HomeMy WebLinkAbout2017-00103 - plumbing � � CITY OF ORONO �
2750 KELLEY PARKWAY * 2 0 1 7 — PJ 0 1 0 3 *
DATE ISSUED: 02/06/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1575 MAPLE PL
PIN : 08-117-23-33-0032
LEGAL DESC : CRYSTAL BAY VIEW
: LOT O10 BLOCK 006
PERMTT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: WATER SOFTENER
VALUATION OF PLUMBING 200
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.10
CULLIGAN SOFT WATER SERVICE CO. MpIL-IN FEE 2.00
6030 CULLIGAN WAY TOTAL 52.10
MINNETONKA,MN 55345-
(952)912-7379 Payment(s)
CREDIT CARD 5107 52.10
OWNER
Atlas Homes
14450 i 1TTH AVE N
DAYTON,MN 55369-
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 governing this type of work
shall be compied with whether or not specified herein.This permit wi(I
expire and become nu(I 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 confortnance with the Sta[e Building Code.This permit may be
revoked at any time for due cause.
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Applicant Pe �tee Signature Date Issued By ature Date
02/06/2017 10:36 FAX 9529335049 CULLIGAN ffiNTKA �j002
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City of Orono FOR CITY.USE.ONIY<.,_,..�::.;,°. .
�'�� o.Box 66 Datg:Received: _ _ ' _
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0 K Ile Parkwa _ - - - �'��;�`
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C1TY OF ORONO—PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Pnor to City Approval) ,
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1. You may apply for plumbing permits by mail or in person 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 retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERM17. WORK MUST NOT BEGIN UNT1L THE PERMl7 CARD IS
POS7ED 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 construcfion or remodeling is involved,a separate huiiding permit must be obtained.
5. All work must be done in accordance with State Code requi�ements.
6. A11 work must be inspected and air tested before it is covered. Ca11 (952)249-4600.
(24-48 hour notice requtred)
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�Residential ❑ Commercial (Approval Required) (BackflowDevice:0 AVB ❑PVB]
�New ❑Additional ❑ Repairs ❑ Rep(ace
❑ In Accessory Structure?
*You wilt need �rior aq�roval and may need CUP. (Per Orono City Code, Chapter 78,Articie I�
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SiteAddress: .� S'"1 S �� �� �0.�
Owner:_`�T�.s�r��,.,, �`���-�$ Mailing Address:
City: Zip:
Home Phone: Alternate Phone: 61 a - b g5 - 3�$��
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::Cnn�f�actor-�nf.c�rmation:,::;<<�>..,�:�.�::�_.:::;:<;�:;�:;;;:::,:��:�:�.�..�^`.
Contractor. ,etl�[ I I[��AI 1A1ATCo ,:t�8ntact Person:
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Address: �Il�l�r��rnyke p.�,_.��,�� State Bond#:
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City: p�
Phone: Alternate Phvne:
❑ Insurance—Current:
Page 1
02/06/2017 10:36 FAX 9529335049 CULLIGAN hINTRA C�003
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FIXTURE BSMT 157 2"D OTHER FI�X�TPE E BSMT Floor Floor OTHER
TypE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
8athtub Laundry Tray
Shower Washer
Kitchen Sink Water Neater
Disposal Water Softener �
Dishwasher Wet Bar
Sillcocks Miscellaneous
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1. CONTRACT PRICE 'is 1.25% of contract price with a(Minimum Fee of$50.00)
a00 .b0 x.Q125 $ 5'0.0 l�
{contract price) (minimum $50.00)
2. STATE SURCHARGE
� x.0005 . $ ' �
(contract price)
3. POSTAGE 8� HANDLfNG (Only on Mail-In Applications) $ 2.00
4. TO7AL PERMIT FEE (Add Lines 'f-3 Above) $_„ s d . �
* CONTRACT PRICE or J�B COST means the actual or estimated dolSa� amount charged for tha
permitted work including materials, labor, profit, and ofher fixed costs. It is the amount ta be charged to
the customer for the work done. If any material, equipment, labor or installations are fumished 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 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.
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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 ancf the regulatians of the-State of Minnesota, and
certifies that all statements made on this application are complete, true and correct.
ApplicanYs Signature: Date: a J � � ��
Buiiding Officiaf/lnspector: Date:
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