HomeMy WebLinkAbout2012-00797 - plumbing ' � � CITYOFORONO * 201z - 00797 *
2750 KELLEY PARKWAY DATE I SUED: 08/17/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 2670 KELLEY PKWY — ! O�
PIN : 33-118-23-12-0039
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION PE : FIXTURES-MULTIPLE
NOTE: PLUMBING FI TURES:
(2)WATER CLOSETS, 3)LAVATORIES,(2)BATHTUBS,(1 EACH)SHOWER,KITCHEN SINK,DISPOSAL,DISH SHER,
AND WASHER
VALUATION OF PLiTMBING 4000
PPLICANT PLUMBING FIXTURE FEE 50.00
AMERICAN MECHA ICAL CO,INC. STATE SURCHARGE PLBG(VALUATION 2.00
7120 71ST AVE.N.
PO BOX 205 MAIL-IN FEE 2.00
LORETTO,MN 55357� TOTAL 54.00
(612)750-0278 PAID WITH CC# 9327
OWNER
Citizens Independent B nk
5000 36TH ST W
ST LOUIS PARK,MN�5416- �
AGREEMENT ND SWORN STATEMENT
The work for which this pe it is issued shall be performed according to
the approved plans and speci cations,applicable City approvals,and the
State Building Code. This pe it is for only the work described and does
not grant permission for addi'onal or related work which requires separate
permits. All provisions of la s and ordinances governing this type of work
shall be compied with wheth or not specified herein.This permit will
expire and become null and v id if construction authorized is not
commenced within 180 days f 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 f r asswing all required inspections are
requested in conformance wit the State Building Code.This permit may be
revoked at any time for due 'use.
$ /7 � / a-- g� � 7 � ���
Applicant Permitee Si at re Date ssue y Signature ate
S PARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
08/14/20'12 21 :35IFAx 7634773629 f�005/007
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��'�� City of Orono �
,y � .fl�ce'.�Ra�1. f Nermi4� �
,�;� ��� RO.Liox 66 ;
' 0.<, . 0��. 275U Kelicy ParlcwaY : Appto+!e�t.�BY� _�Amount S:.
;, �:4t�, jj Cry'slal Bay.MN 55323 .
;.� 5e!��,,;�, ,�.� (952)2d9-4600—Mflill
.� (952)Z49-4616—Fax
" C1TY OF ORONO—PLUMBING PERMYT
(A 11 Commercial Rermit�Mus�l be Approved by the State Prior to Ciry Approv )
tit :Uwvrvw.dli.m .����r/f.'C .�lC'1?F! � ► urnb la�er •�a . d
G 'NEFtAL Yl'�TFO'RA�lA.'I•i01'�4 . �
I for plumbing permits by mail ar in person at the Ciry oi'(iccs. A�plicnti ns will bc
I ►, You may app y
revirwcd and fl permit will bc issued within two wurking days.
II�. Permit cards wiil br Sent by retum mail ufter t�review is comnletod. PrRMI'l'UAIZE N T
vnLin UN'rLL,vOU RECFiVE n PGRMt'r. ORK Mus O F ' •
PER 1 C D ' O' O 'r JO S 7'E. e owners
II 3. Plumbing pz�its may bc issucd QNL.Y tc�licrnsed plumbin�contractor�and to prop ,
residing y the dweUing. a��e bvildin�permit must ,c
I4, When an ncw construction or remodeling is invalvod,a sap
..:_ . . . ,: ,... . . .__ _.� . �btei�ed... _ _. ... .
All work must be done in accordanca with State Code roquiremcnts. -
6. All work must be inspected and air tested before�t is covered. Call(952)249-4�i00.
(Z¢4S h0ur notice requirecl)
-� T�'P�.�C3F������T
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•Residenti�l ❑Comm�rcial(Approval Required)
r Re airs ❑ Replac�l
��eN, [�Additional ❑ P �
� In Acccssory Structurc? y � Code,Cha ter 78,' icle IV)
*You will need iar Aavroval and ma neccl,(,"l��'•�per Orono Gity P
L. or.�satton� I
L b Site/Owner T� t � /!�
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S�te Address: �'
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C�wner: ' %
Zip:
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I-�ome Phont: Alternate Phone:
ontractor lnformatio:�_�
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'ontractor: ` � � � � • � '•s�9yji(�ntact Person: .
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ddress: ����'1 ����� State Bond #: . �
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tty: �.��f' P;�.,— +
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hone: .
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� lnsurance-Current: �/� ---
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08l14/2012 21 :35 FAX �s3a���s2s �oosroo�
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1'TX RJ�.! f3SMT 1 2 U'fHER FIX7'(JRE BSMT � � 7'FIER
TYPG FL FL TYPE
Wal�r Closcl � Rloor Drains
Lava Sewcr L•j ectur �
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�a�i b Laundry Tray
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snow r � w��'� �
Kitch n Sink � WA��Y�
,;. . . , ..., : . _ . . . _ �1Natti So�ftcner
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L7ish aRher / WetBt�r
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Sill• ks Miscellanec�us
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� Yes,this�ection applies
The lacem�nt af on�y one�sid ntial fixture��p���mee�s xU throa af thC following
requ�ments:
1, pugg.�require modificafion to elecfical or gas service.
Z, Has a tolal cost of$500.00 ot less;exc i the cost of tho fixtuce o*ePpliance:
3. is improved,installed or replaced by the hom�wner or licensed plumbing con
Cost of Yermit � • �
Skip next section.if this a}�pties; $ Q
Statc Surchatge
Mail-ln Fcc(If Applicable) $
Total Permit Fce s
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(Pe�rm�t Fec
s Contiaued On Nezt Page) .I
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08/14/2012 21 :3� FA� 7634773629 f�007/007
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LFab ve docs not apply;follow�uid�lines below:
1. CO�1 [�ACT P1tiCE '�is 1.2 of oc�ntract pric;c with a(Miaimum Fce of$50.00
, �"�� _
x.0125$ � i
�°O��P��) � (minlmum ) '
2- S �' tCHAR $ �Q�?_
— x.0005 $ � '""
(oontrect pcitx� — .
3. POSTAGE&lIANDLIIVC;(Oaly on Mail-In Applications) $ 00
4, TOTAL A�.RM1T FEE(qdd Lines 1-3 Abovc) $ ��
' * CONTRAG'C�.�tICE or JOD COST means tho actual or es[imatcd dollar amouirt charg ` for thc -- .,, - :,. . -
� � �p itted rirork inciudtng materials, labor,pc�efit,and other fixed cpsts. It is tbo amount W b arged
the cusWmer for the work donc. If any matcrial,equipment, Iabor or insrallations arc ' hed by
c owner,tenant or ariy other pariy,thc reasonablo tnarkct value af such itcros must be to thc
limated cost or conttact price for permit fee purposes. !n the eve�that thet+� is a dispu� on the
a�founl of the j�b cost, the City may request the submissipn pf a si�ned copy of the aetual ntract.
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Thc dersigned hereby applies to Ihe City for issuance of a Plumbing Permit, agrees t do all
work n strict acCordance with the ordinances of the City and the regulations of the te of
Mi sota, and certifics that all statements made on this application are complete, e and
corre�.
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Appli t's Si�mature: _.. Dalc: ��`J.
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