HomeMy WebLinkAbout2015-00624 - plumbing CITY OF ORONO *� 5 - 0 0 6 Z 4 *
' 2750 KELLEY PARKWAY DATE ISSUED: OS/19/2015
� ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3499 LYRIC AVE
pi�1 : 17-117-23-43-0090
LEGAL DESC : NAVARRE HEIGHTS
: LOT 000 BLOCK 006
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOI�T TYPE : OTHER
NOTE: MOVING WATER METER FROM CRAWL SPACE/WELL ROOM OUTSIDE TO INSIDE THE BASEMENT WALLS INSIDE.
PUBLIC WORKS TO INSPECT. CALL 952-249-4700 TO SET UP AN APPOINTMENT.
APPROVED BY SCOTT IN PUBLIC WORKS
VALUATION OF PLUMBING 1350
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.68
ARCHER PLUMBING LLC TOTAL 50.68
6521 42ND AVE N Payment(s)
CRYSTAL, MN 55427- CHECK 4181 50.68
(763)238-7589
Minnesota State License#: plbg-W 150193261
OWNER
SCHMID, MARK
3499 LYRIC AVE
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for onty the work described and does
not grant permission for ad ' nal or related work which requires separate
permits. All provisions o s and ordinances goveming this type of work
shall be compied with er or not specified herein.This pertnit will
expire and become n d void if construction authorized is not
commenced within l days of the date of issuance,or if conswction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the S[ate Building Code.This permit may be
revoked at any tim e ca � (��
t`i�/
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Applicant Permitee Signature Date Issued By Signature Date
{ FOR CITY USF�VLY � �-�
� �``� City of Oruno � .n:� 1 EU
� �-�� � P.O.Box(i(i Date Recei�ed: ermit# � ��� ' V
2750 Kelley Parkway +
r Crystal Bay,MN 55323 Approvccl Ry� � � Amowit$:�
� (952)249-4600—Main
�,� �� � j (952)249-4616—Fax ��
� c�� ! CITY OF ORONO— PLUMBING PER IT
��KEstiO��`� (All Commercial Pennits Must be Approved bv the State Prior to City Ap�roval)
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GENERAL INFORMATION
1. You may apply for plumbing pennits by mail or in pei•son at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a revicw is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL TEIE
PERMIT CARD IS POSTED Ol�THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to�roperty owners
residing in the dwelling.
4. When any new constiuction or remodeling is involved,a separate building pei7nit must be
obtaincd.
5. All work must be done in accordance with State Code requirements.
6. A11 work must be inspected and air tested bcfore it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
(Check All That Ap� ly)
.�2esidential ❑ Commercial(Approval Required)
❑ New ❑ Additional �2epairs ❑Replace
❑ In Acccssorv Sn�ucture'?
*You will need prior approval and may need CUY.(Per Orono City Code,Chapter 78,Article N)
Job Site/Owner Information:
Site Address: 3 � 1 �l L `1�21 C. ,4V�,
Owner: ��-�L Sc1�:u.r'1��] Mailing Address: S��
c�ty: G ��� z��: �s3� )
Home Pllone: Alternate Phone: ��1 S Z� 2��' �'�� �
Contractor Information:
Contractor: �Z-C-�-CL�2- Pl,.v,i.�13i-� LCL Contact Person: ��'t-S'��"� .'���•v
N�
Address: �,$—Z 1 4 z' ��'� State Bond#: k����5 3Z 4 C
City: �(LyS7��— Zip:�S�l�'� Expiration Date:
Phone: ��i3� 2.3�` �i S B`1 Alternate Pl�one:
❑ Insurance—Current:
I
� _ -____ _ --
° PLUMBING FIXTURES BEING INSTAI,LED � '
a„u,
FIX"IURE BSMT 1's' 2��' OTH�R FIXTURE BSMT lsr 2 ° OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Draius
Lavatory Sewer�jector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Wa[cr Heater
Disposal Water Softener
Dishwasher Wct Bar
Sillcocks Miscellaneous
IV�DUl.UG '���,'IiC �.lZl.(i.LH— �l�1��`C�T�C. .k:2Xr�t ��QK-�
W,�'�Tl'� /��=-"��� r-�
%N S 11'�z �7.�� 13,���;�c.�.�-�7 tv a��S.
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� ��� ��'�fZMIT�FI-F, CALCULATION(S) �� �
IN
SEn OFI= ?Q02 STATE STA"I'UE���
❑ Ycs,this section applies
The replacement of only one Residential tixture or a�pliance that meets all three of the following
requirements:
1. Does not reqttire modificatioi� to electrical or gas service.
2. Has a total cost of�500.00 or less;excludin�the cost of the fixture or appliance: and
3. Is improved, installed or replaccd by the homcowner or licensed plumbing cont�actor.
Skip next section, if this a}�plies; Cost of Per�ni[ $ 15.00
State S�u�chargc $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Perinit Fees Continued On Nest Page)
2
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� _-;�.�. .°.,� ' PERMIT�E���L,CUL1�'���)�l' � �-�`��� �7 �; R$500 40�W,.'.,.,, �,�, J �,;'
If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is I.25%of co��h•act price with a(A4inimum Fee of$50.00)
L'�7
(�3 S—�`� X .o i Zs � 1� . ��
(conuact price) (minimum$5p.00)
2. STATE SURCHARGE ��.
1, �3 S U X.000s $
' ��o��«a�r,,������
3. POSTAGE&1IANDL[NG(Only on Mail-[n Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
��ermittcd work including materials, labor, profit, and other fixed costs. It is the amount to be charged
to the custonler for the work done. If any material, equipment, labor or installations are fuinished by
the owner, tenant or any othcr party, the reasonable market value of such items must be added to the
cstimated 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.
' -::FLUM'BING'PERMIT APPLICATION AGREEM��,T `
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance witl� the ordinances of tl�e City and the rcgulatious of the State of
Minnesota, and certities that all statements made on this application are complete, true and
correct.
�
Applicant's Signature: � Date: ��� ��
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