HomeMy WebLinkAbout2013-00821 - plumbing *' '• II.�IllllllJlll
CITY OF ORONO * 2 PJ 1 3 - 0 0 8 2 1 *
2750 KELLEY PARKWAY DATE ISSUED: 08/27/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2670 KELLEY PKWY
PIN : 33-118-23-12-0070
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING (>$500) �
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULT[PLE
NOTE: UNIT#302
(2)WATER CLOSETS,(3)LAVA"I'ORIES,(1)BATHTUB,91)SHOWER,(1)K[TCHEN SINK,(1)DISPOSAL
AND(1)DISHWASHER
VALUATION OF PLUMBING 4000
APPLICANT
PLUMBING FIXTURE FEE 50.00
AMERICAN MECHANICAL CO, INC. STATE SURCHARGE PLBG(VALUATION) 2.00
7120 71ST AVE.N. MAIL-IN FEE 2.00
PO BOX 205
LORETTO, MN 55357- TOTAL 54.00
(612)750-0278 PAID WITH CC# 6915
OWNER
Citizens Independent Bank
5000 36TH ST W
ST LOUIS PARK, MN 55416-
AGREEMENT AND SWORN STATEMENT
Thc work tbr which this permit is issued shall be perfomied according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. 1�his permit is for only the wark described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions oY laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revok at any time for due cau e.
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Applicant Permitee SignaCure Date
ssue By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
FOR CTTY USE ONLY
, �QA l� City of Orono g'J�/�,J Q
E y � P.O.Box 66 Date Received: / Permit# �O l 3 !>�
�, 2750 Kelley Parkway
?j l Crystal Bay,MN 55323 Approved By: Amount$:
i � (952)249-4600—Main
�',��; � ��j (952)249-A616—Fax
' Fl � ;`�,f CITY OF ORONO—PLUMBING PERMIT
���F"fs tin�`�i (All Commercial Permits Must be Approved by the State Prior to City Approval)
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GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTII,YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON TI-IE JOB STTE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in ttie dwelling.
4. When any new consUuction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with State Cc�de requirements.
6. All work must be inspected and air testetl before it is covered. Call(952)249-4600.
(24-48 hour norice required)
TYPE OF PERMTT
Check All That A 1
�Residential ❑Commercial(Approval Required)
❑ New ❑Additionat ❑Repairs ❑Replace
❑ In Accessory Structute?
*You will need nrior aparoval and may need CUP.(Per Orono City Code,Chapter 78,Article N)
Job Site/Owner Information:
Site Address: �� t� � �:'1' �c.��� � ' � ,/�
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Owner: Mailing Address: �
City: Zip:
Home Phone: Alternate Phone:
Contractor Information: r�
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Contractnr: � `' ���`� � � ���' ,��� °�' 'J f?� �� ontact Person: �����! �
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Address: '�-���-�� ���f � State Bond#: ''�"� ��. :�`
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City: � (.' °` "' � � ����f Zip. ���� �Expiration Date: /,� ��.. � �,
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Phone: Alternate Phone: ���_�" _�- �',�����
�] Insurance—Cunent:
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ff above dces not apply;follow guidelines below:
1. CONTRACT PRICE * is 1. %of contract price with a(Minimum Fee of$50. )
'� � x.0125$ �
(contract price) (minimnm o.o�
2. STATE SURCHARGE � �' /j--
�� U� x.0005 $
(eontiact price)
�, 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.0
4. TOTAL PERMIT FEE(Add Lines 1-3 Above} $ —( �
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount cha ed for the
pexmitted work including materials,labor,profit,and other fix�costs. It is the amount to be charged
� to the customer for the work done. If any material, equipment, labor or installations are ished by
the owner,tenant or any other party,the reasonable r�rket value of such items must be ded to the
estimated cost or contract price for permit fee purposes. In the event that there is a dis e on the
amoum of the job cost, the City may request the submission of a signed copy of the a 1 contrack
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undersigned hereby applies to the Crty for issuance of a Plumbuig erna t, agr to do a1
w in strict accordance with the ordinances of the City and the regulations of e State of
M' esota, and certifies that a11 statements made on this application are compl true and
c ect.
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Ap�licant s Signature: Date:
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