HomeMy WebLinkAbout2004-P07917 - plumbing ` PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po�91�
Crystal Bay, Minnesota 55323 Permit Type: FiXcures
(952) 249-4600 Date Issued: 9i3i2ooa
SITE ADDRESS: 81 Hackbeny Hill
Long Lake,MN 55356
PID: 33-118-23-44-0014
DESCRIPTION:
Proposed Use: Kesident�ai
Permit Class: Plumbing �k�
Pernut Sub-type(s): �,Q,�4�'U�,
Permit Type: Fixtures
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00
Valuation: $ 2,000.00
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 36.00
APPLICANT: Brisbin Plumbing In.c OWNER: Rob&Joy Kallenbach
18687 Jaspar St.NW 81 Hackberry Hill
Ramsey,MN 55303 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APP NT PERMITEE SI SUED BY S[GNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for plumbinb permits by mail or in person at the City offices.
2. Permit cards will be sent by return maii aiter a review is completed. PERMITS ARE NOT VALID UNTIL YOU
RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT C,4RD 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 ne�v construction or remodelinb is involved, a separate building permit must be obtained.
5. All work must be done in accordance with the State Code requiremenls.
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. Compute the permit fee. Sign and date the
certification. [NCOMPLETE APPL[CATIONS WILL NOT BE PROCESSED. If you have questions,
call (952) 249-4600.
Please checic one: New � Addition Repair Replace
Residential Comm rcial
,
JOB SITE: Zi • �
Owner's Name: Telepho e Nu b r:
Mai(ing Address: i City: Zip:
Contractor's Name: Tele one umber: � ��
Mailing Address: City: Zip:
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PLUMBING FIXTURE SCHEDUL
FIXTURE BSMT 1 ST 2ND OTHER FIXTURE BSM 1 S 2ND OTHER
TYPE FL FL TYPE T T FL
FL
Water Closet / Floor Drains
Lavator � Sewer E'ector
Bathtub � Laundry Tra
Shower � Washer
Kitchen Sink Water Heater
Dis osal Water Softener
Dishwasher Wet Bar
Sillcocks I Misc list
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PERMIT FEE CALCULATION(S)
2002 State Statute ❑ Yes, This Section Applies
s
The replacement of a Residential fixture or ap�liance 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
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If above does not apply, follow guidelines below:
1. Contract Price* is .0125 % of job with a Minimum Fee of ($35.00�
c�000, OC7 x .0125 $
(contract price) (minimum $35.00)
2. State Surcharge. ** Add the State Building Code Division a (Minimum Fee of $ .50)
x .0005 $
(contract price) (minimum $ .50)
3. Postage and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* CONTRACT PRICE or f OB COST means the actual or estimated dollar amount charged for the permitted work
including materials, labor, profil, and otl�er 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
reasonabie 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 tlle job cost, the City may request the submission
of a signed copy of the actuai contract.
� ** The STATE
SURCHARGE is .0005 of the contract pr�ce w�der $1,000,000 or $.50 -whichever is greater.
For valuations over�1,000,000 call the Department of Inspection Services for the price.
The undersigned hereby applies to the City for issuance of a P bing Permit, agrees to do all work
in strict accordance with the ordinances of t e City and the r I ion of the State of Minnesota, and
certifies that all statements made on t ' lication r comp te, ue d cor ct.
Applicant's Signature: Date: �
Reset Form
_ _ _ , :.,. . _. . . , _ : ,a
FROM :BR i SH I N PLUMH i NG FAiC hJO. :763 753 6621 Aug. �6 2C E� 12:39PM P2
. �
July 2004
To VU�om It May Concern:
I give my perniission far Timberlaad Builders to pull plumbing permits under my
Eicense number.
If you h�.ve ariy questions,I can be reached at 753-753-6621,ar 612-�9Q-37$6,
Thank you,
��Y ���;,�;., � �,c,a,�
Troy Brisbin CHERYLJ BRfS91N
+� Notary Publ�c
Brisbist Pltimb�,Inc. tviinnssota
18687 Jaspar St.NW ' ��CcmminamnEKD�s:anuary31,20D8
Ramscy,MN 553p3
License nu�ber: OOS572FM