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Home My WebLink About2015-01543 - water heater CITY OF ORONO * 2 0 1 5 - 0 1 5 4 3 * 1 ^ 2750 KELLEY PARKWAY DATE ISSUED: 12/10/2015 t ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1485 GREEN TREES RD PIN : 11-117-23-23-0011 LEGAL DESC : GREEN TREES ON TANAGER LAKE : LOT 001 BLOCK 001 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : WATER HEATER APPLICANT PLUMB[NG FIXTURE FEE(<$500) 15.00 STATE SURCHARGE PLBG(<$500) 1.00 LEGACY MECHAN[CAL SERVICES MAIL-IN FEE 2.00 114 THOMAS CIRCLE#106 MONTICELLO, MN 55362- TOTAL 18.00 (763)314-0877 Payment(s) CHECK 007862 18.00 OWNER MARLIEM& MAI THOR,JOHANNES 1485 GREEN TREES RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of I 80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be � revoked at any time for due cause. � � r � � �� / �- r ��r��( � 1 I � __� P�,��X/h ��_�` � �l.; l�'j ( � / I � Applicant Permitee Signature Date Issued By S�gnature._ Date � � FOR CITY U9F.ONLY f /�� City of Orono ,�� i,� � G�,. � 01� , ��- � , �': / P O Box 66 Date Received: �I� Permit# :j"�( � �� 2750 Kelley Parkway � 1 �� Crystal Bay.MN 5�323 Approved By: �- / Amount$: (952)249-4600—Main � � �. (952)249-4616—Fax y� �c.� CITY OF ORONO—PLUMBING PERMIT ��FSH�� (All Commercial Permits Must be Approved by the State Prior to City Approval) -- i�tt i://��w�.�lli.ntn.��i�l(�('l.l)/PUF/ �c �lwnh �I.►i�rc��a >>.idf 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 J�Replace Cl� ❑ In Accessory Structure? *You will need prior approval and may need('t�P.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: (.��. �`�� i Owner�Q1�� Mailing Address: � r � City: �� Z�P� �� / Home Phone: 1�! � � `��►°A�Yernate Phone: Contractor Information: Contractor: ��'�i�o �sS��" �L(rG �iLL�� . L��J� C� Address:f�� t�Bond #: ��/�7 Z `/ �S City: � /C�G`� Zi��ation Date: � � � Phone: �1� �� Alternate Phone: _ ❑ Insurance—Current: 1 � PLUMBING FIXTURES BE1NG INSTALLED FIX'�URE BSMT I`� 2�D OTHER FIXTURE BSMT I�� 2�D OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower W asher Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ 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 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 licensed plumbing contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 1.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $� � (Permit Fees Continued On Next Page) 2 . , PERMIT FEE CALCULATION(S)-JOBS OVER$500.00 If above does not apply; follow guidelines below: I. CONTRACT PRICE * is 1.25°/o of contract price with a(Minimum Fee of$50.00) x .0125 $ (contract price) (minimum$50.00) 2. STATE SURCHARGE x .0005 $ (contract pricc) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 j ��i 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. PLUMBING PERMIT APPLICATION AGREEMENT 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 he City and the regulations of the State of Minnesota, and certifies that all statements on this application are complete, t e and correct. Applicant's Si nature: Date: / �--� 3