HomeMy WebLinkAbout1991-003583 - plumbing PERMIT
C4i�Y OF ORONO PERMIT TYPE:
* 1335 Brown Rd. South • P.O. Box 66 ��"�j�������'
Permit Number: {iC�;:�i=;=;
Crystal Bay, Minnesota 55323 Date Issued: ii:�:�ii:�:�i�.
(612) 473-7357
SITE ADDRESS: �
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DESCRIPTION:
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CONTRACTOR: __ ��,�,i ���}t�. __ OWNER:
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P CANT/PERMITEE SIGNATURE ISSUED BY:SiGNATURE
l.iit� UL� I�YZt.i�CJ t]��Li�.�ii'vil i Vi2 i�aU.'��.T17 �.:.�."�y�i
Box�66 (1335 So Brcwn Rd)
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,� ` Crystal Bay, MN 55323
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General Instrnctions
1. You r�ay apply for plumbing permits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fees shown below.
Pe_^.nit cards aill be sent by return mail the same da1 the application is received.
3. Permits are not valid until you zeceive a permit card.
4. Work must not begin unless the permit card is available on the job site.
5. Plumbing permits may be issued to licensed contractors only.
6. When any new construction or remodeling is invol ved, a seoarate building permit must
be obtained.
, 7. All work r,iust be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 473-7357.
24 hoar notice reqnired.
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JOB SITE ADDRESS: � �. � � "'�=
- Occu�ancy Type: � Residen ial Commercial
OWNER'S NAME: /�Z���^�� `� `� _ Phone No. : ��7 l - � � '� 7
Mailing Addres s: �< ��� �k r� � << � � City: � �-;,���• r r F=
CONTRACTOR'S NAME: ����"'Z` C%' ��'�� Bu s. No. : G-j 7 ��-`� `� �C�
Mailing Address: �3 =�'� :a �v��� r .z �� [-.���, � City: �2-rc����� r� Zip:,-��� ,�,�
Master Plumber' s State License No. : ��= 7 ��
City Cert. No. : �tr�
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PLIIMBING FIXTIIRE SC3EDIILE
(Show number of fixtures of each ty�e on each floor)
FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER
---+-----^--------- ----------- --------- --�-----
-------------1--�-�- i .
V:atez Closet I , �Sewer Ejectorl
__________y____�________ ____ ____I______ __________________ ___._____1=====____ _____
i i � � �Laundry Tray �
Lavatory � � I I � �
Bathtub ----- I----f--—----;---------i------�Washer-------�----I---•----- ---------------
� I ------ tdater_fieater-I----�---•—--- ---------! -----
Shower-------I-(---i-------i-- --- - 1----- ------
._ . -------- ---•----- ------- ---- -�
----- � �
Ritchen Sink � I IWater Softneri �
� �������������..��������.�_���� ����������������������������1���� ���.����� ���������������
Bisposal Wet Bar �- �
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� ������������� �����r������� �
Bishwasher i ' Sump Fump �
-------------5---- ----- --- -------- ------ ------------- ---- ------- ----------�-----
Sillcocks f � Misc. (List)
: ------------- -----L---�--- -------- ------ ------------- ---- ------- ---------- -----
Floor Drains
------------- ----- ---�---- --------- ------
------------- ---- -------- ---------- -----
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1. Fixture Fee The minimum permit fee is $30.00 $
Compute number of fixtures x $5/fixture
x $3/fixture reset
2. State Surcharge $ '50
- 3. Postage & Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above) $
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The undersigned hereby applies to the City of Orono 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 cor�eEtZ
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�-. --L = ` Date: - `' � /
Signature of Applicant: ,
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