HomeMy WebLinkAbout2009-00742 - install water heater CITY OF ORONO PERMIT NO.: 2009-00�42
, � 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 10/2U2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2749 KELLY AVE
PIN : 21-117-23-23-0027
LEGAL DESC : REG.LAND SURVEY NO.0891
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: INSTALLING GAS WATER HEATER-AIRTEST REQUIRED
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
TEARLE,CHAD&ELEANOR STATE SURCHARGE PLBG(<$500) 0.50
2749 KELLY AVE
EXCELSIOR,MN 55331- TOTAL 15.50
PAID WITH CC# 7304
OWNER
TEARLE,CHAD&ELEANOR
2749 KELLY AVE
EXCELSIOR,MN 55331-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shali be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoke at any time for due caus .
_ .�'���J�/�cl, �Di 2( i (l�( ���t� /oi a/i v
Applicant Permitee Signature Date Iss d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
FOR CITY USE Ol�1LY
� • O,¢Q�,O City of Orono /��,� .�,�y�� ?��
P.O.Box 66 Date Received! Permit#�/ "
2750 Kelley Parkway
� � ,�_. � Crystal Bay,MN 55323 Approved By: Amount$: �'�`
��p4yc (952)249-4600
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
GENERAL'INFORMATION
1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be
reviewed and a pernut will be issued within two working days.
2. Pemut cards will be sent by return mail after a review is completed. PERMIT5 ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL 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 dwelli,ng.
4. When any new consirucrion or remodeling is involved,a separate building pemut must be
obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE QF PERMIT ''
, (�tieck A11=That A. ly
�Residential ❑ Commercial(Approval Required)
❑New ❑Additional ❑Repairs �teplace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address:
Z`1`-I �j �EL.I,� �Y I/� .
Owner: �'aD `�E��-E Mailing Address:
City: Q t�-V/✓� Zip: S s3 3 �
Home Phone: q �2-`�� �- �Z-�-1 Alternate Phone:
'Contractor Information:
Contractor: `�pM� R^���2��N Contact Person:
Address: State Bond#: Q 5� `��2' y r M
c�ty: A��Q��a'�� Zip: Expiration Date:
Phone: � �2"� �5�0y�y�� Alternate Phone: �Jr2" � 12 -5y2�
❑ Insurance—Current:
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater �
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
� Yes,this section applies '
T'he replacement of a Residential fixture or avpliance that meets all three of the following requirements:
1., . Does not require modification to elecirical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $�.�
b ,
(Permit Fees�ontinued�On Neat Page) ' " `.
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. • .
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pernutted work including materials, labor,profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor or installarions are furnished by
the owner, tenant or any other party, the reasonable market value of such items must be added to the
estimated cost or contract price for pemut fee purposes. In the event that there is a dispute on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
/
Applicant's Signature: ����""''��"��� Date: �� '1�l � OI
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