HomeMy WebLinkAbout2004-P07258 - water softner ° PERMIT
CITY OF ORONO Permit Number:
275C� Kelley Pa�rkway - PO Box 66 P07258
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: 2/24/2004
SITE ADDRESS: 4125 Highwood Rd
Mound,MN 55364
PID: 07-117-23-44-0084
DESCRIPTION:
Proposed Use:
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Water Softner
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 15.00
Valuation: $ 0.00
State Surchazge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT' Bergerson Caswell,Inc. OWNER' 7ohn&Roberta Henrich
� 5115 Industrial St. � 4125 Highwood Rd
Maple Plain,MN 55359 Mound MN 55364
TT�UNDERSIGNED HIItEBY REQUESTS PIItMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIEED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WTfH ALL CTI'Y OF ORONO ORDINANCES AND SfATE OF
MINNESOTA BUII.DING CODE REQUIREIvIIIVTS.
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APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Conies: 1-File(SiAnitures Requiredl. 1-Avplicant, 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[NFORMATION
1. You may apply for plumbing permits by mail or in person at the City ofFices.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID LJNTIL YOU
RECENE 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice required.
!s:structions Cumpiefe all items on this application. Compute the permit fee. Sign and date the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions,
call (952) 249-4600.
Please check one: New Addition Repair �Replace
� Residential Commercial
���,� r �c� JOB SITE: �%,.�'=�� f�/C���i��l��i ���, /�/'i�>�f/�G' r"i;/� Z�p; .-�� .J ��
� h,� r{ - Owner's Name: ,Tc�ii.�� ��J. ,�f�,,�,�;�y Telephone Number: ;� �; <i i i- 3 i-� /
�� y Mailing Address: ��=�,;� City: Zip:
Contractor's Namee �f�� ;i��o�� - _'�5��.2--i/ //�� Telephone Number: ;t'�- �/'i'%-3�� �
Mailing Address: ' - � r f City �� � Zip: " = �""i
�i� i,F;,, c� :/����f' � �/>,f�
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1 ST 2ND OTHER FIXTURE BSM 1 S 2ND OTHER
TYPE FL FL TYPE T T FL
FL
Water Closet Floor Drains
Lavato Sewer E'ector
Bathtub Laund Tra
Shower Washer
Kitchen Sink Water Heater
Dis osal Water Softener
Dishwasher Wet Bar
Sillcocks Misc list
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PERMIT FEE CALCULATION(S)
2002 State Statute [►]�Yes, This Section Applies
The replacement of a Residential fixture or a�pliance 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 horneowner 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�
x .0125 $
(contract price) (minimum$35.00)
2. State Surcharge. **Add the State Building Code Division a (Minlmum 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 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 installation 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 price under $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 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 Signature: �E� �(�� %���i�k�_ ,�� Date: ��% �`�