HomeMy WebLinkAbout1997-009789 - water softner � PERMIT
LiTY OF ORONO PERMIT TYPE:
�� 2750 Kelley Parkway- P.O. Box 66 Permit Number. ; .; :�:_,•.,'� ��
Crystal Bay, Minnesota 55323 Date Issued: �
(612) 473-7357
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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C1TY OF URONO APPLICATION FOR PLL;�MBII'Q�P��T
Box hb (2750 Kelley Parkway) � , '�159?
Cry�tal �ay, MN 55323 '
GENERAL INFORMATION
L You may apply for plumbing permits by mail or in person at the Ciry offices:
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECENE A PERMTT. WORK MUST NOT BEGIN UNTII, THE PERMIT CARD IS
POST'CD ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors aad to property owaers 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 required.
Instruction� Coa�plete all items on this application. Compute the permit fee. Sign and date
the certi�cation. INC011�lPLET� APPLICATIONS WILL NOT BE PROCFSSED. If you have
questions, call 473-7357.
Please check one: New Addidon Repair �Replace
Residential � Commercial
JOB SITE: o�0 �..o w,a �.'�v.��. `--�+`^e- Zip;
Owner's Name; S��. �i n��c � Telephone Number: c:.t'j�,- �,3 K 6
Mailing Address: Ci 7� ;
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�� TelephoneNumber:_ �-►�y g -c�!y 7
CIiSTOM PLUMBING INC. � �
2105 Daniels St. Cl�'' p�
P.O. Box 694 G FII�TURE HED E
Long Lake, MN 55356-0694
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT �1ST 2ND OTHER '
TYPE FL FL . TYPE FL FL
Water Closet Floor brains
Lavatory 5ewer, Ejector
Bathtub Laundry-Tray
Shower Washer
. Kitchen Sink Water Heater �
Disposal Water $oftener � �
Dishwusher Wet Bar
Sillcocks Misc (list)
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PERMIT FEE'CALCiJLATION
1. 1.25°!o of Contract Price* or Minimum Fee ($35.00) ,_. a,.p
X .oi2s $ 3�- �
(contract price) .
_ 2. State Surcharge. ** Add the State Building.Code Division .
. Surch�rge to each permit. x .0005 $ . 5p
( � Pnce)
or $.50, whichever is greater
3. Postage and Handlin� (Only mail-in,applications) $ 1.50
4. TOTAL PERNIYT FE� (Add lines 1-3 above) $ �'"l. `° � .
* CONTRAC'f PRICE or JOB COST means the aetual or estimated dollar amount charged for the permitted .
work including materiaLs, labor, profit, and other fued costs. 1t is the amount fo be c�argecl to the
cvsiomcr for the work dane. If any�materia�, equipment, labor�or installation aze furnished.�y the owner,
tenant or aay other party the reasonable market value of such items must be added to'the estimated cost
or contract price for permiC 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.SLTRCHARGE is :0005 of she contract price under $1,000,000 or �.50 - whichever is
' .greater. For valuations over$1,000,000 ca1� ihe Department of Inspectional Services for the price. �
The unc�ersigried h�reby 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 certif es thaf:all. statements made on this app�ication are complete, true. and
correct. _
' nature: � Aa�e: �:�:-� t�.�t 7 .
Applicant s Sig : �