HomeMy WebLinkAbout2006-P10153 - vacuum breaker '�
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PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P10153
Crystal Bay, Minnesota 55323 Permit Type: Vacuum Breaker
(952) 249-4600 Date Issued:
7/28/2006
SITE ADDRESS: 2920 Fox St Unit#
Long Lake,MN 55356
PID: 04-117-23-31-0018
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Vacuum Breaker Permit Sub-type(s): Vacuum Breaker
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 15.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc. Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: Weld&Sons Plumbing Company,Inc. OWNER: Mr. &Mrs. Chad Abraham
3410 Kilmer Lane N 186 Seminary Dr
Plymouth,MN 55441 Meulo Park, CA 94025
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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APPLICANT PERM[TEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, i-Assessing,(If Septic, 1-Septic) Page 1
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��¢����, City of Orono FOR CTTY USE ONLY
�� �� P.O.Box 66 Date Received: Permit#
�� .„ . ��: 2750 Kelley Pazkway
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�,� �'�'� ��,�, ��;� Crystal Bay,MN 55323 Approved By: Amount$:
`� �s'�,y� ,�.� � (952)249-4600
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CITY OF ORONO-PLUMBING PERMIT
(All Commercial permiLs must be approved by the Building Official or Inspector)
GENERAL INFORMATION
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 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 permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new const�vction 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 A 1
�Residential ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs [�Replace
❑ In Accessory Structure?
*You will need arior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address: �L���T-�' j-��}( S-(�t�f'
Owner: 't���-,��i��;,� Mailing Address: n��2G j`-G3� -t��
City: �%'�i;.��� � n� �J Zip: �_�`3`-i�
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �✓�� 1i:1 C%y�� S�v�-, ��;,z,M b,r4 Contact Person: I �'�^'� Su��r�
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Address: State Bond#: j�_ g�U -=7��
C�ty: Zip: Expiration Date: IZ'�'� -'��
Phone: Alternate Phone: �ij�-ZZ�-U��y
Weld & Sons Plumbing � Insurance-Cunent: SC�-Cv�/�t� �✓� �.�G
3410 Kiimer Lane North
Plymouth, MN 554�1 i
763-475-0296
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathroom Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous -
V�Cu�,� �r4 �r �
��� PERMIT FEE Ct�LC�UL�T10N(S) � �
BASET3 OFF —2002 STATE STATUE
[� Yes,this section applies
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The replacement of a Residential fixture or aonliance that meets a(1 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;excludine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed coniractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $ , v�
(Permit Fees Continued On Next Page)
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��'�CALCT.ILATION S -JOBS OVEI2 $5'OO.Ot�. P �:;
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
x.0125$
(coniract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee ofS.50)
x.0005 $
(wntract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ ].50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
• * CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 installations aze furnished by
the owner,tenant or any other party,the reasonable mazket 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 SURCNARGE 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.
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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 Staxe of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: --�i--' Date: 7 Z�--0�
�- ,�� Resa�t 6fl � '
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