HomeMy WebLinkAbout2012-00130 - water softener ` " CITY OF ORONO PERMIT NO.: 2012-00130
27�0 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 02/15/2012
952 249-4600 FAX: 952 249-4616
ADDRESS : 2320 GLENDALE COVE LA
PIN : 34-118-23-33-0064
LEGAL DESC : GLENDALE COVE
: LOT 005 BLOCK 001
NERM(T TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
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APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
WA'I'ER DOCTORS STATE SURCHARGE PLBG (<$500) 5.00
8201 CENTRAL AVENUE
SPRING LAKE PARK, MN 55432- TOTAL 20.00
(763)286-6243
Minnesota State License#: 082337
OWNER
NOZNESKY, JUSTIN&SARA
2320 GLENDALE COVE LA
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
I'he work for which this permit is issued shall be performed according to
d�e approvcd plans and speciticalions,applicable City approvals,and the
State Building Codc. "I�his permit is for only the�vork described and does
not erant permission for additional or relatetl work which requires separate
permits. All provisions oYlaws and ordinances governing this type of�vork
shall be compied���ith whether or not specitied herein."Chis permit will
expire and become null and void if construction authorized is not
commenced within I 80 days of the date of issuance,or if construction is
suspended for a period of I 80 da��s at any timc after work has commenced.
The applicant is responsible for assuring all required inspections are
requcsted in conlormai �e with thc Statc[3uilding Code.This permit may bc
revoked at anv time�� due cai�e.
� / �� / �O'
Applicant P�rmrtc,e S��n� i Date �� � ��
Issu� av Signature Date
SE ARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
t OR TY IISE ONLY
�� ���� City of Orono /(
�` P.O.Box 66 Date Recei ee.^� 2--�Permit# �o �a ���
� '�;;;R„,,., �t, 2750 Kelley Parkway
� ��'�'�r��= �� Crystal Bay,MN 55323 Approved By: Amount$: ��'
���r�y���/(952)249-4600-Main
�% (952)249-4616-Fax
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
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GENERAL INFORMATION
l. 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 A 1 )
�Residential ❑ Commercial(Approval Required)
�.New ❑ Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need arior apnroval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
Job Site/ Owner Information:
Site Address: �3 a � ��eN DHl-C C (�v e' �- �
Owner: N n Z�� �S K Y ��� Mailing Address:
City: (`�rfOrvD Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: W �'� ��� S Contact Person: � ���
Address: �O( CEKT�2►!}(, 1���' State Bond #: Og�3�-{� �j
City: 5�����`� L� ���Zip:S�s �3z Expiration Date: ( — 3( `" (�'
Phone: 7L3 -S�'S=I�SOa Alternate Phone:
� Insurance -Current: �r�2�— /Z
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� �� � � ��� �PLUMBING FIXTURES B�INCr�INSTALLED '� � ��� � �
FIXTURE BSMT 1 T 2N 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 Miscellaneous
� � � PERMIT FEE CALCULATION(S) �
BASED (�FF - 2002 STATE STA�'UE
,� 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 electrica(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 $ a0�00
(Permit Fees Continued On Next Page)
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PERMI"I' FEF, CALCULATION(S) -JQBS 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)
y � � °� X .0�25 $
(contract price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(contract price)
3. POSTAGE&HANDLING (Only on Mail-In Applications) $ 2.00
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 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 City may request the submission of a signed copy of the actual contract.
� �FL�[JMBING�PERMIT APPLICA��ION AGIZLEMENT � � � ' �
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 statements made on this app(ication are complete, true and
correct.
Applicant's Signature: Date: � �5����
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