HomeMy WebLinkAbout2012-00880 - plumbing � � � CITY OF ORONO * z 0 1 z - 0 0 B 8 0 *
2750 KELLEY PARKWAY DATE ISSUED: 09/OS/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2425 MAPLE LA
PIN : 33-118-23-44-0021
LEGAL DESC : DANIELS LONG LAKE HEIGHTS
: LOT 002 BLOCK 003
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: WATER HEATER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345 MAIL-IN FEE 2.00
(952)912-7379 TOTAL 22.00
PAID WITH CC# 0597
OWNER
ROTHSTEIN&MEGAN SHINKLE,DAVID
2425 MAPLE LA
LONG LAKE,MN 55356-
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 only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction 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 State Building Code.This permit may be
revoked at any time for due ca se.
� `.��Lt�u.t..�r(1 "�1/ Cv l / �. � l � l t 1-_
Applicant Permitee S�gnature Date Iss d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
09/05/2012 13:20 FA% 9529335049 CULLIGAN �NTRA f�002
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F USE ONLY
$b'� P:0 Box�roao ��� ���� �g�
� O Daro Reccivo�� Pem�it
2750 Kelley Peiicwey
� Crystal Hay,MN 55323 Approved By: Amount S:�_
��� (952)�{9-4600
CTTY OF ORONO—PLUMBING PERMIT
(All Commercial permitv must be approvad by�he Buitdmg Official or Inspector)
GENERAL INFORMATION
l. You may appty for plumbiag pe�mits by mail or in person at the City offices. Applications will be
reviewed and a petmit will be issued witfiin two working days.
2. Permit cards wiU be sent by roturn mail after a review is completed. PERMITS ARE NOT
VALm UNTII.YOU RECENE A PERMTf. }�VORK 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 construction or romodeling is involved,a seperate building permit must be
obtained.
� 5. All work must be done in accordance with Stste Code requirements.
6. All work must be inspeated and air tested before it is covered. Call(9S2)249-4600.
(24-48 bour notice required)
TYPE OF PERMIT
Check All That 1
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �Raplace
❑ In Accessory Structure? �
+You will aeed orior aooroval and may need CUP.(Per Orono City Code,Chapter 78,Article 1V)
Job Site/Owner Information:
Site Address: ay a5 (na►P� l..o►r�2__
Owner: �avt 1b�1�,�c,►r MailingAddress:
City: Zip: .ss 351.
Home Phone: b 1 Z.-�7 0 •�t a�.9 Alternate Phone:
Contractor Information:
��t�ac�okN Contact Person: n►
��3 ' DITIOf�ING
�030 CUILIGAN WAY State Bond#:
Addr��NET , 45
�,C��: (952) 933-7200 Zip: Expiration Date:
Phone: Atternate Phone: � -`��a-�3 I 7
❑ Tnsurance—Current:
1
09/05/2012 13:21 FA% 9529335049 CULLIGAN MNTRA f�003
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTF�R
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Batfitub Laundry Tray
Shower Washe�'
Kitchen Sink Watex Heater
.. ;. _ ,. . _ Disposal __ Water Softener _.
Dishwasher Wet Bar
Sillcocks Miscellaneous
�
� Yes,this section applies
The replacement of a Residentiaf fixhue or appliance that meets all thrce of the following requirements:
1. Does not require modification to elactrical or gas service.
2. Has a total cost of SS00.00 or less;excl ' the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensad contractor.
Skip aext section,if this applies; Cost of Permit S 15.00
State Surcharge S S•00
Mail-In Fee(If Applicable) S 2.00
Total Permit Fee S
(Permit Fe�s Conrinned On Next Page)
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09/05/2012 13:21 FA% 9529335049 CULLIGAN �NTRA �004
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T,:r*, a: ,c �C� `!iY•� .t^.�f;'�Y: :h�"•�:o,'r.r
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If ebove does not apply;follow guidelincs below:
1. CONTRACT�'RICE *is 1.25%of conttact price with a(Miaimnm Fce ot S50.00)
x.0125�
(contract pncc) (minimum SSo_oo)
2. STATE 3URCHARGE *�Add tfie State Bldg Code Div.Surchatge(Minimum Fee of SS.00)
x.0005 $
(conuact price) (minimum S 5.00)
3. POSTAGE&HANDLING(Only on Mail-in Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S ��0�
,,�. ��... ;„� . . _ . _ .. _ _
■ " CONCRAGT PR10E or JOB COST means the actual or estimated doUac am�unt charged for the
permitted work including materials�labor,profit,and othet fixed costs. it is the amount to be charged
to thc customer for the work done. If any material,equipment, labor or instellations are i�umished by
the owner,tenant or arry other pariy,the rea4onable market velue of sach items must be added to tha
. estimated cost or contract price for permit fee purposes. In the event that thera is a dispube on the
amount of the job cost,the City may request tfie submission of a signe� copy of tho actual contract.
■ "`*The STATE SURCHARGE is.0005 of the cflntract price under�1,000,000 or$5.00—whichever is
greater. For valuations over S 1,000,000 call the Building Department at(952)249-4600 for the price.
The undersigned hereby applies to the City for issuance of a Ptumbing Permit, agrees to do all
work in strict aceordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statemants made on this application are complete, true and
correct.
Applicant's Signature: Date: Q—5 • � �
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