HomeMy WebLinkAbout2005-P08646 - water softner f
" PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P08646
Crystal Bay, Minnesota 55323 Permit Type: Fix�ures
(952) 249-4600 Date Issued: 4iz�i2oos
SITE ADDRESS: 312s Fox st
Long Lake,MN 55356
P I D: 04-117-2 3-3 3-0011
DESCRI PTION:
Proposed Use: Kesidential
Pernut Class: Plumbing
Permit Sub-type(s): Water Softner
Permit Type: Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Water Softener,R.O.,Iron Filter
FEE SUMMARY: PermitFee: $ 15.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 15.50
APPLICANT: Clearwater Systems OWNER: Timothy&Gayle Devries
1519 148th Avenue NW 3125 Fox St
Andover,MN 55304 Long Lake, MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEIVIENTS SPECIFIED
AND AGREES T DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOT UILDING CODE REQUIREMENTS.
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A L N RMITEE SIGNATURE I "SUGD BY SIGNATURE
Copies: 1-File(SiQnitures Required). 1-Aovlicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
� FOR C[TY USE ONLY
� City of Orono �, .� ?
� � '� P.O.Box 66 Date Received: �'—/'��� Permit#
_ ��i,� � 2750 Kelley Parkway
� j'�?�,�;3 � Crystal Bay,MN 55323 Approved By: Amount S:
���oyo (952)249-4600
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CITY OF ORONO -PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing pernuts 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. 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 pernuts may be issued ONLY to licensed plurnbing contractors and to property owners
residing in the dwelling.
4. When any new consnuction or remodeling is involved, a separate building pennit 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 arior approval and may need CUP.(Per Orono City Code, Chapter 78,Article IV)
Job Site/ Owner Information:
Site Address: ��2-� �JC
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Owner:L�n� ���Sor���c��" Mailing Address:
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City: S , Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: 9�� n,� Contact Person: ,�m �/.Sol�
Address: /S�� ��(�� N(.J State Bond#: (�JC 373
City: Zip:�.�o�{ Expiration Date: /Z�3/�D.S � �
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Phone: 7(T-5���-��J Alternate Phone:
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❑ Insurance-Current: �
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PLUMBING FIXTURES BEING INSTALLED
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 W asher
Kitchen Sink Water Heater
Disposal Water Softener '
Dishwasher � i �
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Sillcocks Miscellaneous
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PERMIT FEE CALCULATION(S) �
BASED OFF - 2002 STATE STATUE
� 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 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 contractor.
Y
Skip next section, if this applies; Cost of Perrnit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50 -
Total Permit Fee $
(Permit Fees Continued On Next Page)
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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$35.00)
x.0125 $
(contract price) (minimum$35.�0)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(conh-act price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 �
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
■ * CONTRACT PRICE ar JOB COST means the actual or estimated dollar amount charged for the
peinutted 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 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 conhact price for pernut fee pwposes. 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 SURCHARGE 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.
' ` .PLUMBING PERMIT APPLICATION AGREEMENT
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 ements made on this application are complete, true and
correct.
Applicant's Signatur . Date: � ��
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