 1�X S�-
Owner:�S�����u�� Mailing Address:
City: Z,ip: _
Home Phone: Altci7�ate Pliolle:
�Oliilc`3CtOI' iilfGil11ut1Cii: I
�OI1t1'i1Ct01': Q�9� � �� �011tc`iCt �GI'SOli: ��h'\ ��S�/L/
Acidress: �S(�'-/ J�� �v. lvt,�J, State Bond #: (-+�- ��3
Clty: �n�ov� 2 Zip5S3oXExpiration Date: ��1 0
P17one: 7�03'`C3�-O��S' Alternate Phone: ��°�`��� ��C� �
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❑ Insuratice- Ctlrrent:
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� PLUMI3ING FIXTURES BEII�G INSTALLED _
FIXTUR� BSMT 1 2' OTHER FIXTURE BS'_VIT 1' 2 OTHER
TYPE FL PL TYPL' FL PL
Water Closet Floor Drains
Lavatory Se�;�er Ejector
Bathhib LaLmdry Tray
Shower Washer
ICitchen Sink Water Heater
Disposal Water Softener
Dishwasller Wet Bar
Sillcocks �i�scellaneous �
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PF,RMIT FEE CALCUL�ITION(S)
BASED OFT - 2002 STATL STATUE
❑ Yes, this section applies
The replaceinent of a Residential fihhire or appliance that meets all tlu•ee of�the follo�ving requirements:
1. Does not requize modification to eleehical or�as service.
2. Has a total cost of$500.00 or less; excluding the cost of the �('ixture or appliai�ce: and
3. Is improved, installed oi•replaced by the homeo��ner or licensed eontractor.
S]<ip nest section, if this applies; Cost of Perrnit $ 15.00
State Stu�charge S .�0
Mail-In Fee (If Applicable) $ 1.50
�'otal Pere�iit Fee �
(1'erenit Fees Continued On Next Page)
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� PEIZIVIIT FEE CAI..CULATION(S)—J0�3S OVEP` $500.00 �
If above does not apply;follow guideluies below:
1. CONTRACT PRICE *is 1.25%of conhact price with a(Minimum Fee of$35.00)
C���� x.0125 $
(contract pricc) (minimum S35.00)
2. STATb: SURCHARGE �`* Add tl�e State Bldg Code Div. Surcharge(Minimum Fee of�,.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ �-5�—
4. TOTAL PERIVIIT FEE (Add Lines 1-3 Above) $ ���v
■ * CONTR�CT PRIC� or 70B COST means the achial or estimated dollar amount charged for the
pern�itted�vork including nlaterials, labor, profit, and odier fixed costs. It is the amount to be charged
to the custoiner for the work done. If any material, equipment, labor or installations are furnished by
the owner, tenant or any other party, the reasonable niarket value of such items must be added to the
estimated cost or conh-act price for permit fee puiposes. In t11e event that there is a dispute on tl�e
amount of the job cost, the City may request the subnussion of a signed copy of the acriial connact.
- ** The STATE SURCIIAI':GE ;s .0005 of the contract price under �1,000,000 ar $.�0 — whichever is
greater. For valuations over$1,C00,000 call the Buildin�Dcpartment at(952) 249-4600 for the price.
PLUMBING PERIVIIT APPLICATION AGItEEMENT
The undersigned hereby applies to the City for issuance of a Plumb�ng Pet7nit, agrees to do all
worl< in strict accordance with the ordinances of the City and the regulations of the State� of
ivli1l11eSUia, drici cCIi11iCS `Li1di �1ii si�tict "I�iS illaii� Uil i113S d��ii(:�iii0ii dic CGiii�icti;, iTii� aiiu
correct.
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Applicant's Signattire: Daie: � � _
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