HomeMy WebLinkAbout2017-00534 - water softners CITY OF ORONO * 2 0 1 7 - 0 0 5 3 4 *
� „ 2750 KELLEY PARKWAY DATE ISSUED: OS/22/2017
. ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1175 MOONEY LAKE DR
PIN : 25-118-23-41-0017
LEGAL DESC : MOONEY LAKE PRESERVE
: LOT 8 BLOCK 1
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: NEW:2 WATER SOFTNER, 1 R.O.,3 IRON FILTERS
VALUATION OF PLUMBING 14000
APPLICANT PLUMBING FIXTURE FEE 175.00
CLEARWATER SYSTEMS,INC. STATE SURCHARGE PLBG(VALUATION) 7.00
1519 148TH AVE NW TOTAL 182.00
ANDOVER,MN 55304 Payment(s)
(763)4340445 CHECK 34655 182.00
Minnesota State License#:plbg-61240
OWNER
ADELMAN,TIMOTHY
4545 TRILLIUM DRIVE
MEDINA,MN 55340-
AGREEMENT AND SWORN STATEMENT
The work 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 dces
not grant permission for additional or related work which requires separate
permiu. 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 res nsible for assuring all required inspections aze
requested in con ance with tate Building Code.This permit may be
revokedpt time for suse. /�
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icant P i ' ature Date Issued By Signa re Date
�p� City of Orono FOR CITY�SE ONLY
O P.O. Box 66 Date Received: _ ����-� —�
2750 Kelley Parkway � .
Crystal Bay, MN 55323 Permit# ���'f � -- �;(����j�
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CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn qov/CCLD/PDF/pe plumbplanrevapp pdf
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
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 dwelling.
4. When any new construction or remodeling is involved, a separate building permit 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 OF PERMIT(Check All That Apply)
�Residential ❑ Commercial (Approval Required) [Backflow Device:
❑avB ❑PVB�
New ❑ Additional ❑ Repairs
❑ Replace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Job Site / Owner Information:
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Site Address ;� � f ,S ���>���/S ';� �(�evs �� .
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Owner���R2�� �:v� � Mailing Address: l � �'.5�� ��``��v, /� �
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City:�� C>�' � �G Z %2�� Zip: s .��`{7 �
Home Phone: Alternate Phone:
Contractor Informa#ion: ,
'� � � ' S �- Contact Person: �l/�'� i �
Contractor� � ���zcc�1��-�J� � �n�
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Address�d�,�7 / �� /1�- !(J�2-J State Bond #:
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City;���1 ��C���'�— i'��G'l�/ Zip:�� �n�-� Expiration Date:
Phone: ��''� ���� `��"7 � Alternate Phonef�'2-- �2l 7����,.;
❑ Insurance — Current:
Page 1
PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1ST 2ND OTHER FI�PEE BSMT 1sT 2ND OTHER
�rpE Floor Fioor Floor Floor ,
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener �.
Dishwasher �ar��C�.
Sillcocks lti�s�cellan ous �
PERMIT FEE' CALCULATION
�r
1. CONTRACT PRICE "` is 1.2-5% of contract price with a (Minimum Fee of$50.00) ✓�t(I .
/� c`X%
.-„-._., .,_.:�.r_..�'_�.� ��C_... � L r,/
r`��r ��� ` x .0125 $�.....:�i�`� —_
(contract price) (minimum $50.00)
2. STATE SURCHARGE r� l��,3
x .0005 $
(contract price)
3. POSTAGE & HANDLING (Only on Mail-In Applications) $ _
�v
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) � � �
* 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 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 copy of the actual contract.
PLUMBING PERMIT APPLICATION AGREEMENT
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 statemen� made on this,ap�ation are complete, true and correct.
, ;� f - - . :�-�_ . s y -Z ��".
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Applicant's Signatur�: , �� ""---�� _ Date.
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,:
Building Official/ Inspector: Date:
Page 2