HomeMy WebLinkAbout2012-00738 - plumbing CITY OF ORONO * z 0 1 z - 0 0 7 3 s *
� � 2750 KELLEY PARKWAY DATE ISS En: 08/OU2012
, ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2670 KELLEY PKWY #24 J
PIN : 33-118-23-12-0057
LEGAL DESC I : STONEBAY OF ORONO CONDOMINNM
: LOT 000 BLOCK 000
PERMIT TYPE II : PLUMBING(>$500) ,
PROPERTY TYPE I : RESIDENTIAL
CONSTRUCTION TY1�E : FIXTURES-MULTIPLE
NOTE: 2 WC.3 LAV, 1 T I�B, 1 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER, 1 WASHER
VALUATION OF PLUMBING 4000
A PLICANT PLUMBING FIXTURE FEE 50.00
AMERICAN MECHANI AL CO,INC. STATE SURCHARGE PLBG(VALUATION) 2.00
7120 71ST AVE.N. i MAIL-IN FEE 2.00
PO BOX 205
LORETTO,MN 55357- MISC FEE 0.00
(612)750-0278 TOTAL 54.00
iOWNER
Citizens Independent Bank
5000 36TH ST W
ST LOUIS PARK,MN 5$416-
AGREEMENT A D SWORN STATEMENT
The work for which this permit is issued shall be performed according to �
the approved plans and specific tions,applicable City approvals,and the i
State Building Code. This pe it is for only the work described and does
not grant permission for additi nal or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether r not specified herein.This permit will
expire and become null and voi if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 ys at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with he State Building Code.This permit may be
revoked at any time for due cau e.
:��-1 l�C.. / /
/
Applicant Permitee Signature Date Issued By ' nature ate
SE ARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
i
` FOR CITI'USE ONLI'
' �
City of Orono Date Received: Pennit# �_
OQ°�� P O [30�66 � -
Q, �
3750 Kelle��Parkwa} qpproved By: Amount$
,� � +.. �. Cns[al Bay,MN 55323
i� -���'�' : o`�':� (9�'_)249-a600—Main
�''Rssao�`w (95"_')249-�616—F1�
CITY OF ORONO — PLUMBING PERMIT '
(All Commercial Permits Must be Approved by the State Prior to City Approval)
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! GENERAL INFORMATION
I. You may apply for plumbing permits by mail or in person at the City offices. Applications wi11 be
reviewed and a permit will be issued within two working days.
? Pennit cards�viil be sent by return mail after a review is completed. PERMITS ARE NOT
�'ALID L'NTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNT[L 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.
1. ��'hen any new construction or remodeling is involved,a separate building permit must be
obtained.
A11 work must be done in accordance:�ith State�::�de�eq,'�remerts.
�, 411 �vorh must be inspected and air tested before it is covercd. Caii (953)249-46�0• I
(2�3--18 hour notice required)
TYPE OF PERMIT
, (Check All That A 1
'�j�Residentiai ❑ Commercial (Approval Required)
i
Re airs ❑ Replace
❑ tiew �'Additional ❑ P
❑ In .-�ccessory Structure?
"you will need prior annroval and may need(:_[_�P.(Per Orono City Code,Chapter 78,Article IV)
i Job Site / Owner Information:
�
.,' �, ' ' � �
" � � I� � �� � ' ,A� .�fv , -
Site Address: ?r' l� ' °' �� `- ' ''
O���ner: Mailing Address:
Cit�: Zip: ---
Home Phone: Alternate Fnone:
� Conti•actor Infor�nation: //
� ti �"�C.f C���.l'� 1�%[�
: , ,���r ,�}.,� .� . Contact Person: c�f�
Contractor: r ✓�1�� 1 C � �
r`��t �'�jC�' ��'�/
�,r�.,• ��,:,� State Bond #:
Address i r� / ^^��
3 / � ''/��
Z� ���� Expiration Date:
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City: ��,- •� p' ' ?, � "%i- L C'�` i
�'�,� J��a� t��,��� Alternate Phone. �/�' � � �
Phone: j��, �
�� Insurance—Current: l�4�'�
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, PLUMBING FIXTURES BEING INSTALLED
2 OTHER FIXTURE BSMT 1 ?' OTHER
FIXTL'RE BSMT 1 TYPE � FL FL
' TYPE FL FL
'� Water Closet �
Floor Drains
Sewer Ejector
, Lavatory
Laundry Tray
I Bathtub i
W asher � �
� �
' Sho��er � �
Water Heater i
Kitchen Sink '
� Water Softener i
Disposal � �I I I i I
Wet Bar 'I
Dish��asher /
' cellaneous i
M�s
�� Sillcocks �
' I�
PERMIT FEE CALCULATION(S)
I BASED OFF - 2002 STATE STATUE
U Y'es,this section applies
The replacement of only one Residentiai fixture or appliance that meets all three of the follo�ving
requirements:
1. Does not rec�uire modification to electrical or gas service.
2 Has a total cost of$500.00 or less;excludin the cost of the fixture or appliance:and
;. is ;n,nr�ved, installed or replaced by the homeowner or licensed plumbin�contractor.
$ 15.00
Skip next section, if this applies; State S uchar�ge $ � � 5.00
Mail-In f ee(If Applicable) $ 2.00
Total Permit Fee $
I i
,�
(Permit Fees Continued On Next Page)
2 I
� r
I PERMI'T F�E�ALCUT.ATIO�I S'- —°�OBS O`�R$��(1.00
i
If above does not apply;follow guidelines below:
I. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.0
� ' l
� X.�125�
(contract price)
(mmimum S51'00)
2. STATE SURCHARGE �/G��y x.0005 $
/
(contract pnce)
' - n A lications) $�•��'
Onl on Mail I pp
! ;. POSTAGE&HANDLING( y
$ /�
4. TOTAL PERMIT FEE(Add Lines 1-3 Above)
l
I * CT PRICE or JOB COST means the actual or estimated dollar amount n�to�e charged
■ I CONTRA
permitted work including materials, labor,profit,and other fixed costs. It is the a�ncu
to the customer for the work done. If any material, equipment, labor or installations are fi� ' ished by
the owner, tenant or any other party,the reasonable market value of such items must be a� ed to the
estimated cost or contract price for permit fee purposes. In the event that there is a dis� te on the
I amount of the job cost, the City may request the submission of a signed copy of the actul contract.
i
I PLLJMBTNG'P�ERI�IT AFFL�CATTQN AGREEMENT
Th��e imdersigned hereby applies to the City for issuance of a Plumbing Permit, agre� to do all
w rk in strict accordance with the ordinances of the City and the regulations of th State of
M nnesota, and certifies that all statements made on this application are complete, true and
co�rect.
. ���f--��
A�plicant's Signature:
Date:
� ReS�t Farm
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