HomeMy WebLinkAbout2005-P08946 - water softner PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p08946
Cry��tal Bay, Minnesota 55323 Permit Type: FiXtures
(952) 249-4600 Date Issued: 7/11/2005
SITE ADDRESS: 3640 7acobs Mill Rd Unit#
Long Lake,MN 55356
PID: 32-118-23-24-0010
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Fixtures Permit Sub-type(s): Water Softner
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 15.00 Valuation: $ 400.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 15.50
APPLICANT: Richard Custom Water OWNER: Matt Vanslooten
6121 Excelsior Blvd.#206 3640 Jacobs Mill Rd
St. Louis Park,MN 55416 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA B�ILDING QODE REQU►REMENTS.
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APP AN� EIjM(TEE SIGNATURE " [SSUED BY S[GNATURE
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Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, ]-Septic) Page 1
FOR CITY USE ONLY
' ��` City of Orono
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O4 `rO P.O.Box 66 Date Received: Permit#
�r,.,,� 2750 Kelley Parkway
� � ',jy�`C�,�;' Crystal Bay,MN 55323 Approved By: Amount$:
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CITY OF ORONO —PLUMBING PERMIT
(All Commercial pennits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a pernut will be issued within two working days.
2. Permit cards will be sent by retuin mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECENE A PERMIT. WORK MUST i�'OT BEGIN UNTIL THE
PERiVIIT 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 consh-uction or remodeling is involved, a separate building peimit 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.
(24-48 hour notice required)
TYPE OF PERMIT
(Check All That A ly)
❑ Residential ❑ Commercial(Approval Required)
❑ New ❑ Additional ❑ Repairs ❑Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
Job Site/ Owner Information:
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Site Address: .�v C�� � l�U�� �� ��� ` � "'�
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Owner: �� -���_�"��"' Mailing Address:
City: ����'� �� Zip:
Home Phone: Alternate Phone:
Contractor Information:
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Contractar: _ /C'/�iC�a�S �!�'���z�" �!iaContact Person: ����t/iG'ii�'
Address: � ��`� � �'X���� ����`� �`�tate Bond #:
City: �-=�`��=�'is /�"• Zip: :�f�//�Expiration Date:
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Phone: a ` � %�F'`' "' ` Alternate Phone:
❑ Insurance— Current:
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PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower W asher
Kitchen Sink Water Heater
Disposal Water Softener ��
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATLTE
❑ Yes,this section applies
The replacement of a Residential fixhire or appliance that meets all tYuee of the following requirements:
1. Does not require modification to electrical or gas service. ����
2. Has a total cost of$500.00 or less; excluding the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section, if this applies; Cost of Permit S 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Pernrit Fee $
(Permit Fees Continued On Next Page)
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' • PERMIT FEE GALCULATION S)-JOBS OVER $500.00
.
If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of conhact price with a(Minimum Fee of$35.00)
x.0125 $
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(conn•act price) (minimum S .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the achial or estimated dollar amount charged for the
pernutted wark 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 instailations are furnished by
the o�vner, tenant ar any other party, the reasonable market value of such items must be added to the
estimated cost or conhact price for pernut fee puiposes. 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 Building Department at(952) 249-4600 for the price.
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 regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct. , >
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Applicant s Signature: / �' -� �� Date: l✓
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