HomeMy WebLinkAbout1998-010361 - backflow preventer PERMIT
;) ITY OF ORONO PERMIT TYPE:
?_750`Kelley Parkway- P.O. Box 66 �-'Y�,����:I iu��
Crystal Bay, Minnesota 55323 Permit Number: �;�;;:::;_,�
:612)473-7357 Date Issued: ���j•1 �J'��;«,
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APPLICANT/PERMITEE SIGNATURE � ISSUED BY:SIGNATURE
�t���
CITY OE l.�IB:QN� AFPE.ICAT�ON FQR gI.�JMBING PER11�T
}!ox b6 (2750 Kelley Parkway}
Crystal �ay, 1VIN 55323
GENERAL INFORMA�'ION ,
L You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cazds 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 sepazate 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. Ca11473-7357.'24-hour notice required.
Instructioi�� Coaiplete all items on this application. Compute the permit fee. Sign and date
the certificatioii. INCOI���LET� APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, ca11473-7357.
Please check one: New Addition Repair Replace
�_ Residential Commercial
JOB SI'F£: `Z�S �7 Gt o� �c d�S �Q,c� Zip:
: Owner's P�ame: ���y _ Teleghone Number: ;. �,�o �d�
MailingAddress: L/6�'"/�cR..�P�Ls✓ �cs�'r City: do-a� v Zip;_�'��
Contractor'sName: ��' � TelephoneNumber: ,3� �—��
MailingA:ddress: .- ��s City: o �' Zi . � _. �o
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PL�JMBING FIXTURE:SCHEDULE
FIXTURF BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE ' FL FL TYPE EL FL
Water Closet `Floor Drains
Lavatory_ , Sewer Ejector
Bathtub Laundry Tray
Shower " Washer`
Kitehen Sinlc Water Heater
Disposal ' Water Softener
Dishw;�sher Wet Bar'
Sillcocks Misc (list)
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A�c�7 0�'�/'.�addes�
�E�IT F�� �A►I.C�TLA�I4I'�T
1. 1.25% of Contract Price* or Nlinimum Fee 35.00 X ,0125 $ ���G
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(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ ��
(contract price) '
or $.50, whichever is greater
3, Posta¢e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3,,�—
* CONTRACT PRICE or JOB COST means the actual or e:stimated dollaz amount chazged for the permitted
work including materials, labor, profit, and other fiaed 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 perm.it 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 Inspectional 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 rnade on this application are cornplete, frue and
correet.
, � +�� Date• � l�
Applicant s Signature: '
DATE TIME
CITY OF ORONO CALLED IN �/��� ��.- a�
INSPECTION NOTICE SCHEDULED �O—L���L f.' O D
PERMIT NOt��.3 �� COMPLETED
ADDRESS �
OWNER CONTR. ,�2'l.�ac/ �t.4�2�
TELEPHONE NO. /.3.�— J��o .3;�0
� DESCRIPTION
� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 0 LUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 M1IGFINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next in pection 24 hours in advance.473-7357
OwnerlContrac si •
Inspector.
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