HomeMy WebLinkAbout1997-009683 - plumbing , -� PERMtT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley P�way - P.O. Box 66 �
Crystal Bay, Minnesota 55323 Permit Number: .. _. _ :
(612) 473-7357 Date Issued:
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 _ �.�i .
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CFT� O� C�Y�.QR7Q� �gL�C�i�if�l`TFO� . � IliTG �Rl��
B�x b6 (2750 Kelley Farkway) � � �t���
Crysta.� �ay, 1�Il\' S5323 �,��
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, GENEITAI.INFQRMATION .r�t ` �,
L You may apply for plumbing permits by mail or in person at the City offices. -
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECENE A PERMIT. WQRK 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Ca11473-7357. 24-hour notice requ'ued.
Instructiaim� Coa�plete all item5 on this application. Compute the perrnit fee. Sign and date
the certificatiaii. INC0114PLET� Al'PLICATIQNS WILL NOT BE PROCESSED. If you have
questions, ca11473-7357.
Please check one: New Addition Repair Replace
Residential Commercial
3Q� S�:�� ��__ �. �� �)°J Zip;
Owner's Name:�`S"�Lc� ,d- Tj�l,�_�� �eiephone Number:
1Vfaiiuig Acidress: �ity: �ig;
Contractar'sl`1ame: �`� � � '��` TeieghoneRTumiaer: �' — � ���-
1V�ailingA.ddress: � City: Zip:
���JMBIl'�G �+,��URE SCI�EB�T�.E
FIXTUR.E BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet � Floor Drains
Lavatory 4 Sewer Ejector
Bathtub Laundry Tray
Shower � Washer
Kitchen Sink Water Heater
DisposaI Water Softener
Dishw.,sher Wet gaz
Sillcocks Misc (list)
���.r�r� �� e�.�.cur,�.Trc��
1. 1.25% af Contract Price* or l�inimum Fee (S35•Ot�1
/��, . �'n x .0125 $ ��
(contract price)
2. State Surcharge. ** Add the State Building Code Division .
Surcharge to each permit. _ /'�.� x .00QS $ . s� -
(coniract price)
or $.50, whichever is greater
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3 1• /,C
* 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. 1f any material, equioment, labor,or installation aze fumished by the owner,
tenant or any other pazty the reasonable market value of such items musi 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 Ciry may request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of lnspectional 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 dinances of the City and the regulations of the 5tate of
Minnesota, and certifies that all s tements made on this application are complete, true and
correct.
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A plicant'sSignature: Date: � �-/
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