HomeMy WebLinkAbout2004-P07340 - plumbing ITY F R N PERMIT
C O O O O
2750 Ke11e�;�'arkway - PO Box 66 Permit Number: po�34o
Crystal say, Minnesota 55323 Permit Type: FiXtures
(952) 249-4600 Date Issued: 3i29i2oo4
SITE ADDRESS: 235 Hollander xd
Wayzata,MN 55391
PID: 25-118-23-43-0026
DESCRI PTION:
Proposed Use: xesidentiai
Permit Class: Plumbing
Permit Type: Fixtures Pernut Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: � 43.75 Valuation: $ 3,500.00
State Surcharge Fee: $ 1.75
TOTAL FEE: $ 45.50
APPLICANT: Standard Plumbing&Applicance OWNER: David&Cheryl Kelsey
8015 Minnetonka Blvd 235 Hollander Rd
St. Louis Park,MN 55426 Wayzata, MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�'�.�'�..` ���� . �--� U�� ��2 ��
APPLICANT PERMITEE SIGNATURE ISS D BY SIGNATURG �
Copies: 1-File(SiQnitures Repuired), 1-Aoolicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1
`�CITY OF ORONO APPLICATION FOR PLUMBING PERNIIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
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 RECEIVE A PERIVIIT. WORKMUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED Ol\
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 sepazate building permit must be obtained.
5. All work must be done in accordanae with the State Code requirements.
6. ' All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notic�
required,
Instructioas Complete 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
JOB SI1'E; � �v S �/°��.�-�s �a� Zip:
Owner's Name: �.�� _Telephone Number: �3�.�2 3-�4 b�
Mailing Address: _ a- � , fFa I i �..,�.c�- City:�.�,,,..�., Zip:
Contra�tor's Name: l l, Telephone Number:9�=�'�-3��j
MailingAddress:�i �S` l��-,�.-,�.�'�CQ.� .1`? � City: Zip: .�,�-�'it�6
�
,
pLi7MBING FIXTURE SCHEDULE
FIXTURE BSMT 15T 21�D OTHER` FIXTURE BSMT 1ST 2ND OTHER
TXPE FL FL TYPE FL FL
Water Closet �` Floor Drains
v� :
Lavato � . Sewer E'ector �
Bathtub � , i;aun Tra ,: ,
. ..
Shower Washer
Kitchen Sink � Water Heater "
Dis sal 1 :Water Softener
Dishwasher 1 � Wet Bar �.
Sillcocks Misc(list)
PERMIT FEE CALCULATION(S)
2002 State Statute ❑ Yes, Tlus 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 licenced contractor.
Skip next section; Cost of Permit $ 15.00
State Surcharge $ .50
Mail In Fee $ 1.50
If above does not apply, follow guidelines below:
1. Contract Price* is .0125 % of'ob with a Minimum Fee of($35.00)
� ��
c�5'b� x .0125 $
_ (contract price) (minimum.$35.OU) :
2. State Surcharge. ** Add the State Building Code Division a (Minimum Fee of$ .50)
x .0005 $
(contract price) (minimum$ .50) ;
3. Postaage and Handling (Only mail-in applicauons)' $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* CONTRACT PRICE or JOB COST means'the actual or estimated dollaz amount charged for the permitted
work including materials,labor,profit,and other fued costs. It is the amount to be charged to the customer
for the work done. If any material, equipment, labor,or installauon are furnished by the owner,tenant or
any other pazty the reasonable mazket value of such items musc be added to the estimated cost or contracc
price for permit fee purposes. In the event that there is a dispute on the amount of the job cost,the City ma��
request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contract price under S1,OOO,U00 or $.50-whichever is greater.
For valuations over$1,000,000 call the Department of Inspection Ser,vices 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 certifes that all statements made on this application are complete, true and
correct.
. L�'J�-` �`�� Date:� -�9--�`�
Applicant's Signature•