HomeMy WebLinkAbout2005-P08782 - plumbing PERMIT
CITsY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P08782
Crystal Bay, Minnesota 55323 Permit Type:
Fixtures
(952) 249-4600 Date Issued:
5/27/2005
SITE ADDRESS: 175 Golden View Dr Unit#
Long Lake, MN 55356
P��� 33-118-23-43-0015
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Plumbing Undefined
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 Valuation: $ 1,750.00
State Surcharge Fee: $ 0.88
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.38
APPLICANT: Bergerson Caswell, Inc. OWNER: Thomas&Lilie Fiepke
5115 Industrial St. 175 Golden View Dr
Maple Plain,MN 55359 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.
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APPLICANT PERMITEE S[GNATURE I SUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Box 66 (2O7R0 Ke011ey Parkway) APPLICATION FOR PLUMBING R�R�V[�'�-o��Nd
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID LINTIL 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice required.
Instructions Complete all items on this application. i,ompute the permit fee. Sign and daie the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions,
call (952) 249-4600.
Please check one: New Addition Repair Replace
,�1 Residential Commercial
JOB SITE: /�S �'OLvf/r/ �1l�cJ ,�r�- , �,��'�✓C� , /�it/ Zip:
Owner's Name: �'�lli�� �itP,e-� Telephone 1Vumber: �.��-�3? o?l�/
Mailing Address: sAin City: Zip: �i 53��3
Contractor's Name: f.��f2se�/� -Asc�'�// / C- Telephone Number: 7G.3 y��-3/�-/
Mailing Address: S%/s jrvdUsi,E'�r�G S�` � City:/'�Ild�� O�Airt-� Zip: 3rS35�
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1 ST 2ND OTHER FIXTURE BSM 1 S 2ND OTHER
TYPE FL FL TYPE T T FL
FL
Water Closet Floor Drains
Lavato Sewer E'ector
Bathtub Laund Tra
Shower Washer
Kitchen Sink Water Heater
Dis osal Water Softener
Dishwasher Wet Bar
Sillcocks Misc list ,�
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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 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 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�
���� ����'� utii f5 %7S� �D x .0125 $ ��. 00
(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 Hanciling (Only mail-in applications) $ 1.50
4. TO�'AL PERMIT FEE (Add lines l-3 above) $ -313�
* 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 m�:st be adc�ed tr +h� �s±imate�+ �ost o: contract price �or 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 SURCHARGE is .0005 of the contract price under $1,000,000 or $.50-whichever is greater.
For valuations over$1,000,000 call the Department of[nspection Services for the price.
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 application are complete, true and correct.
Applicant's Signature: ������� Date: S o`�3� d5