HomeMy WebLinkAbout2012-01135 - plumbing . . � �
. � CITY OF ORONO * 2 0 1 2 — 0 1 1 3 5 *
. , 2750 KELLEY PARKWAY DATE ISS ED: 1U07/2012
� ORONO,MN 55356-
� (952) 249-4600 FAX: (952)249-4616
ADDRESS ; : 2670 KELLEY PKWY �Z��j
PIN � : 33-118-23-12-0063
LEGAL DESC � : STONEBAY OF ORONO CONDOMINNM
� : LOT 000 BLOCK 000
PERMIT TYPE ' : PLUMBING(>$500)
PROPERTY TYPE � : RESIDENTIAL
CONSTRUCTION TY'PE : FIXTURES-MULTIPLE
NOTE: 2 WC,3 LAV, 1 I UB, 1 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER
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VALUATION OF PLUMBING 4000
APPLICANT PLUMBING FIXTURE FEE 50.00
AMERICAN MECHAINICAL CO,INC. STATE SURCHARGE PLBG(VALUATIO ) 2.00
7120 71ST AVE.N.
PO BOX 205 MAIL-IN FEE 2.00
LORETTO,MN 5535�7- TOTAL 54.00
(612)750-0278 � PAID WITH CC# 9327
� OWNER
Citizens Independent ank
5000 36TH ST W ,
ST LOUIS PARK,MN 55416-
AGREEMEN'�AND SWORN STATEMENT
The work for which this plermit is issued shall be performed according to
the approved plans and sp�ecifications,applicable City approvals,and the
State Building Code. Thi�permit is for only the work described and does
not grant permission for a�dditional or related work which requires separate
permits. All provisions o�'laws and ordinances goveming this type of work
shall be compied with wh�ether or not specified herein.This permit will
expire and become null vid void if construction authorized is not
commenced within 180 d�ys of the date of issuance,or if construction is
suspended for a period of 180 days at any time aRer work has commenced.
The applicant is responsi�ble for assuring all required inspections aze
requested in conformanc�with the State Building Code.This permit may be
revoked at any time for 2ilie cause.
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Applicant rmitee Si nature Date Issued y S' ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB .
11/07/2012 03:23 FAX 7634775629 I�002/004
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0 2750 Kclley i'arlcw2Y �,���',�"::3,•.::���,�,'�:�c�':j��jqu�b"$t•;�•
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� ' (952)�49-4�—FRxin ... � i
CITY OF ORONO-PLUMB�Nr PE�T :
' (All Commercial Yermits Must be Approved by the State Prior to City�pp��);
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its by mail or in person at rhe City offices. Applicatian, will be
1�_ You may aPply for plumb�6 P��
' � reviewed tsnd a permit will bc issucd within two wotk�ng daYs•
,� �, pccmit cards wi1L be scnt by retuzn mail after a�vUw is co�PT OT �,G N UNT1L'p
VAL[D rTNT1L YOU R!?C&1VE A PERMI ,
! p�:ItMIT CARD 1S Y STLD ON TH .JU�1'E•
� R. Plumbing permits may bc issucd ONLY w liccnsed plumbing con�xxcu�rs a�'d tO��'OPertp� v�mas
re�iding in the dwelting. te building permit must b
i}. When ar�y new cot�s'huction or reatodelittg is involved,a sepsta
, obtained.
�S. All work must be done in secordance with Scste Code requirements.
;G, Al1 work must be inspectcd end air tcsted bef�Yc it is c,over�d. C�11(952)249-4600.
(24-48 hour aotice teya�rc� ,
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csidcnlial ❑Commarc:ial(Approval Rcyuired)
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� � ❑Additional ❑RePaus ❑Replace +
I [�]New
� [�] 1n Accessory Structure?
i •you wi11 n rior a vai s�nd may necd. '��UP.(Pe�'Omno Gity Code,Chaptor�B,A �icic 1V)
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I S�te Addre,ss:
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��r. Mailing Address:
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Ii�me Phone: Alternate Phone:
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COnti3CtOr: �. QL1I�//�yj.C�LaCt 1 CTSOn:
/��(� State Bond#: � `� ���
iAddress: �
IC;�,: ► Zip:��Expiration Date: /����
�Ph�ne: Alternate Phune: � L , ��7U
� � Insurancc—Current: .'� � -
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11/07/2012 03:23 FAX 7634773629 f�003/004
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TYP�I FL FL _
Wa�,erJCloset � Fluor Dcains
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Sewcr Ejcetor ;
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Laun�y'�Y i
Batht�b ( '.
Washar
ShovWer `
W atcr Hcater �
Kitc;Nen Sink r `
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pispbsal _ —
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Wec Sar
Uisl�washer
Miscellaneous
Sillcocks
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Yes,this section applics
'1 c rep����nent of oaly one eside tial fixture r �' tha�mects a11 three af the followin�
rcquircmants:
l. Does not re9uire modification to electrical or ges servicc.
tal co
. of SS00.00 or l�ss;Exc udin the cost of che tixturc or applianc�: ,d
2. I�35 A U .
�� ed lumbi cont t c
' ' 3. (s impmvcd.installed or ceplaced by the homeowner on c�cns p n8
Cost nf Permit $ �15.0
, ' Skip next scction.if this applics; •�� E S .UO
, fitate S g 2.0
' M,ail-In Pee(If Applicablc) $
�'otel Pcrmit Fce s
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�pprmit Fces Continued Qn Next PA�c)
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11/07/2012 03:23 IFAx 7634775629 f�004/004
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lf above does not apply:follow guideline�balow: �
�i l. GnN'�'RAC'T PRtCE "' is 1.25%of contracL price with a(Mlnimum Fcc of 550.00)i
� � x.0125$� ' —
� (ppntractP��) (minimum S5U.q0
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� 2. s•rAT�suKc � ' , X.000s $_,�—�—�
_L�—.--
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I on Mail-In A licr�tions) $ 2.OQ �
� 3. PUSTAGF&HANllLiNG(Only PP ;
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I� 4. TO'fAL YERMiT Fk�E(Add Lines 1-3 Above) � �
,� � • �;ONTRAC�'1+ PR1C� or 70B COST mcar►s the actual or estimated dollar amount char�ed r the __
• pennitted work including materials•�abor,proft,and othcr fixcd costs. it is the ecn�unt to bP�, arged
tc�thc customer for the wock done. lf any materia�,equipmaft, labor or installacions are fur�is ed bY
th�owncr,tenant or tu+y other party,thc ceasonablo marlcet value of such itGms must bo ad�c to the
es4imat.�d cost or contract price f�r p��mit fee purposcs. in Ute event thet thcre is s dispulce on the
a�ount of the job cost, the City mtiy reque�t the subr[lission �f a signcd copy of the actuaL niract,
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Thc u�d�.h'signed herebY aPP��es to che City for issuance of a Plumbing Permit, agrecs;to do aU
w��rk �in strict aecord�r►ce wi�h the ordinances pf the City and the regulations of th� S te of
I Minn�snla, ancl certities that all state made on this spplication are complete,� e and
, cc�rreat. �
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I' I Date• ��' ��
Appli�ant's Signaturc: . — � " '
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