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HomeMy WebLinkAbout1996-007772 - plumbing � P��RMIT � eCITY OF ORONO PERMIT TYPE: � 2750 Kelley Parkway- P.O. Box 66 F�!�������#� Crystal Bay, Minnesota 55323 Permit Number: (J;�'j���� (612)473-7357 Date Issued: i�:^;��:w;�q�., SITE ADDRESS: ���,d�' LYD I A�ia t�VE L:H �' . I .N. ; �I—11?—z:'—�'_:—�_�t y:�;i i DESCRIPTION: 1 FI�TE��;E �'lur����irr� F'�rrait• Ty��� FIitTt1�;���_ F'1�.tt��t�?i�� �1�=��'�:: T���►w FiEF'L�1�:�� E�;I'=:T I��� i i.�t�TER NEATE�t REMARKS: FEE SUMMARY: �'t�Lt 3(��'i i'i�( ��.;r;:� ��s? F�e �:�:� , i�i; t1i�IL IN _--______�.�.��i� :=:u��cF������.v __------ —�-���s� �'��t•L I �N�. �,:�7 .t�r.-� °:����,t.�_��.�t 1 �$:_��. .��,i:t CONTRACTOR: -- �1F��1 a.i:�nt• — OWNER: [:t)���T���t�l F'LE�f� I#��C� :�:'.�-_,41 i��.�i'::a Ff:F_EL�� EI_��ti�� i�'�1 � H I LLt=��HY FC? ��`+�.:�.::� �Y�'3I AFC� �?�+� C�i I Ntv�T��t�i��::€� ��I��� ��:1�.:; i�h�=itdi i t�#1�1 ��_�:s 1 t,�.!;�' } �,,�.�-(i;,'t�7:=� �.7 j,-,�;F�F�,h. T�-!� �1�lU�F�°=;I tat��L:i �-�I��:(��;Y �:��:��1�'=;T'=; �`��'�i I'�;°w�i���}� s±} t�t=��::�: �'�-i� ��t�a_ i�1�'�'i��'��`�;•���t���'';� '���'�=:�i�I E:Cy �=tt,t�� �t;���':�: �'��� C�i�a �L�. �}�=:�'t��: ��4 ��±�'l:�:# i:,::4•�#�`;...?f����':1�: ��i�� F�tk.: ;::�-:h:' 3��F ���l���i���+ j���`�i I����i?�i.��'� Htt�l� �;T�iTE �:�F i�i i��i��:'�=t i�Tia L,�_3��.�I i�liM ,,.;_i�� �;�;��L;z�°I�i=��it�'�°=� . L � ��� -� APPUCANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �CS�(. , • �1�11•�2 .a C1TY OF ORONO APPLICATION FOR PLUMB�GPL�tMIT I3ox 6b (2750 Kelley Parkway) �P Cryst�l Bay, MN 55323 GENI;RAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. 2, Pennit cards will be sent by rcturn mail after a revicw is completed. PERMITS ARE NOT VAI_ID UNTIL YOU RGCGIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THG PGRMIT CARU 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 constn�ction or remodeling is involved, a separate building permit must be obtained. 5. All work must be done in accordance with the State Code reyuirements. 6. All work must be inspected and air tested before it is covered. Call 473-7357. 24-hour notice requircd. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357. Please check one: New Addition Repair _� Replace Residential Commercial JOR SI'I'C: a�/�(�—�` ����,� Q�- Zip: Owner's Name: �' _ � ��.¢�,�.� Telephone Number:_ �l_��__ MailingAddress: Cus�p�,��y�.���� City: 'Lip: Contractor'sName:� 2105 D,�N�,�L� �T___ TelephoneNumber: �'�q--O ��4'� MailingAddress: P.O, gp) 94 _ _City: Zip: � LAKE, MN 55356-OG94 PLUMBING FIXTURE SCIIEDULE FIXTURE BSMT 15T 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER 1'YPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Disllwasher Wet Bar Silicocks Misc (list) . • ,. P�RMIT FCE CALCULATION l. 1.25% of Contract Frice* or Minimuni Fee ($35.00) ,'S.�'.���z x .0125 $ ��, � �, (contract price) 2. State Surchar�e. ** Add the State Building Code Division Surcharge to each permit. x .0005 $ �O (contract price) or $.50, whichever is greater 3. Postage and Handling (Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ o�,�� O O * CONTRACT PRICE or JOB COST me<1ns 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 iur iiie woric done. Ii any materiai, equipment, labor, or installation are furnist�ed by the owlier, tenant 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 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 Inspectional Services for the price. T'he undersigned hereby applies to tlie City for issuar�ce of a Plumbing Permit, agrees to clo all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesnta, and rertifies tl�at �ll staten�ents made on ttiis �ipplication are complete, true and correct. Applicant's Signature: �p�� �.���zs Date: ,�'– ��—�,6