HomeMy WebLinkAbout2010-00761 - plumbing CITY OF ORONO PERMIT NO.: 2010-00761
'�� 2750 KELLEY PARKWAY
' ORONO, MN 55356- DATE ISSUED: 08/24/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3355 GRAHAM HILL RD
PIN : OS-1 17-23-1 1-0008
LEGAL DESC : GRAHAM HILL PRESERVE
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING (> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCT[ON TYPE : FIXTURES- MULTIPLE
NOTF,: WATER SOFTGNIiR
IRON FILTER
REVERSE OSMOSIS
VALUATION OF PLUMBING 3800
APPLICANT
PLUMBING FIXTURE FEE 50.00
CLEARWATER SYSTEMS, INC. STATE SURCHARGE PLBG (VALUATION) 5.00
1519 148TH AVE NW
ANDOVER, MN 55304 TOTAL 55.00
(763)434-0445
Minnesota State License#: 61240
OWNER
Graham Hill Partners LLC
15050 23RD AVE N
PLYMOUTH, MN 55447-
AGREEMENT AND SWORN STATEMENT
Thc work for which this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or rclated work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specilied hercin."I'his permit will
expire and become null and void if construction authorized is not
commenced«ithin 180 days of the date of issuance,or if consVuc[ion is
suspended for a eriod of 180 days at any time atter work has commenced.
The applican ' res�i e tbr assuring all required inspections are
requ te �n con� �a with the State Building Code.This permit may be
rev at an �me � r ue cause.
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� 1 / �� / /
ic itec Signature ' Date Issued B ignature
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO
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FOR CITY USE ONLY "
. � O,¢p�O City of Orono
P.O.Box 66 Date Received: Permit#
� �;?, 2750 Kelley Parkway
a �� � ���� Crystal Bay,MN 55323 Approved By: Amount$:
�� �.a� (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Buiiding Official or Inspector)
GENER:AL INFORMATION
L 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. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOli RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB STTE
3. Plumbing pernuts 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 pernut 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 prior approval and may need CUP. (Per Orono City Code, Chapter 78,Article IV)
Job Site/ Owner Information:
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Site Addres •s_..�--��� —�� ' ;>.�i-�L---- .��� � .
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Owner��,����-�� ��l ��� Mailing Address:
City: Zip:
Home Phone: Alternafe Phone:
Contractor Information:
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Contracto : _ f- � -1 i(-��' �i'�,� ContactPerson: �'��
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Address:`�j� / �G�,� State Bond #:
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City: � � Zip�a 5_z'� )Expiration Date:
Phone: �;,�Z —�z���/�..� Alternate Phone:
❑ Insurance—Current:
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FI�TURE 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 Washer
Kitchen Sink Water Heater
Disposal Water Softener j
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Dishwasher Wet Bar
Sillcocks Miscellaneous
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��,���: � PERMIT�FEE CALCULATION(S) � : � ���
�� �' '`" �'- �� BASED OFI' 2002 STATE STATUE ��' "` '�� � �
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❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not requue modification to electrical or gas service.
2. Has a total cost of$500.00 or less; excludin�the cost of the fixhue or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section, if this applies; Cost of Pernut $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
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,,- � . ..
N _.,, ; m�{ :�°� PERMIT:FEE�CALCLTLATION(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$50.00)
�-������� x.0125 $
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00)
x .0005 $
(contract price) (minimum� 5.00)
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
pernutted 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.
• ** The STATE SURCHARGE is .0005 of the contract pnce under$1,000,000 or$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
�A;GRE'EN.tENT'�4 �
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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 Signa Date• �
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