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Home My WebLink About2010-00895 - plumbing CITY OF ORONO PERM[T NO.: 2010-00895 "" 2750 KELLEY PARKWAY � ' ORONO, MN 55356- �ATE [ssuEn: 09/24/2010 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4099 HIGHWOOD RD PIN : 07-117-23-44-0012 LEGAL DESC : HIGHWOOD LAKE MTKA : LOT 014 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : FIXTURE NOTE: CONNECT NF,W ADDITION W/4" SCHDULE 40-SE�ATTACHED(PER LYLE OMAN) VALUATION OF PLUMB[NG 1300 APPLICANT PLUMBING FIXTURE FEE 50.00 TUMA CONSTRUCTION STATE SURCHARGE PLBG (VALUATION) 5.00 5045 COUNTY ROAD 19 MINNETR[STA, MN 55359- TOTAL 55.00 (763)479-2982 PAID WITH CC# 4077 OWNER SERAN III, ALONZO 4099 HIGHWOOD RD MOUND, MN 55364- AGREEMENT AND SWORN STATEMENT "I'he work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. 'Chis permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within I 80 days of the date of issuance,or if construction is suspended Yor a period of 180 days at any time after work has commenced. The appl nt is res nsible for suring all required inspections are reques m conY ia wi , ate Building Code.This permit may be > revo� at any e for du ause. /�✓ /� � z�/ �d `?� (' �_ t �n�'i!'�/ / j `�� . pplican ermitee Signature Date Issued By Sig ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � ' FOR CITY USE ONLY � j � , ,�p� City of Orono O K O P•0.Box 66 Date Received: Permit# � �;��P i 2750 Kelley Parkway � � ��^. F Crystal Bay,MN 55323 Approved By: Amount$: ��'��"y5�o"` (952)249-4600 � � � � �� 8oe CITY OF ORONO-PLUMBING PERMIT ' (All Commercial permits must be approved by the Building Official or]nspector) GENERAL INFORIVIATION 1. You may appiy 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. Pemut 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 TAE 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 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 ly) ��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 I�') Job Site/ Owner Information: � � � � Site Address: `1 � � �-� � � �� Z�, �; Owner: �`�'�- v�t Z v ��''�"� Mailing Address: S � w'�-`t- City: � �- c;� r�l v Zip: .S S� � � Home Phone: Alternate Phone: Contractor Information: Contractor:�u'"'`G� �!v��f �� y�C ntact Person: ��"` I u!.�'L �l Address: 5 `J`�� -' � 12� � `� State Bond #: Z-v ( U — Z �s'�-{� City: d��'^ti-c�^,s�-C-t Zip:s�� 3� Expiration Date: �.� � Phone: �� -��c�- ��j r�f Z- Alternate Phone: �� -�� 3� � ❑ Insurance-Current: 1 � T � S � ��. ., ��' .' : ��,.. -.. ` '"��.'�3ING FIXTURES BEIl�1G�:iNSTALLED�� ' FIXTURE BSMT 1 2 OTHER FIhTURE BSMT 1 2' OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer ICitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous � cs rn.v�-z,c.._+- /U -�� (�-c�,� i �-i'c�� } � `/ �� S�_�.�, �.I� �-!U �j�- -E -� � T l� �-� �� _ � � ^ PERMIT FEE CALCULATION(S) j ; �., � BASED OFF - 2002 STATE STATUE I ❑ 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; excludinQ the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 1' « � ` , � ` � .t:PERNT�T,'FEE"�CALCT7LATION(S -JOBS 4VER �500.00 ` �, If above does not apply; follow guidelines belo��: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) 1 �� X.oi2s $ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Di��. Surcharge(Minimum Fee of s5.00) x .0005 $ (contract price) (minimum� 5.00) 3. POSTAGE R,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 doilar 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 perrrut 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$5.00—whichever is greater. For valuations over$1,000,000 cail the Building Department at(952)249-4600 for the price. ` � � � , � �e 7�a �,� y� r '� a �" �a � `9� �� " �i��W'�� `d�� r��'`�� .� � „� ,e. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all wark in strict accordance with e ordinan es of the City and the regulations of the State of Minnesota, and certifies that statem �cation are complete, true and correct. � Applicant's Signature: �' — Z � � � � e: 3 i i 'I �,_6�. ��-0� a��„ �i r----------- I �-0�, Z,-0� . �r---------- . i �I i I� r-------- �,� I'-0" 1'.p" �� . , m �� '" �� — --------------------------------- —� I� �I � I� �I N I �I � , r---------------------- ' ' ! 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