HomeMy WebLinkAbout2012-00491 - water softner e ^
CITY OF ORONO * 2 0 1 2 - 0 0 4 9 1 *
2750 KELLEY PARKWAY DATE ISSUED: 06/OS/2012
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
REPRINTED ON 6/5/2012
ADDRESS : 460 EAST LONG LAKE RD
PIN : 35-118-23-14-0010
LEGAL DESC : UNPLATTED 35 118 23
: LOT MB BLOCK MB
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: REPLACE WATER SOFTENER
' APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
WATER DOCTORS STATE SURCHARGE PLBG(<$500) 5.00
8201 CENTRAL AVENUE
SPRING LAKE PARK,MN 55432- MAIL-IN FEE 2.00
(763)28Cr6243 TOTAL 22.00
Minnesota State License#: 082337 PAID WITH CC# 8380
OWNER
JOHNSON,DAVE&ELIZABETH
17395 CONIFER COURT
CHASKA,MN 5531&
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This pertnit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All 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 d e cause.
.�� �l / �i 2� i /.Z�
icant Permite ignature Date Iss By Signature Date
SEPARATE PERMITS REQUIRE�FOR WORK OTHER THAN DESCRIBED ABOVE.
JuruQ�s<^.�11:10a Robert Hoey 763-535-1805 p.3
,
I?OR CITY USL ONLY . . �
Og��O City of Orono ;
P.O.Box 66 Dete Reaeived: . Perroit#
2750 Kelley Parkway
����� Cry�stal Buy,MT:55323 Approved By: Atnoutit S:
(952)249-4600—Main
� (952)249-4616—Fax
CITY OF ORONO — PLUMBI�TG PERMIT
(AIl Commercial Permits Must be Approved by the State Prior to City Approval)
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GE�tERAL INFOR1�tA'T�ON '
1. Yon may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit wili be issued within two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE ItOT
VAL[D UNTIL YOU RECEIVE A PERMIT, WORK MUST NOT BEGIN UN'F7L THE
PERi�'I1T CARD IS POSTED ON TAE JOB SITE.
3. Plumbing permits may be issued QNLY to licensed plumbing contractors acid to properiy ow�ners
residing in the dwetling.
4. Whcn any new constroction or remodeling is involved,a separate building perrnit must be
obtained.
___
5. All work must be done in accordance with State Code requirements.
6. Al1 work must be inspected and air tested before it is covered. Call(952}249-4600.
(24-4$hour notice required)
E o P RMIT
.
Check All That A � 1 �
�Residentia] ❑Commercial(Approval Rec�uired)
❑New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
«You will need orior annroval and may need CUP.(Per Orono City Code,�hapter 78,Article I�
�Job Site/Owrter Iriformation: �
Site Address: ��� ��T l�0� � l��� �0��
Owner: t`�I�� V l� g � til
� SO� , �A- Mailin Address: A- �
City: Zip:
Home Phone: Alternate Phone:
Contractox Infoxination: ,�
Contractor: w� �� S Contact Person: ��%��
Address: �o�D� CcX/'R�I-L i!�t State Bond#: �G�- � ��('O �
C�ty: G�R�NG `�}k� I�N'K. Zip�,S'K�Expiration Date: I�'3�' ��J
Phone: Alternate Phone:
��3-�3s�,�,°
❑ Insurance--Current:
1
Jur�0F.�2•11:09a Robert Hoey 763-535-1805 p.2
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FIXTURE BSMT 1 ' 2 OTHER FIXTURE BS�IT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory 5ewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sinic Water Heater
Disposal - _ Water Softener � - - � -
Dishwasher Wet Bar
Sillcocks Miscellaneous
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❑ Yes,this section applies
The replacement af only one Residential fixture or appliance that meets all three of ihe following
requirements;
1, Does not reyuire modification to electrical or gas service.
2, Has a total cost of�500.00 or less;excludine the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip next section,if this applies; Cost of Permit S I5.00
State Surcharge $ 5.00
Vfail-In Fee(If Applicable) $ 2.00
Tot�l Permit Fee $ O�d
(Permit Fees Contioued Oa re�ct Page)
2
Jun�0.5.12,11:09a Robert Hoey 763-535-1805 p.1
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If abore does not apply;follow guidelines below:
1. CONTRACT PRTCE * is 1.25%of contract price with a(Minimum Fee of 550.00)
x.O125 S
(contract price) (minimum 550.00)
2. STATE 5URCHARGE �
x.0005 $ �(�
(conliac�price)
3. POSTAGE&HANDLING(On(y on Mail-In Applicatians) � 2.00
4. TOTAL PERMIT FEE(Add Lines I-3 Above) S
- ■ * CONTRACT PRICE or �OB C05T means the actual or estimated doltar amount charged for the
permitted work including materials, iabor, pr�fit,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 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 everrt that there is a dispute on the
amount of the job cost, the Ciry may request the submission of a signed copy of the actua] contract.
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees ta do a[I
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 applicati�n are complete, true and
correct.
Applicant's Signature: Date: (9:5��
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