HomeMy WebLinkAbout2016-01453 - plumbing - 7
'� `-` CITY OF ORONO * 2 0 1 6 - PJ 1 4 5 3 *
2750 KELLEY PARKWAY DATE ISSUED: 11/2U2016
ORONO, MN 55356-
. (952)249-4600 FAX: (952) 249-4616
ADDRESS : 2670 KELLEY PKWY 207
PIN : 33-118-23-12-0055
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (2)WATER CLOSETS,(3)LAVATORIES,(2)BATHTUBS, 1)SHOWER,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISWASHER,(1)
WASHER
VALUATION OF PLUMBING 4Q00
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 2.00
AMERICAN MECHANICAL CO,INC. MAIL-IN FEE 2.00
7120 71ST AVE.N.
PO BOX 205 TOTAL 54.00
LORETTO,MN 55357- Payment(s)
(612)750-0278 CREDIT CARD 6203 54.00
OWNER
Citizens Independent Bank
5000 36TH ST W 207
ST LOUIS PARK,MN 55416-
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 permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this rype 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued Signature Date
FROM :Rmerican Mechanical FAX N0. :763 477 4085 Nov. 21 2016 08:23AM P2
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�"Krsria�',j (952)249-4616—Fax Approv�d�y � ' ^ � , ;
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CITY QF QRONO— PLUMBING P€RMIT
(All Commercial Permits Must he Approved by the St�ts Prior to Gity Approval)
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1. You may apply for plumbing pennits by maif or in person at the City offices. Appli�ations will be
reviewed and a permit will be issued within twp working days.
2_ Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VA�ID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE pERMIT CARD lS
POSTED OW THE JOB S1TE.
3. Plu�bing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. tA�h�n an}r,neeRc caons�ucfion or remadeEing is inttpfteed,.a separa�e iltliidtng p�rmit musf be a�3f�ine�d.
5. All work mus# be dane in accardance with State Code requiremerrts.
6. All work must be inspected and air tested before it is covered. Call (952)249-4600.
(24•48 hour notice required)
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�Residential ❑ Commercial (Appnpv�J Required) [BackiYow Dcvice:�AVB [�PVB]
�] New � Additiona3 ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need Cl1P. (Per Orona City Gode, Chapter 78, Article IV)
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Site Address: �
pwner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
"���`ao��a�=;;�n�r►�atta�n:,
Contractor: � Contact Person: �f/1
Address: � State Bond#: �Cr �� �
CitY: LU Zip: Expiration Date: ��7
Phone: �� / � " �����Alternate Phone: _
� Insurance—Current: , ��
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Page 1
F,�20M ,:�nerican Mechanical FAX N0. :763 477 4085 No�. 21 2016 08:24AM P3
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FIXTURE BSMT 1gT 2ND OTHER FIXTURE BSMT 1�T 2H° OTHER
i'1�PE } Ffoor Ftver I N� I f Ffoor Ftoor ;
Water CEoset Floor Drains
Lavatory Sewer Ejectnr
Bathfub 2 Laundry 7ray
s�cawer f w�ast�er � /
Kitchen Sink Water Heater
Disposa{ ! Water Softerter
DiShwasher Wet Bar
Silicacks , Miscellanecws
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1. CONTRACT PRICE * is 1.25°r6 of contraot price with a(Mi�imum Fee of$50.00)
-��� � ,,..x.0125 � � � .
.��traot�.t�,�e.3 k'��50.�00,) .
2. STA'1`E SUitCHARCE
��/l� x .0005 $ �
(con�act Qnce)
3. POSTAGE&WANDLING (�nty on Mail-In Applications) $ 2.00
�
4. TOTAI. PERMIT FEE(Add Lines 1-3 Above) � � ,
* CONTRACT PRtC� ar JOB C�ST means the actual or estimated doElar amount charged for the
permitted work including materials, labor, profit, and other fixed oosts. It is the amount to be charged #o
the customer for the work done. If any material, equipment, iabor o� instaElations are fumished by the
owner, tenant vr any other party, the reasonable market value �rf such iiems must be added to the
estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
ar+q�x�t r�f�e fob�st.�t,he �ily r�nay��t�s# ��t�issiori��f�•si�raed��r��of�e sc�wsxl�r,rrtrac#-
r n:.: ����n
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The undersigned hereby applies to the Ciry for issuance of a Plumbing Permit, �grees to do all work in
strict accordance wi#h the nan the City and the regulations of the State of Minnesota, and
cerkifies that all stateme d th' ppl":catian are complete,true and correct.
Applicant's Signatur . Oate� �/���/�
Building Offici�l/ Inspector: Date:
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