HomeMy WebLinkAbout2010-00077 - plumbing � CITY OF ORONO PERMIT NO.: 2010-00077
2750 KELLEY PARKWAY
� ORONO, MN 55356- �ATE ISSUE�: 02/1U2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 155 GOLDEN VIEW DR
PIN ; 33-118-23-43-0014
LEGAL DESC : PETERMAN 2ND ADDN
: LOT 005 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
COIVSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
ST. CROIX VALLEY ECOWATER STATE SURCHARGE PLBG (<$500) 0.50
3440 YOERG DR
HUDSON, WI 54016- MAIL-IN FEE 1.50
Minnesota State License#: 064997-WC TOTAL 17.00
OWNER
SMITH, DOUGLAS
I55 GOLDEN VIEW DR
LONG LAKE, MN 55356
AGREEMENT AIVD SWORIV STATEMENT
"1'he work for which this permit is issued shall be perfornied according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which rcquires separatc
pennits. All provisions of laws and ordinances governing this rype of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period ot�180 days at any time a�ter work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State[3uilding Code.This permit may be
revoked at any time for due oause.
♦
��� � i i i i
Applicant Permitee Signature Date Issued By " ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO
Jan-Z.�-2005 10:48am From-CITY OF ORONO +9522484616 T-466 P �02/003 F-033
t '� � A,
CITY OF ORONO APPLICATTON �'OR PLUI-IBL'�1G PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
G��IETtAL IlVFORM TI N
1, You may apply for plumbing permiu by mail or in person$�the City offices.
2 Perm�L�r E1VE A pERM T e W QR�MUST NOT BES IN UNTI TH£PBR1�tIT�ARD S PO D�D OIN
YOU REC
'HE JOS S1TE• owners tesiding
3. Plumbting p��its may be issued ONLY co licenscd plumbing conuactots aad �o properry
,n�he dwelling.
4, When any neW+ construction or remodeling is involved, a separace buildwg Permi[must be obiained.
S. All work must be done in accordance wich che Sia�e Code requirements.
5. All u�ork mus� be in4pecced and a�r tesud before it is covered. Csll (952) 249-46a0. 24-hour nocice
required.
Instructi�ns Comglete ali items on LiCa�TI�Ns WILL NOT BE P OCESSED n If youthave
cercificacion. INCOMPLETE aPP
questions, call (952) 249-4600.
Addition Repair �Replace
Please check one: �e�" Commercial
Residential
�y j 4�
JOB SITE: 1 S�l�c�lc��a� (,%1�t.t.� �4� (�i6 E'�I�,�v �'1')l�� s�' Zip:� -3� '
Owner's Name. t l a 5 t'Y1 � Telephone Number: �S�'�'��' �
- .� _ � City: � �F , ' � Zip:y S��L�
vlailing Address: ��� ��'�'n ' } � _�� TelephoneNumber:`>iS� �8�- ����7
Contractor's Name:�-I-- ��r City: ��c.zc� Zip:_��G'/„�
,
Mailing Address:��D .�, �-Y 4'� �; p
LY.1Vi ING FIXTL'RE SCHED E
�,�g� BSMT 1ST 2ND O7HER FIXTURE BSMT pL ZFND I OTHER
�ixT TYPE
TYPE FL FL
�loor Drains
W aser Closet
Sewer E'ector
Lavato
Laun Trav
Bachnib
W asher
Showcr
Wacer Hea[er
Kitchen Sinlc '
Waur Softcner
Dis sal
Wet Bar
Dishwasher
Misc (list)
Sillcocks �
Jan-ZI-20D5 10:48am Fram-CITY OF ORONO +95224A4616 T-466 P 003/003 F-033
� ✓ .
pF�r_ CAL U7.ATI��1
?�U2 State St tute ��, This Seciion Applies
The replacement of a Residencia fixture or a liance that meets all �hree of the fallowing
requirements:
1� D_oes n�require modification to electrical or gas service. �
Z) Has a caral cost of S500.00 or less; excludin the cost of che fixture or appliance:
and
3) Is improved, installed or replaced by the homeowner or licenced contractor.
Cost of Permir S 15.00
Skip next section; SQ
State Surcharge �
I�v1ai3 I.^. Fee 5 1 50
If above does not apgly, follow guidelines below:
1.
Contr ct Price* is .0125 %a of job with a 1�Iinimum Fe of �35-00)
x .0125 S
(convact price) (minimum 535.0�)
2, State urch r�e. "`* Add the Sta�e Building Code Division a (I�Iinimum Fee ot $ .��)
x .0005 �a
(concracc price) (muu.mum S .5�)
3. Pos a�e and an lin� (Only mail-in applications)
� 1.50
4. TOTAL PERMIT FEE t
Add lines 1-3 above) �
CpK7RACT PIt10E or 30B COS7 means�he actual or esdmated dollar unount charged tor the permitted
t work inciuding enaceTi�i6,14t�o=,gT°F�t.and ocher fixed costs. It is the amoun[to be charged co the customer
for the work done. If any material, equipmeni, iabor,or inscalia[ion ara ��n'•:sh�d bY we p`"rner, tenanc or
azyy o�G1 p�y the reasonable market value of such items u�on the amounc of theob�osto,sctie=C ry may
price for pezmit fee purpose9. In�e�Yenc�hat There is a disP
request the subm�ssion of a s�gned copy of►he acmal conCract•
** 'ihe STATE S(1RCHARCE u •�5 of the enntract price�d�uon�S�e�rvi�for th price.�hever is gr�acer.
For valuacions over$1,000,000 cail �h� D�P�en�of tnspec
The undersigned hereby applies �o the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinanees of the Ci�y and che regulations of the State of
Minnesota, and eertifies chac all statements made on this application are eomplece,
crue and
correct. / ' �
� Date: � ( l" �l J
ppplicant's Signacure: