HomeMy WebLinkAbout2012-00741 - plumbing � CITY OF ORONO
2750 KELLEY PARKWAY * � 0 1 2 - 0 7 4 1 *
. DATE ISSUE : 08/OU2012
ORONO, MN 55356-
' (952) 249-4600 FAX: (952)249-4616
ADDRESS � : 2670 KELLEY PKWY #'/p�
PIN : 33-118-23-12-0036
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE I : FIXTURES-MULTIPLE
NOTE: 2 WC,3 LAV, 1 TUB, SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER, 1 WASHER
VALUATION OF PLUMB G 4000
APP CANT PLUMBING FIXTURE FEE 50.00
AMERICAN MECHANICA CO,INC. STATE SURCHARGE PLBG(VALUATION) 2.00
7120 71ST AVE.N.
PO BOX 205 MAIL-IN FEE 2.00
LORETTO,MN 55357- MISC FEE 0.00
(612)750-0278 TOTAL 54.00
O NER
Citizens Independent Bank
5000 36TH ST W
ST LOUIS PARK,MN 5541
AGREEMENT AND WORN STATEMENT
The work for which this perrnit is is ed shall be performed according to
the approved plans and specification,applicable City approvals,and the
State Building Code. This permit is or only the work described and does
not grant permission for additional o related work which requires separate
permits. All provisions of laws and rdinances governing this type of work
shall be compied with whether or no specified herein.This permit will
expire and become null and void if c nstruction authorized is not
commenced within 180 days of the d te of issuance,or if construction is
suspended for a period of 180 days a any time after work has commenced.
The applicant is responsible for ass ing all required inspections aze
requested in conformance with the S te Building Code.This permit may be
revoked at any time for due cause.
Vt� l l l�;y?4-�irLJ l l
Applicant ermitee Signature Date Issued B ignature Date
SEPA TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE.
• I
_ +
FOR CITY USE ONLY
� 0,���0 City of Orono
P.O Box 66 Date Received: Permit#
� 2750 Kelley Parkway
.� "'*• a Cr�stal Bay,MN 55323 Approved By: Amount$.
`�t� y.�, t,,o`' (9�2)249-4600—Main
�'xasso�� (952)249-4616—Fas
CITY OF ORONO - PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
fitt��Jl�s�r�s�d�.c�(i.r��n.��o�1('CLD/i'1)F/�e �luntb lanreva_i��._tlf�
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 return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT 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. ��'hen any new construction or remoc;eling is involved,a separate building perniit 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 1
�Residential ❑Commercial(Approval Required)
❑ New [�`Additional ❑ Repairs ❑ Replace
/
❑ In Accessory Structure?
*You will need prior approval and may need('li�.(Per Orono City Code, Chapter 78,Article IV)
Job Site/ Owner Information:
Site Address: �.�� �� �%�(����.��z•����`'
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �'3Z��'i('�J�' 6���P�i9M�c�< Contact Person: �� �"��r°<��Crcte�'i�
r
Address: ��x' `�":�\� State Bond #: ��- ����L/�' �j
City: L� -- ' Zip���� Expiration Date: ����J'
Phone: (��l�"�gZ�� '����7'J Alternate Phone: ��i>}- ���� �/��
� Insurance—Current:
1
4
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 � Washer /
Kitchen Sink + Water Heater
�
Disposal � Water Softer.er � I
Dishwa$her / Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STA"I�E STATUF,
❑ Yes,this section applies
The replacement of only one Residential fixture or appliance that meets a►1 three of the following
requirements:
1. Does not require modification to electrical or gas service.
2. Has a tetal cost of$500.00 or less; excluding the cost of the fixture or appliance:and
3. Is i�nproved, ir.stziled or replaced by the homeowner or licensed p!ambine contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
. . -�
F��h�TT��'����G��.�.'I'��'� ����� � $�St�€?.�3t�.
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00�
�'�J � x A 125$ � '
(contract price) {mmimum 550100)
2. STATE SURCHARGE �/av�
` x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $�
� * C NTRACT PR10E or JOB COST means the actuai or estimated dollar amount charged f r the
per itted work including materia(s, labor,profit,and other fixed costs. It is the amount to be ch rged
to t e customer for the work done. If any material, equipment, labor or installations are fu 'ish d by
the wner, tenant or any other party,the reasonable market value of such items must be ad�ed the
esti ated cost or contract price for permit fee purposes. In the event that there is a disp�te o the
am unt of the job cost, the City may request the submission of a signed copy of the actuali con ract.
PLUI�'TB°T�G��T'.t�PI��;���TTC3��1.�"`'. E1VT��T !;
The un ersigned hereby applies to the City for issuance of a Plumbing Permit, agrees rto d all
work i strict accordance with the ordinances of the City and the regulations of the'Sta e of
Minnes ta, and certifies that all statements made on this application are complste, true and
correct.
� Date: ���f.��
Applic nt s Signature:
F'��set"�o�'t�l'
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