HomeMy WebLinkAbout2005-P08579 - plumbing PERMIT
C I TY J F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P08579
Crystal Bay, Minnesota 55323 Permit Type: FiX�ures
(952) 249-4600 Date Issued: ai6i2oos
SITE ADDRESS: 165 Luce Line Ridge
Maple Plain,MN 55359
P I D: 31-118-23-34-0008
DESCRI PTION:
Proposed Use: Kesicienriai
Permit Class: Plumbing
Pernut Type: Fixtures Pernut Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 35.00 Valuation: $ 2,500.00
State Surcharge Fee: $ 1.25
TOTAL FEE: $ 36.25
APPLICANT: Home valu Inc. OWNER: MI'•&Mrs.Church
5401 E River Rd 165 Luce Line Ridge
Fridley,MN 55421 Maple Plain MN 55359
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITE IGNATURE SUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Auulicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1
�
� PERMIT FEE CALCULATION(S}-JOBS OVER$SQ0.00 -
• If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of connact price with a(Minimum Fee of$35.00)
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2„S D� `� ��
x.0125$ � .S
�ct price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50) �
2, S 0� �� x .0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
' perrnitted work including materials, labor,profit, and other fixed costs. It is the amount to be charged i
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 pernut 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 `
■ ** 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 Building Department at(952)249-4600 for the price.
' , • PLUMBING PERM�T 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 statements made on this application are complete, true and x
conect.
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Applicant's Signature: `{^� Date: �—� � - � S—
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- PLUMBING FIXTURES BE1NG INSTALLED
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet � Floor Drains
Lavatory � Sewer Ejector
Bathtub J Laundry Tray
/
Shower / W asher
;
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
���� �� �PERMIT�FEE'CALCULATION(S)� '�� ' '
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` BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies �
3
The replacement of a Residential fixture or appliance that meets all tlu�ee of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excluding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section, if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
— Mail-In Fee(If Applicable) $ 1.50 - - --`
Total Permit Fee $
(Permit Fees Continued On Next Page)
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� FOR C[TY USE ONLY
� ,�` City of Orono
Og�`YO P.O.Box 66 Date Received: Permit#
�; 2750 Kelley Parkway
a �-'�=2 �. Crystal Bay,MN 55323 Approved By: Amount$:
. �d����'�o�o` (952)249-4600
���08
CITY OF ORONO -PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
' 1. You may apply for plumbing pemzits by mail or in person at the City offices. Applications will be
„ reviewed and a pemut will be issued within two working days.
2. Pernut cards will be sent by retuin 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 consnuction or remodeling is involved, a separate building pennit 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)
❑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:
Site Address: � �.� � � �-' � � ���' �- � � /.�� �
Owner: �o t- G ���2C=�� Mailing Address: ��.S � '��t' �%��= �' ��3 �.
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City: �� C� � G Zip: ..S � .� S `�'
Home Phone: �S � - y 9 S �/S/,S Alternate Phone:
Contractor Information:
Contractor: ��v r"'� V � � �-' Contact Person: /�C�=�-% ��C�-��e-
Address: .�`/� I L ��''� �`� State Bond#: y� G �
City: t����� Zip:3�y.�1 Expiration Date: �� ' � � -G�
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Phone: �G1' S �/' .2 G>j � Alternate Phone: �v/� - �" E` y' � 73 `�
❑ Insurance-Current:
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