HomeMy WebLinkAbout2013-00543 - plumbing • � - CITY OF ORONO * Z pJ 1 3 - 0 0 5 4 3 *
2750 KELLEY PARKWAY DATE ISSUED: 06/20/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2670 KELLEY PKWY — L(� L�� �.G3
PIN : 33-118-23-12-0051
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 121 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES- MULTIPLE
NOTE: PLUMB[NG FIXTURES: (2)WATER CLOSETS,(3)LAVATOR[ES,(1)BATHTUF3,(I)SHOWGR,(1)KITCHEN SINK,
(l)DISPOSAL,(1)DISHWASHGR
VALUATION OF PLUMBING 4000
APPLICANT PLUMBING FIXTURE FEE 50.00
AMERICAN MECHANICAL CO, INC. STATE SURCHARGE PLBG(VALUAT[ON) 2.00
7120 71ST AVE.N.
PO BOX 205 MAIL-IN FEE 2.00
LORETTO, MN 55357- TOTAL 54.00
(612)750-0278 PAID WITH CC# 6915
OWNER
Citizens Independent Bank
5000 36TH ST W
ST LOUIS PARK, MN 55416-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perionned according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or rela[ed work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible tbr assuring all required inspections are
requested in conformance wi[h the State Building Code.This permit may be
revoked at any time for due cause.
� � � �� � � � �� �3 �� l�� ��� 13
Applicant Permitee Signature Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
06/19/2013 21 : 43 FAX 7634775629 f�005/007
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��� Ciiy of Orono ����%)��� ���_ , �
O P.ci.Box 66 T3arc Rccc� �/,L� Porm�t a
2750 Kalley Pa�vay
(�yglu!Buy.MN 55323 APWcn�ed F3y :,, Amount$:��
(9i2)249-46(�-Mxu�
� �., (952)249--0b1b-N'ax
� e,` CITY QF OROND—PLUMBING PERMTT
f��fSHDQ'� (A11 Commercial Pernuts 117ust be Appx�oved by t�e Stata Prior to City Approval)
� li.mn. v/CCLD/PDT/ e lamb �l$nreva . df
GENER�L INFbRNiA�TIQN
1. Xou may apply for plumbing permits by mail or in person at tho City offices. Applications wi€1 be
reviewed and a permit will be issued within two working days_
2. Pormit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID C1I�fTll,YOCI RECEiVE�P`ERMiT, R'ORK M[JST NOT HEGIN LTNTiI.THE
PERMIT t'ARQ 1S�9�TTl��QN�JOS SiTE. �
3. Plumbing perrnits may be issuod ONLY co licensed p�umbing contractors and to p�operty owrsers �
residing in the dwelling.
4. When any new canstruction dr remodeling is involved,a separate building pe�mit mixst be
p6tained.
5, All work must be done in aocordance with State Code requirements,
6. All work must be inspected and air tested befc�re it is covared. Call(952)249-A600.
(Z4-48�our notice required)
TY�E OF PERMIT �
(Ck�ecic All 7��li�t APP�Y�_
�egidential �Cvmmercia,l(AppCovAl Rpquired)
❑ New ❑Additional �RePaus ❑R,3plac,�
Q ln Accsssory Structure7
*You wi�need��j,q�'g�rm+al anci may need QJA. (Per Oroao City Code,Chapter 78,Article N)
Iob Site/Owner Information:
Site Address: � � -
pvvnur: Mailin�Address:
City: Zip:
Horne Phone: Alternate Phone:
�ontr,a�tor Infoi-mat�ou;
Cantractar: �l Contact Person:
Addr��s: � State I3ond#: � U7 7�0�
City: d Zi���'Expiration Date: ����"'"��
�—�
Fhone: ��'7��L�� Alternate Phone:
❑ lnsuranee—Cunrer�t:
1
I
06/19/2013 21 :44 FAX �634775629 f�007/007
, ' � • �
!f above do not apply;follow guidelines below: I
1. �ONTTiACT P'RICE 'is t.2�of oon�price wi1,h a(1Vlinimum Fee of 550.00)
, � x.0125$ ;
', oamtructpricc) (minlmnm�50.00) I
2. '' 3TATE$URCHARGE l�UDV r Q� I
G x.Oq05 � �
(oonnautptiNce) M�_�
3. POSTAC�&HANDLING(Only on 11�ai1-In Applicati�ns) $ 2.00
d. �'OT.A,�.�P�r�'��(Add Lines 1-3 Abova) S
� ��
■ ' CON'�'RAC'I' PIi.iCP or JOB COS"f moans the actusl or estimated doflar amount ck�arged for the
peamittBd work including maxe�ials,labor,prnfit,snd othe�fixed cosls. It�s the amouat to be charged
to the cpstomer for the work done. If any material,equip,nent,labor or installauons are fiarnished by
the o�wt�er,tenant or a:ry othe�party,the re�sonable market va.lue of such it�tns must be added to!ha
estimat�d cost or contrad price for penn,it fee ptpposes, In tha eveut that th�re is a dispute pn the
amount�of the jab cost,the City may request the submission of a si�ned copy of the actuaf conpact,
I, i
'I'he undersf gned hereby applies to the City far issuance of a Plumbing Permit, a�r�es to do all '
work in st�i.ct aocardance with the orc1.inances of the City an�d the regulations of the Stste of
Minnesota, and certifies thst all statemen ade on this applicat+on are complete, true and
coarect.
� ��AppIicant's Si�nature. ,,.._ Date.
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