HomeMy WebLinkAbout2017-00508 - plumbing ' CITY OF ORONO * z 0 1 7 - 0 0 5 0 8 *
2750 KELLEY PARKWAY DATE ISSUED: OS/16/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 100 BAYSIDE TR
PIN : 06-117-23-22-0026
LEGAL DESC : BAYVIEW FARMS 2ND ADDN
: LOT 1 BLOCK 1
PERM[T TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: NEW: WATER SOFTNER
VALUATION OF PLUMBING 2749
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.37
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345- TOTAL 53.37
(952)912-7379 Payment(s)
CREDIT CARD 5107 53.37
OWNER
NORD, RANDAL& LINDA
P.O. BOX 429
MAPLE PLAIN, MN 55359-
AGREEMEIVT AIYD SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,appiicable 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 goveming this rype 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
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By Signature Date
05/16/2017 07:54 FAX 9529335049 CULLIGAN MNTKA C�002
� City of Orono FOR CITY SE ONLY;
� �O P.O. Box 66 Date,ReceiVed.
2750 Ke11ey Par�Cway Permit# �G � 1��b�—'–""
, �, Crystal Bay,MN 55323 ,:
fi G (952)249-4600–Main Approved B.y
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�'/KFsxva`' (952)249-4616—Fax y�":� '�
Amount$ "�
CiTY OF ORONO—PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
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GENERAL INF�RMATION ` '; , >
1, You may apply for plumbing permits by mail or in person at the City off'tces. 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
UNTIL YOU RECE(VE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD 1S
POSTED ON THE JOB S1TE. p P owners
3. Plumbing permits may be issued ONLY to iicensed plumbing contractors and to ro erty
residing in the dwe(ling.
4. When any new construction or remodeling is involved, a separate building permit must be obtained.
5. Ali work must be done in accordance with State Code reqttirements.
6. All work must be inspected and air tested before it is coverecf. Call (952)249-4600.
(24-48 hour notice required)
` ' TYPE OF'PERMIT(Check AII That ApP�Y) '` �
�Residential ❑ Commercial (Approval Required) [Backflow Device:[]AVB ❑PVB}
� New ❑ Additionaf ❑ Repairs ❑ Replace
❑ 1n Accessory Structure?
*You witl need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article I�
Job'Si#e I Qwrier:lnformat�on:
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Site Address: 1�1� �0��5��� �`��� 1
Owner:_Q��� �o r c� Mailing Address:
City:
Z;p. 55 3 5
Home Phone: _^lb 3 � 559 - �3`�g Alternate Phone:
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Confracto.r.lnformation:"
Contractor: ��tact Person:
6030 CULLiCA�! 1iVAY
Address; , �r,anr�-rc�n��n, ���*+ �����—State Bond #:
(A�2� �3�-�200
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ lnsurance —Current:
Page 9
05/16/2017 07:54 FAX 9529335049 CULLIGAN MNTRA f�003
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FIXTURE BSMT 1sT 2"o OTHER F{�XYTPEE gSMT �sr 2ND 07HER
Typ� Floor F{oor Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscelfaneous
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1. CONTRACT PRICE *is 1.25% of contract price with a(Minimum Fee of$50.00)
�y9 . oD X.a��S � 50,0�
� (contract price) (minimum $50.00)
2. STA7E SURCHARGE
x .0005 $ I . 3�
(contract price)
3. POSTAGE� HANDLfNG (Only on Mail-In Applications) $ 2.Ob
4. 7�TAL PERMIT FEE (Add Lines 1-3 Above) $ �3' 3�
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted 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 instaltations are furnished by the
owner, tenant or any other party, the reasonable marke# vafue of such items must be added to the
estimated cost or contract price for peRnit fee purposes. In.the event that there is a dispute on the
amount of the job cost, fihe City may request the submission of a signed copy of the actual contract.
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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 alf statements made on this applicatio� are complete, true and correct.
Applicant's Signature: � Date: -5 � ( ' 1
Building Official/[nspector: Date:
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