HomeMy WebLinkAbout1998-010719 - back flow PERMIT
�'Y OF ORONO PERMIT TYPE: . —
i 2750 Kelley Parkway- P.O. Box 66 �'��-�-'````'���`=
Crystal Bay, Minnesota 55323 Permit Number: :;i�i�?i °�
(612)473-7357 Date Issued: i�:�=s�:_;:�:=s:-i
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PLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CIT�' �� U1tONQ° �P�.ICAT'E�N FOIt PLTJMBIlOt�PER1iRI'T
�ox b6 (2750 Kelley Parkway)
�rystal �a,v, l�vIN 55323
GENERAI.INFORMATION
1. You may'apply for plumbing permits by mail or in person at the City o�ces.
2. Permit cazds will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMTT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POST�D ON THE JOB-SITE
3. Plumbing permits may be issued ONLY to iicensed plumbing contractors and to property owners residing
in the dwelling.
4. When any new construction or rcmodeling 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 a�d air tested before it is covered. Ca11473-7357. 24-hour notice required.
Fnstructioii� Coa�pletP all item� on this application. Compute the permit fee. Sign and'date
the certificatioii. INCO:iT2LET� AFPLICATIaNS WILL NOT BE FROCFSSED. If you have
questions, call 473-7357.
Please check one: �Tew �Addition Repair Replace
Residential Commercial
JUB SI'FE: ✓�Od �c .S �P;���
�wner'sNames '' ` TelephoneNumbers
1VIailing�iddTesS: Sdo yC�.rc�r4e�.� �.� C�tY: D��-� Zip: �,S'�;S�
�antractcir'sName:�_�� �� �= /✓i�, �, l Telep�oneNwnber: + �,�����
Mailing A:ddress:�2��T��:,�„��_,�(�r, City: Zip: 4 ,���
PLUMBING FII�TURE SCHEDULE
FIXTURF BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE ' FL FL TYPE' FL EL
Water Closet Floor Drains
Lavatory. Sewer <Ejector
Bathtub . Laundry`Tray .
Shower Wasi�er
Kitchen Sink Water Heater '
Disposal Water Softener
,Dishws,sher Wet Bar
Sillcocks Misc (list)
' ��,p�lG���.✓ /�.d v���/`�.--
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p��� �E ��iI.CT TE.E�1�`£�l�I
1, 1.25% of Contract Price* or l�i�um �'e� (�3�5•O(�l ���
/��1 x .012� $
(contract price)
�. State Surcharge. ** Add the State Building Code I�ivision
Surcharge to each permit. X •0005 $ ` � -
. (contract price) �
or $.50, whichever is greater
3. Fostage and Handlins (Only mail-in applications) $ 1.50 �
4. �'OTAL PERMIT FEE (Add lines 1-� above) $
* CONTRACT PRICE orJOB COST means the actual or estimated dollaz amount chazged for the permitted
work including materials, labor, profit, and other fixed costs. It is the amount to be chazged to the
customer for the work done. If any material, equipment,labor,or instatlation aze furnished by the owner,
tenant or any other party the reasonable market value of such items must be added to the estimated cost
or conuact price for permit fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ciry 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 valuarions over $1;000,000 call the Department of Tnspectional Services for the price.
The unciersigned 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 Stat� of
Minnesota, and certifies that aTl statements made on this application are complete, true and
conecc.
Applicant's Signature: Date:
-� DAT C, ' TI�ME
CITY OF ORONO CALLED IN y ' • L��
INSPECTION NOTICE SCHEDULED � ����
PERMIT NO. �U���
COMPLETE
ADDRESS �� 1�1�'' ���
OWNER� CONTR. ��- p�
TELEPHONE NO. 3 �' ���-� �
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 LUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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W WORKSATISFACTOAY:PROCEED �OJECTCOMPLETE
� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
C! CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETl1RN
� CITATION ISSUED
C'STOP ORDER POSTED.CALI INSPECTOR
i' INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex�inspection 24 hours in advance.473-73�J7
OwnerlContract�r6f�i�e:
Inspector. � `� "
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