HomeMy WebLinkAbout2010-01210 - water heater replacement _ .. CITY OF ORONO PERMIT NO.: 2010-01210
� 2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE �ssuEn: 12/28/2010
952 249-4600 FAX: 952 249-4616
ADDRE�S : 1480 GREEN TREES RD
PI N : 1 1-1 17-23-23-0016
LEGAL DESC : GREEN TREES ON TANAGER LAKE
: LOT 006 BLOCK 001
PERMIT TYPE : PLUMBING (> $500)
PRONERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NO'�E: WATGR HGATGR REPLACEMEN"I'
VALUATION OF PLUM[3ING 1600
i
APPLICANT PLUMBING FIXTURE FEE 50.00
ADAM'S ON TIME PLBG STATE SURCHARGE PLBG (VALUATION) 5.00
13791 JONQUIL LANEN
DAYTON, MN 55327- MAIL-IN FEE 2.00
(612)205-6060 TOTAL 57.00
Minnesota State License#: 066818 PAID WITH CC# 9200
OWNER
PLATOU, CARL& SUSAN
1480 GREEN TREES RD
WAYZATA, MN 55391-
AGREEMENT AIYD SWORN STATEMEIYT
The��ork for�chich this pennit is issued shall be performed accordin�to
the approved plans and spcci�ications,applicable City approvals,and the
State Building Code. This pennit is for unly the�vork described and does
not crant permission for additional or rclated work which requires separatc
permits. All provisions of laws and ordinances coverning this type of work
shall be compied with whcUicr or not spcciticd herein."fhis permit will
expire and become null and void if construction authorized is not
commenced within I RO days of the date of issuance,or if construction is
suspendcd for a period of I 80 days at any time after work has commenced.
'Chc applicant is responsible for assuring all required inspections are
requested in conformance with lhe State l3uildinc Code.This permit may bc
revoke�at any time t�>r duc c usc.
� /�i ��i /O �� i g i LU
Applicant Pcrmitce Si naturc Date Issuc y$ignature Datc
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� City of OronO POR CiTY USE ONI,Y
�¢ �p P,O,Box 66 Dace kteceived/����D Permit# ��d"d o��
h;,.;,;,. 2750 Kelley Parkway
� �� ��.':� � Crystal BaY,MN 55323 APProved By: Amount$:�_
���aa� (952)2a9-a600
CITY OF ORONO—PY.,UMBING PERMIT
(All Commercial permits must 6e app�oved by the Suilding Ofticial or Inspector)
GENERAL INFORMATION
1: You z�nay app1y for plumbing permits by mia�l or in person at the City offices. Applications will be
reviewed and a permat will be issued within two working days.
2. Petmit cards will be sent by Xetuim maii a�er a review is completed. PERMITS,A,RE NOT
VALID U�ITIL YOU�ECEIV�A PERMIT. WORK UST NO B�GIN U al,THE
PER I'�'CARD S POSTED ON THE JOB S1TE.
3. Plwnbing permits may be assued ON�X to lieensed plumbing contractors and to properry owners
residiog in the dwel(ing,
4. When any new construction or remodeling is involved,a se�arate building�ermit must be
obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested be�ore it is covered. Call(952)249-4600_
(24-48 hour notice required)
TYPE OF PE1�ZT
Check Al�That A �
�Residential ❑Commercia((Approval Rec�uired)
❑ New ❑Additional ❑ Repairs �■ Replace
❑ In Accessory Structure7
*Xou will need rior a roval and may need C�L _F_.(Per Orono City Code,Chapt�r 78,Article IV)
Job Site/ Owxier Infoxxnation:
� s�te aaa�es5: 1480 Green Trees Rd
o�er: Carl Platou Mailing Address: 1480 Green Trees Rd
ci�: Wayzata �xp: 55391
H[ome Phone: �952) 476-0903 ,n�.���ate Pk�one: (239) 594-1594
IContractor�nformatxon:
�1im e OrrTlma PIumDing Q,waler Haawq�l�C D e a n Ka m rat h
�Con,lxactor: Co,ntact P�rsoz�:
Addz-ess: �3791 Jonquil Ln N RCROS61066
State Boz�d#:
clt Dayton �:55327 z
�`� Z�. Expiration Date: � I �( Z O�'�
Phone: (612) 205-6060 �ternate Phone: �612) �91-4002
❑ Iz�surance—Cunent: ��uity 80304500
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,. ,,,,,
., ..
; �'LUM.BfiI'Cr EIXTYJRES B...EINCr,IIVSTAL�.ED,;. �
FIXTURE BSMT � 2 OTHE12 FIXTURE BSMT 1 Z OTHER
TYP� FL .FL xY�'E k'I� FL
Water Ctoset Floor prains
Lavatory Sewer Ejector
�3atk�tub Laundry Tray
Shower Washer
ICitchen Sink Water Heater ,�
Disposal Wxter Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
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a �;pER1V1IT��EE�AY,CLTLATXO�?�t(Sy ��;, -
, B�SEL?,O�F,': 2QU�,STI�TE S�'�ATUE;-� , -�-, �
❑ Yes,tk�is section applies
The replacement of a Residential fixtu�e Qr appliance that meets all rhree o;Fthe following requirements:
1. oes not require modi�cation to electrical or gas service.
2. Has a total cost of$500.00 or less;excludin�tk�e cost of the fixture or appliane�:and
3. Is improved, installed or replaced by the homeowner or licensed contractor.
Skip�►ext section, if this applies; Cost o;f Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) � 2_00
Total Permpt Fee $
(Perra�t Fees Co�ntinued O�n Next�age)
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' :,; .PER�IWII�",-�E�'±�AyLCU'LA�'�OT�T�S �.-JOB�S`0�'ER�'�500.�00:::� :,. ::., ,.
if above does not apply;follow guidelines below:
1. Ca�1TRACT P�t10E "` is 1.25%of contract prace with a(��nimum Fee of$50.00)
1,600.00 x.oa2s$ 50.00
(convact price) (minimum 550.00)
2. �TATE SURCHARGE **Add the State�ldg Code I�iv. SurchaXge(Minimurr�k'ee oi$5.00)
1 ,600.00 X.000s $5.00
(contract price) (minimum$ 5.00)
3. POSTAGE&HAND�.�7VG (Only on Mail-I�n Applications) $ 2.00 '
4. TO�',A,�,PERMIT F�E(A,dd Lines 1-3 Above) $57•00
• * CONTRACT �kZICE or JOB COS'� means the actual or estimated dollar amount charged for the
permirCed work including materials, labor,profit, �d other fixed costs. �t is the amount to be charged
to the customer for the work done, lf a�ny material, equipment, labor or installations are fumished by
the owner, tenant or any other party, the reasonable market value of such item,s must be added to the
estimated cost or contract price for permit fee purposes. �n the ever�t that th�re is a dispute on the
a�ount of t�e job cost, the City may request the submission o�a signed copy of the actua] contract.
■ �*Thc STATE SURCHARG�is .0005 of the contrae�pr�ce under$1,000,000 0�$5,00—whichever is
g�eater. Por valuatio�,s over$1,000,000 cal]the Buildi.ng Department at(952)249-4600 for the price.
, � . ..� . pi':�1vf�iNG`P�Rivi�"T APPLIC�rZO AGRE
.:.. ;� - . :�; -,� .� . N'' � MENT ,
�
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do a11
work in strict accordance witk� the ordinances of the City and the regulations of th� State of
Minnesota, and certi�es that all statetn�ents made on this application are complete, true and
correct.
!�
Applicant'S signature: , pat�: 12/2$/10
�R�set�Fiorrri'
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