HomeMy WebLinkAbout1999-011385 - water softner PERMIT -
CIT�Y OF ORONO PERMIT TYPE:
��f50 Kelley Parkway- P.O. Box 66 r°i i i�e;:-i;�;v:;
Permit Number:
Crystal Bay, Minnesota 55323 �.-'-�. :����=���
(612)473-7357 Date Issued: - . - - - -.
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - �, _ OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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4..L'1'Z Q'E' ��Ql�ti �kV1; �s"e�Y�,�E`�� �i.r�I.�l:t7o.h�.Q'1� FQ1� �J�.��ti��i P�i101VtYi'
�ox f b (2750 Kelley Parkway)
Crysi�al Bays l�d 553��
GEI�TERAL�NFOI�MATION
1• You may apply for plumbing permits by mail or in person at the City o�ces.
2. Permit cazds will be sent by retum mail after a review is completed. PERMITS qRE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST IVOT BEGIN UNTIL THE PERIvIIT CARD IS
POSTED ON THE 30B SITE.
3. Plumbing permits may be issued ONLY to licensed lumbin contractors and to ro
in the dwelling. P g P Peny owners residing
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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call 249-4600. 24-hour notice required.
Fnstract�ons Complete all items on this application. Compute the permit fee. Sign and date
the certification. INCOIVIPL,ET'E AppLICATION� �VII.L NOT BE PRQCFSSEI}. If you ha�►e .
questions, call 249-4600.
Please check one: New Addition Repair r/ Replace
_,� Residential Commercial
��� s�: ID 58 Lo n-�a.. 'n��v�, ��o� o M r� �p: 55�;�-
C�wner's I'�a�me: � J, �'etep�ic�ne NunB�er: (�/� - 1,,c7� -r�c,� 9�-
1VIailing Address: _/D.S�� ,�
--�Q�ra ,Lir,a/�_ �}-r.�� CitY� �I��U �ig:.�l���
�ontractor's 1\Tame: �'etephone Plcimber: /a -�a 7-
����a��: 6 e��: z�p: z� `�03�.
PF,LTI�I�fING FII�TURE �C�EI2ULE
FIXTURE BSMT 1ST 2ND OTHER FiXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water CIoset Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shawer Washer �
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher We� Baz
Sillcocks hRisc (list) �
P'E�LF� FE+E C�S.F.CUE..�iT101�d
1, 1.25% of Cantract Price* or 1�Finimum Fee (S35.t1(1}
X .�izs $ �5, 0 6
(contract price)
2. State Surchar¢e. ** Add the State Building Code Divisian
Surcharge to each permit. x .0005 $ Jr' d
(contract price)
or $.50, whichever is greater
3, Pastage and Handlin� (Qnly mail-in applicatians) $ 1.50
4. TOTAL PERMIT FEE ' (Add lines 1-3 above) $ ��. 0 O .
* CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged for the permitted
work including materials, labor, profit, and other fixed costs. It is the amount to be chazged to the
customer for the work done. If any material, equipment,labor,or installation are furnished by the owner,
tenane 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 contrace.
** The STATE SURCHAItGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the j?ePartment of Tnspectional Services 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: �{ �7 q