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Home My WebLink About2017-00202 - plumbing CITYOFORONO * 2017 - 00z0z * ' 2750 KELLEY PARKWAY DATE ISSUED: 03/03/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2670 COUNTRYSIDE DR W PIN : 04-117-23-12-OO13 LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 005 BLOCK 002 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER SOFTENER NOTE: WATER SOFTENER VALUATION OF PLUMBING 2000 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 1.00 CRO[X CRYSTAL WATER TREATMENT MAIL-IN FEE 2.00 3440 YOERG DR HUDSON, W[ 54016- TOTAL 53.00 (715)386-8667 Payment(s) Minnesota State License#: plbg-WC64997 CHECK 16212 53.00 OWNER DEVERE, ROBERT&JEAN 2670 COUNTRYSIDE DR W LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. Ali 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 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. , C� �e�.� � � �� Applicant Permitee Signature Date Issued ignature Date . , , �p�. _ City of Orono RECEfV�U FOR CITY USE ON�Y Q ; P.o. Box ss Date Received: `i 2750 Kelley Parkway � _ ' Crystal Bay. MN 55323 MAR p 3 ��>> Pefmit# � � t� (952)249-4600—Main Approved By` +i+a��` � (952)249-4616—Fax CITY OF ORONO Amount$: CITY OF ORONO- PLUMBING PERMIT � (All Commercial Permits Must be Approved by the State Prior to City Approval) �:' ` '' '` ' '. .�� http:Nwv�+wr.dli.mn.qov/CC��IPa�lpe plumbplanrevapp.pdf GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNT1L THE PERM{T CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to 6censed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved, a separate buikling permit 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�8 hour notice required) TYPE OF PERMIT(Check All That Apply) ❑ Residential ❑ Commercial (Approval Required) [Backflow Device: ❑AVF3 ❑PVB] ❑ New ❑Additional ❑ Repairs [�] Replace / � ❑ In Accessory Structure? *You wrtr need prior approvat and may need Ct1P. (Per Ororto City Code, C�apter 78, Article li� Job Site t Owner information: Site Address: �,�70 �i,�r��,,.S;C� t�r W Owner: .�►,� ��,v�.✓�e_ Mailing Address: City: drar-,c�, : r�N Zip: 55�5� Home Phone: �(��-�D�- a"�3`� Altemate Phone: C�l2�- qf-f�� f I�4 Contractor Information: COrltraCto�: Croix Crystal Water Treatment Contact Person: ��m Address: 3440 Yoerg Dr State Bond #: City: Hudson Zip: 54016 Expiration Date: Phone: 715-386-8667 Altemate Phone: ❑ Insurance - Current: Page 1 PLUMBING FIXTURES BEING INSTALLED . . FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sr 2ND OTHER TYPE Floor Floor TYPE Floor Floor Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener X Dishwasher Wet Bar Silicocks Miscellaneous P��M#T FEE C�t�.�tiLA�'tOiV 1. CONTRACT PRICE *is 1.25% of contract price with a (Minimum Fee of$50.OQ) x .0125 $ ��,vc (contract price) (minimum $50.00) 2. STATE SURCHARGE x .0005 $ �� J,�' (contract price) 3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00 � �ti 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 installations are fumished 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 everrt 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. - PLUMBING PERMIT APPLICATION AGREEMENT 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 r�egulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. ApplicanYs Signature: Date: �� Building Official/ Inspector: Date: Page 2