HomeMy WebLinkAbout2017-00433 (Plumbing) CITY OF ORONO * 2 0 1 7 - 0 PJ 4 3 3 *
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2750 KELLEY PARKWAY DATE ISSUED: OS/02/2017
ORONO, MN 55356-
� (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1432 BALDUR PARK RD
PIN : 08-117-23-43-0007
LEGAL DESC : BALDUR PARK
: LOT 007 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOIY TYPE : WATERSOFTENER
NOTE: NEW: WATER SOFTNER
VALUATION OF PLUMBING 1499
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.75
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345- TOTAL 52.75
(952)912-7379 Payment(s)
52.75
OWNER
NYQUIST,MR. &MRS. JOHN
1432 BALDUR PARK RD
WAYZATA, MN 55391-
ACREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
Ihe 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 l80 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 aIl 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
05/02/2017 08:32 FAX 9529335049 CULLIGAN MNTKA f�002
� City of Orono ' FOR GJ�Y USE NLY
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� '� �O P.O. Box 66 Date Received �� �� ���' ��-�-. ,`
2750 Kelley Parkway 4'"
t,, �, Crystal Bay, MN 55323
Permit# ' -� �-� t i
sfi� �L� (952) 249-4600--Main Approved By ���
�'�f�HOa (952)249-4fi16-Fax . � � .
Amount$ :`. t "�'�
CITY OF ORONO— PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.aovICCLD/PDF/pe plumbplanrevaDp.pdf
' GENERAL INFORMATION <
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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
UNTIL YOU RECEIVE A PERMIT. WORK MUST N07 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 dwelling.
4. When any new construction or remodeling is involved, a separate buiiding permit must be obtained.
5. Ail work must be done in accordance with State Code requiremenfs.
6. All work must be inspected and air tested before it is covered. CaIE (952)249-4600.
(24-48 hour notice required)
, ,
° TYP.:E OF P.ERMfT(CF�'eckAfl ThatApply), '
�Residential ❑ Commercial (Approval Required) [Backflow Device: Q AVB ❑PVB]
�New ❑ Additional ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 7$, Article I�
'Job;$ite /Qwner'fnformation: ;:
Site P,ddress: I�i3
$A1�„_r- Q0.� 1� R�
Owner:`�o�� '�����5� Mailing Address:
City: Zip:
Home Phone: 95a-`1� 1 - � `�� � Alternate Phone:
Co.ntractor lnformation: '
Contractor: ••ULLIGAN WATFR r�n�n�-r+������4ntact Person:
6030 CU�ILlGAlV 1hIp,Y
Address: ti11�1�ETOt�KA, M� ���4TState Bond #:
. (9��2) 9:��••72�i0
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance— Current:
Page 1
05/02/2017 08:32 FAX 9529335049 CULLIGAN MNTKA [�003
;- a ...;:: f , �. ; Pl.U:MB.(NG FIXTURES_BEING:.I�ISTAL�'ED ' ` `''
�
� FIXTURE BSMT '{ST 2ND OTHER FIXTURE BSMT 1sT 2"D OTHER
TYPE Floor Floor TYPE Floor Floor
Water C(oset Floor Drains
Lavatory ( Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Neater
Disposaf Water Soffener '
Dishwasher Wet Bar
Sillcocks Miscellaneous
'k'�� ..�_g .. '.. .� �' ���."r�.. . ,_:,r; . � '',.;'�.PEF�MfT:FEE CAL.GU';LP+,TEON : z �` , . �
a .�,. � _
1. COM1iTRACT PRiCE * is 125% of contract price with a (Minimum Fee of$50.00) ;
, � �''
1yqQ . �� X .o�2s � '�.�-
(contract price) (minimum $50.00)
2. STATE SURCHARGE
f ,.
� x .0005 $ � l �'1
(contract price)
3. POSTAGE � HANDLiNG (Only on Mail-!n Appiications) $ 2.00
4. TO7AL PERMIT FEE (Add Lines 1-3 Above) $ Sa,�-5
"' CONTRP,C7 PRICE or JOB COST means the actua! or estimated dolfar amount charged for the
permitted work including materials, labvr, 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, the reasonable market value of such items must be added to the
estimated cost or contract price for permit 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 capy of the actual contract.
; ��� " ,,� � h�` � P,,L.UM�I:NG :P�R11Af:T,AP..PLICAT�ONHAGI�EEI�IIENT'�; �... �; "�...�; y �, �d�.�, �...;
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do afl 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: -5- a ` ,�
Building Official/ Inspector: Date:
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