HomeMy WebLinkAbout2012-00277 - plumbing CITY OF ORONO * 2 0 1 z — 0��
,, 2750 KELLEY PARKWAY DATE ISSUED: 04/12/2012
ORONO, MN 55356-
' 952 249-4600 FAX: 952 249-4616
ADDRESS : 3438 LIVINGSTON AVE
PIN : 17-1 17-23-43-0020
LEGAL DESC : NAVARRE HEIGHTS
: LOT 019 BLOCK 002
PERMIT TYPE : PLUMBING (>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER
VALUATION OF PLUMB[NG 1 100
APPLICANT PLUMBING FIXTURE FEE 50.00
BOB JASPER PLUMBING STATE SURCHARGE PLBG (VALUATION) 0.55
5840 ENSIGN AVE N
NEW HOPE, MN 55428- MAIL-IN FEE 2.00
(763)234-7240 TOTAL 52.55
Minnesota State License#: 059797 PAID WITH CC# 8283
OWNER
MESSETH/CAOLA, MARK& SUSAN
3438 LNINGSTON AVE
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The��ork for which this permit is issued shall 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 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.
'I'he applicant is responsible for assuring all required inspections are
requested in confonnance with the State Buiiding Code.This permit may be
revoked at any time for d cause. � �
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Applicant Vermit e S�gn ure Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Z01z-Oa-1Z 06:56 UNITED HEATING&L4C 61z5ZZ656Z» +95lla9a6�6 P vZ
� FOR CITY USE ONLY
II ' � A, City ut Orono Da�e A�ecoi�cd, �— Permi.t.i� �—
� '�'�`Y P.O.Bax 6G
I 0 � 2750 Ke11eY PerkwaY AppiOveQ BY� �— '°'mount S' ,
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(A5�)za9-a600—Main
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CI�TY OF ORONO — PLU�VIBING PERMI T al
(All Commercial PcrmiCs Must be Approved by tbe State Prior io City App )
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�GErr�L�'oRM:A,.TiaN , �
�. you may apply for plum.biucag permits by rr�il or in person at the City o�ices. Applicetions will be
reviewed and a permit will bc issucd�*rithin two working days•
Z, Pcrmic cards wi.11 be sent bY return mail after a teview is complettd, P�KMIT5 ARE NOT
VALID UNTxT,XOU RECEIVE A PERMIT. WORK MUST NOT IEGILrLCiLvTIY.THE
p�RMIT TED ON THE O$S TE.
3. Plwn.bito.g pernuts may bc issued ONL�'to licensed plumbing contractors a�d t0 p[operry owncrs
resadi.nB in the dwelling.
a, When any new constru�tion or rcmodcling is involved,a aaparate building peX�1011T Ili7u9i be
ob�ained.
5. A11 wOCk must bc dono in accordancc with Stute Code raquiremenu.
6. All work must be inspcct�d and air tcsted before it is eovered. Call(952)249-4600.
(24-48 hour nvtice rec�uircd)
TYPE OF PE��I'I'. ; �
Check'Al1 That A 1 '
I �Residcntial ❑ Commacial(Approval ltoquacd)
❑New ❑Additional []Repairs �Replace
��urb��
❑ in Acces;ory Structurc? `
"'�'ou will ueed�riur aaaroval and may aeed CUP. (Per Orono Ciry Code,Chepler 78,Article iV)
Job Sitc/Ovvricr Tnfoxmataon:
Sitc Address: y � � �� V� '?ys �'`'� f�V-�
Owner:�V?c.h n t G� 01-� . Mailing,A,ddress_ ������ M�v
c,ty: v r�.� � zip: �'S~3 � I
Home Phone: �S � 3� `�l�/7 Alternate Phone;
�Contractor Sn�oz�z�atiox�:
Coz�cractox� �v� �� �� I��' �C�ntact Person: �� 6 ��s ��
Address:`�� �� �5��r � �� State Son#: 0 �� � � � M
�a 5��� �
City: �� �C Z1p: Expiration Date: `�—3 j — a 0/ �
Phone: � �3 �3`�1 � �`� � Altemate Phone;
� Tnaurance—Current: �� (�2�.l
1 `�) � I
2012-04-12 06: 7 UNITED HEATING&AC 61�52�656� » +9522494616 P�/�
1f above does not apply;follaw guidelines below:
I1. CONTRACT PR�CE *is 1,25%of conuact price with a(Minimum Fee of SS0.00)
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xA125$
� ���.� (con cc price) (minlmum SS0.00)
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E� �'C� 2. STATE SiJRCHARGF
�' {�v' x.0005 $
�(' (convact pricc)
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3. POSTAGE&HANDLING(Oaly on Mail-In Applications) $ 2.00
I �I 4. TOTAL PERMiT FEE(Add Lines 1-3 Above) $
i
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• '' CONTRACT pR10E or J0� COST means the actual or esemated dollar amount charged for the
- permittcd 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 installations are furnished by
the owner, tenant or any other party, ttte reasonablc mar�Cet value of such itcros must be added to the
estimated cost or eontract pnce for permit fee purposes. Ip the event that there is a dispute on the
amount of th�job cost, the City may request the submission of a signed copy of the actual eontract
The undersi�ned hereby applies to the City for issuance of a Plumbing Permit, a�rees to do all
work in strict accordance with thc ordinances of the City and the r�gulations of the St�te of
Minnesota, and certifies that all sta.temcnts made on this application are complete, txue and
correct.
Applicant's Signature: f• �r U� Date: �� /� �� '�� ���
3