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HomeMy WebLinkAbout2005-P09166 - plumbing PERMIT CIT`."�'�F ORONO 275� Kelley Parkway- PO Box 66 Permit Number: P09166 Crystal Bay, Minnesota 55323 Permit Type: Fixtures (952) 249-4600 Date Issued: 9/13/2005 SITE ADDRESS: 3060 Fox St Unit# Long Lake,MN 55356 PID: 04-117-23-32-0002 DESCRIPTION: Proposed Use: Residential Permit Class: Plumbing Permit Type: Fixtures Pern,it Sub-type(s): Water Heater DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 15.00 valuation: $ 0.00 State Surcharge Fee: $ 0.50 Misc. Fee: $ 1.50 TOTAL FEE: $ 17.00 APPLICANT: H.P. Pipeworks OWNER: Robert&Kimberly Melamed 3670 Dodd Road Suite 100 3060 Fox St Eagan,MN 55123 Long Lake,MN 55356 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. � C�1��k-�-�C APPLICANT PER'�tITEE SIGNATURE SUED BY SIGNATURE Copies: 1-File(SignaturesRequired), l-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1 ��� CITY OF ORONO APPLICATION FOR PLUMBING PERMIT Bol 66 (27�0 Kelley Parkway) Crystal Bay, MN ��323 GENER�L LNFOR1�iATION 1. You may apply for plumbing permits by mail or in person at the Ciry offices. �. 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 con[ractors and to property owners residing ui the dwelling. -�. When any new construc[ion or remodeling is involved, a separate building permit must be obtained. �. All work must be done in accoraance with the State Code requiremen�s. 6. All work mus: be inspected and uir tested before it is covered. Call (952) 249-4600. 24-hour notice required. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call (952) 249-4600. Please check one: New Addition Repair ✓ Replace ✓Residential Commercial JOB SITE: :�(�� ��C. 5� • Zip:�Cj �S�o O«ner's Name: p1�j.Q,( Q� � Telephone Number: �rj�-�3�-�{()�� l�Iailing Address: j�•r�� City: �(�n V Zip: -�j S 35� Contractor's Name: p��.S Telephone Number: /�'(-�,� �-�i..�p i��ailing Address: �Yj� p�� �d - City:� ' Ctiri Zip: ��� �3 PLUNIBING FIXTURE SCHEDULE I FIXTliRE SSViT iST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL FL TYPE FL FL �Va�er Closet Floor Drains La�atory Sewer E'ector Bathrub Laund Tra Shower Washer Ki[chen Sinlc Water Heater Dis osal Water SoBener Dishwasher Wet Bar � Sillcocks Misc (list) � `7 - C� ��� —�+�1' PERMIT FEE CALCULATION(S) � 2002 State Statute � Yes, This Section Applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: , 1) Does not require modification to electrical or gas servic�. �� 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 licenced contractor. Skip next section; Cost of Permit $� 15.00 State Surcharge $ .50 Mail In Fee $ 1.50 If above does not apply, follow guidelines below: 1. Contract Price* is .0125 % of job with a Minimum Fee of ($35 00) x .0125 $ (contract price) (minimum $35.00) 2. State Surchar�e. ** Add the State Building Code Division a (Minimum Fee of $ .50) x .0005 $ (contract price) (minimum $ .50) 3. Postage and Handling (Only mail-in applications) $ 1,50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ _�� � � 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 charged 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 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 acrual contract. *" The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is grea[er. For valuations over $1,000,000 call che Department of Inspection Services for the price. The undersigned hereby applies to the City for issuance of a Plumbing Pernlit, 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' ,his �pplication are complete, true and conect. Applicant's Signature: � Date: p �I Q�