HomeMy WebLinkAbout2016-00678 - waater softner , CITY OF ORONO * z 0 1 6 - 0 0 6 7 8 *
� 2750 KELLEY PARKWAY DATE ISSUED: 06/14/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1082 LOMA LINDA AVE
PIN : 08-117-23-23-0009
LEGAL DESC : LOMA LINDA
: LOT 008 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: REPLACE:WATER SOFTNER
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 025
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULL[GAN WAY
MINNETONKA, MN 55345- TOTAL 52.25
(952)912-7379 Payment(s)
CREDIT CARD 5107 52.25
OWNER
TOMAN, JULIE
1082 LOMA LINDA AVE
MOUND,MN 55364
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 does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified hereia 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 afrer 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. I,�
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Applicant Permitee Signature Date Issued By Signature Date
0�/14/2016 08:57 FA� 9529�35049 CULLIGAN MNTKA C�002
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FOTi CTTY U5F,pNLY
p� City of Orono �/I/ �� �'7�l'
r �� �Q P,O,Box 66 Daie lteceived: ��7 7 �Permit# �/� ��(% /�5
a�,;,,,� 2750 h,elley Parkwuy
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'�'�%r,��o (952)2q9-4600
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C1�TX OF ORONQ–�LU117BING P��.2MZT
(All Commercisl permiu must be approvcd by the Building OfFicial or Inspector)
G�NERAL INFOl�MATION
1. You may apply for p�umbing permits hy mail or in person at the Ciry offices. Applications rvill be
reviewed and s pem�it will be issucd within iwo working days_
2. Permit cards will Be sent by retum mail after a review is completed. FERMITS ARE NOT
VALID LJNTIL'Y'OU RECEIV�A p�RMIT. WORK MY15T NOT BEGP.V YJ;�'�'IL THE
��RMIT CARD XS P05TED pN'r'H�JOB SITE.
3. Plumbin�permits may be issued ONLY to licensed pinmbing contractors and to properry owners
residing in the dwelling.
4. When any new constructian or remodeIing is involved,a sepazate buiIding permit must be
obtained.
5. All work must be done in accordance with State Cod�requirements.
6. All work must be inspected and air testcd before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE OF P�,RMIT
(Check AIl That A, ]
�Residential ❑ Commercial(Approval Requircd)
❑New ❑r�dditiona] ❑Repairs �Replace
❑ in Aceessory Structure? i
*You wifl need riar a roWal and may nead CUP.(Pcr Orono Ciry Code,Chapter 78,Articic 1V)
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J'ob Site/Owner Xz�formation:
Site Address: �Q�� �0 v�nC, !.-.^i✓� I�
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Owner: �•.1�e I o�a v� 1Vlailing�lddress; ;
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CitS'� Zip: ��3
Horne Phone: �1 a -`I l 9 ��1�6$�F Alternate Phone: '
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Contractor Information: �
,
GU��.Q����yqT Contact person:
6030 CULLIGAN Wqy G �
�f}�$�rpJ� State Borad#: �
(952j 93�-720Q �
�Ih'� — Zip: �xpiration Date: �
Phone: Alternate Fhone: :
,
[� Znsurance–Current:
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06/14/2016 08:57 FAX 9529335049 CLiLLIGAN MNTRA C�003
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FIXTURE BSMT 1 2 OTHER FIXTLTI� BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower W ashtr
Kitchen Sink Water Heater
Disposal Water Softener �
Dishwasher W�$�
Sillcocks Misccllaneous
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n�� �i.1.' 1 ' :'I�v�i. ,"� $ � �1 n� �.���i�✓I"�^i"if,i�� �'�� �M1�rltr✓'-rIYM
,�;�;!, .��,�;y;l�-; !'i�l!1�'����1;!�!':k��i���!'„ '�':' '.,[�,lE,��:�.n—r.��tir���A' ��J�t'nC.'�',�l�w;• a� 41���'� ,:,x�;�•nJ
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'jt �1�{) �,y, r• , �yy�y�.y�, y�}� i;i[t �)�[�'r7�1 �.y .� . .�k�'�'';';�f^� �� d;, w;a''�
,',X'��'i r I„ �1,r`�'p� �li I�� :'","' ,n! ��N�1'�f4�1V�;U��',i71;�1 l:'J,�_'i�'�'"i'�i�ii}� �7 ������'� :I�
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❑ Yes,lfiis soctian applies
The replacement of a Residential frxture or appliance that meets a11 three ofthe following requirements�
1. Docs not require modification to electrieal or gas service.
2. Has a Cotal cost of$500_00 or less;excludine the cost of tho fixt►uc or appliance:and
3. Ys improved,installed or rcplaccd by the homeowner or licensed eontractor.
Skip ncxt section,if this applies; Cost of Permit $ ]5.00
State$urcharge $ 5_00
Mail-In Fce(If Applicable) S Z.00
Total Permit Fee $ '
(Permit Fees Continued pn Next Fage)
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06/14/2016 08:57 FAX 95293a5049 CULLIGAN MriTKA f�004
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�w����:,��'��r.'''•.i,���i!;.���;����lt'�.'�����;�;?���:,.:;,b'„��,Q�';5�,,„�4�'�;,,�`�R;,R',$��Ob:!0,'�;�;.j,"r`s'��';�,�;;��,';,.�!:��;;:.c'�;
1f abovc docs not�pply;follow guidelines below:
1. CONTRACT PRICE *is 1,25%of contract price with a(Minimu�m�'ee of$50.00)
x_0125 S
(wntrdct priCe) (minimum SSD.00)
2. STATE SURCI�ARCE **Add thc Statt$ldg Code Div.Surcharge(Minimum Fee of 55.00)
GTG�� ��
./ x.0005 $
(wntt8tt prlce) (minimum$ 5.00)
3. PQSTAGE&HANr1�L1NG(Qnly on Msil-In Applications) $ 2.00
4. TOTAI.PERMIT F'��(Add Lines 1-3 Abave) $ .�o� . c�7
■ * CONTRACT PRICE or JOB COST means the actual or estimatcd dollsr amount charged for the
permittod work including materials, labor,profit,and other fixed r.osts. It is the amount to bc charged
to the customer for the work done. If any macerial,equipment, labor or installations arc ivmished by
the owner,tenant or any other party,thc ressonable market value of such itcros must be added to the
estimated cost or contract price for perntit fee purposes. In the event that there is a dispute on the
aznount of thc job cost,thc City may reqtlest the submission of a signcd Copy of the actua! contrac�.
■ *"The STATE SURC7�TARG�is.0005 of the contrsct priee under$1,044,000 or$5.00—whichcver is
greater. For valuations o�er�J,OOQ,Q00 call the Building Deparlment at(9S2)249-4600 for the price.
't:! w ��(5�/� � i�- - F7� r�!�r,, �p ���. ?�y��,y 'y�r", y�� ;y •Lrr'r„ iv�"f i
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do a11
work in sfict accordance with th� ordinances of tY►e City and the regulations of the State of
Minnesota, and certifies that all statements made on this applieation are complete, tru� and
correct.
Applicant's Signature: � Date: ' �.� '
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