HomeMy WebLinkAbout2012-00796 - plumbing -� � CITY OF ORONO * Z 0 1 2 - 0 7 9 6 *
` 2750 KELLEY PARKWAY DATE ISSUE : 08/17/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2670 KELLEY PKWY �U5f
PIN I : 33-118-23-12-0038
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500) i
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE i : FIXTURES-MULTIPLE
NOTE: PLUMBING FIXTU S:
(2)WATER CLOSETS,(3)L VATORIES,(2)BATHTUBS,(1 EACH)SHOWER,KITCHEN SINK,DISPOSAL,DISHWASH R,
AND WASHER
VALUATION OF PLUMB�NG 4000
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AP LICANT PLUMBING FIXTURE FEE 50.00
AMERICAN MECHANIC L CO,INC. STATE SURCHARGE PLBG(VALUATION) 2.00
7120 71ST AVE.N.
PO BOX 205 i MAIL-IN FEE 2.00
LORETTO,MN 55357- TOTAL 54.00
(612)750-0278 PAID WITH CC# 9327
WNER
Citizens Independent B
5000 36TH ST W
ST LOUIS PARK,MN 55 16-
AGREEMENT A D SWORN STATEMENT
The work for which this permit s issued shall be performed according to
the approved plans and specific tions,applicable City approvals,and the
State Building Code. This pe it is for only the work described and does
not grant permission for additio al or related work which requires sepazate
permits. All provisions of laws nd ordinances governing this type of work
shall be compied with whether r not specified herein.This permit will
expire and become null and voi if construction authorized is not
commenced within 180 days of e date of issuance,or if construction is
suspended for a period of 180 d ys at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with he State Building Code.This permit may be
revoked at any time for due ca e.
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App icant Permitee Signa u e Date Issu By Signature ate
S ARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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08/14/2012 21 :34 FAX 7634775629 1�002/007
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� City of Orono ::,�:a:�:r;�: r :•: { . :;`•�' ��' ' " • •'' (�/�
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(952)249-4600—Main ��,:��iL'����q�,:,:,���.. .,.,�.., :,.�r.::;�,._....��.:•;•'�:
(952)249�616—Fmc
CITY OF ORONO—PLUNBING PERMIT
(All ommercial Permit�Must be Approved by thc State Prior to City/lpproval)�
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l. You may apply for plumbing pennits by mail or in person at tho Cily offices. Applications ill b�
r�vi wed s�nd a permit will be issucd within two working days_
2. Pe it cards will bt senl by�+etum mail after a reYvicw is complated. PE:itMiTS ARE NOT
V ID UNTll.YQU RECENE A PERMIT. WO M 1. N .Tr�
'1' .A TS S T E. .
3. Plu bing pesmits may be issued QNLY to licenscxi plumbing contiactors and to property o, ers ,
resi ing in the dwelling.
4. Wh any new coIIstructipn or remodeliug is involved,a separate building ptnnit must be
,, � ob ed. . _. . .._ . _ , . . _ .
5. All ark magt be donc in accordance with State Codc requirements.
6. All ork must be inspected and air tested bcfore it is covered. Call(952)249-4600.
(2 8 hour notice requircd)
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Rcsidcn ial ❑Commcrc;ial(Approval Requircd)
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�New ❑ Additional ❑Repai� ❑Replace
Q !n Acce sory S�ucture?
"'Y�u '1 � r s roval and may need�.(Per Orono Ciry Codc,Chapter 78,Artic 1V)
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Site Addre s:
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Owner: i ^RI9� � Mailing Address:
Ciry: zip:
1 fome pho e: AlternAte 1'hone:
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Contractor. ( . ���ontact Person: •y ��'
Address: �G�i �a � Sta�e Bond#: .
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�ity: (.�J'� t7 Zip;� �Expuration Date: ��� .
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Phone: ���1 S���D�L� Alternate Phone: ! � �
� Insurance--Current: ��
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08/14/2012 21 :35 FAX � 7634775629 i f�003/007
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FTXTUR�' BSNI'C 1 2 OTl-�R F1XT[JRE BSMT 1 2 ° Tl R
TYPE � FL FT. TYYE FL l�L
Wa�r Clo�et � Floor Drains �
Lavatory I �j Sewot F.jector
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Laun Tray
liathtub �'
Shower � Washcr � �I
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Kicchen I ink Water Hcal�er
_ Dispos I � Watcr Softencr ,
Dishw I hcr r W�$�
Sillco s Miscellancous
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�I Yes.this sect�on applics .
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'Th rcple�cement of only one
' ential xt or 1' ce that meets all�hree of the following ,
uiroments: � .
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1. Doas require modification to ci�ctrica�or�s servicc•
Z, �a��t of$500.00 or less;e u ' the oost of the fixture or appliance: ,
3. Is itnproved,ins�slled or roplaced by tho homeowner or licensed plumbing con
Skip next sa:lion,if this apPlies; Cost of Parmit S 1 00
Statc Surcharge s
ail-In Fee f A licxble) $
M, (� PP
'1'otal Permit N'ce
$
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(Permit Feea Continaed On Nezt PAge) � ,
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08/14/2012 21 :33 FAx 763477�629 f�004/00�
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If above doe�not apply;follow guidelines bclow: �
�, (�nNTRACT PAIC'E �is 1.2 0 of cantract prica witl�a(N�inimum Fec of S50'00)
w,v�
x.0125$_�
(conanct prico) (minimu�n SSo.
2. '�'A F StJRCSALt� ��� �� '
x.0005 S_ +
(conU7►Ct price)
3. STAGE&FlAA1DLIIVG(Only on Mail-in Applicacions) $ 2•4 �
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4. �nTAL PE'RMiT FEE(Add Lines]-3 Above) $
' " ' '" ' ■ " + �ON 'RACT PRTCE or JOB COST means the a�ctual or estimaced dollar arnount c for
permitl d worlc inctuding materials,labor,pro�t,and other fixed costs. lc is thc amount to b char8e
co thc c stomor for th�work doae. If any matarial.equipmeat,labor cn iostatlations are shed
the ec,tenant or any other party.the reagonable matk�t value of such items must be a.d w
cstimat cost or contract pricc for permit fee putposes. 1n thc event that thcre iS a d'Ispu on
umount of the job cost, che C.ity may rcquest the submissian of a s+gned capy of thc acwal ntra .
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Thc under igneci hereby appl�cs to the City for isguance of a Plumbing Permit, abrces ��d� f
work in. s ict accordance with the ordinances af the Ciry and the regulations af the �
Minnesota and eertifies that all statements made on this application art: complete, rue d
correct.
Applicant'. Signature:
, Date:����r �
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