HomeMy WebLinkAbout2016-00823 - water softener i '�
CITY OF ORONO * Z 0 1 6 - 0 PJ 8 Z 3 *
2750 KELLEY PARKWAY DATE ISSUED: 07/18/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 565 FERNDALE RD N
PIN : 36-118-23-14-0004
LEGAL DESC : UNPLATTED 36 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOIv TYPE : WATER SOFTENER
NOTE: WATER SOFTENER REPLACEMENT
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345- TOTAL 52.25
(952)912-7379 Payment(s)
CREDIT CARD 5107 52.25
OWNER
VEIT,TRAVIS
565 FERNDALE RD N
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 only the work described and does
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 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 I80 days at any time afrer 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 cause. _
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Applicant Pe 'tee Signature Date Issued B ignature Date
07/18/2016 08:57 FAX 9529�a5049 CULLIGAN MNTKA �002
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��� City of OronO �;i',:�° ;FOR, ,,�,',y S(�F�O L1�1�°���
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CITY Q� ORONO-- PLUMBING PERMIT
(All Commercial Pe�mits Must be Approved by the State Prior to City Approval)
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1. Yau may apply for plumbing permits by mail or in person at the City pffces. Applications will be
reviewed and a permit will be issued within two working d�ys.
2. Permit cards will be sent by return mail after a review is compfeted. PERMITS ARE NOT VALID
UNTIL YDU RECEIVE A PERMiT. WORK MUST NOT�EG1N IJNTfL THE PERMIT CARb IS
POSTEb ON THE JpB SITE.
3_ Plumbing permits may b� issued ONLY to licensed plumbing contractors and to properLy owners
residing in the dwelling_
4. When any new consfruction or remodeling is involved, a separate building permit must be obtained.
5. All work must be done in accordance with State Code requirements.
6. �1U work must be inspected and air tested befiore it is covered. Call (952)249�+600.
(24-48 hour notfce required)
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�Residenfiial ❑ Gommercial (Approval Required) [Backflow bevice=�AVB []PVB]
�New 0 Additional ❑ Repairs � Replaca
❑ In Accessory Struc�ure?
'Yau will need rior a rova! and may need CUP. (Per Orono City Code, Chapter 78,Article 11n
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Site Address: b5 �� ��� �� �
Owner: ���.5 V e�� Mailing Address:
City: Zip:
Home Phone: b1 a - �`�l - 073�Alternate Phone:
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Contrac�j Contact Person: J�k�,�ll,�-� .
� �030 GUL[,IGqI� WAY
Address: State Bond #:
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..,_ (s52} g3�-7200
City: � Zip: Expiration Date:
Phone: _ . Alternate Phone: �15� � `7 � a ' 7.� ��
❑ lnsurance —Current:
Page 9
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07/18/201B 08:57 FA% 9529335049 CULLIGAN MNTKA f�00�
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Fe.7����C�.� .Mw,:r.er
FIX7URE BSMT 15T 2ND 4TyER FIXTURE 65M'T 15T 2ND OTHER
TYPE Floor Ffoar TYPE Floor �loor
Water Closet Floor Drains
�avatory Sewer Ejector
Bathtub Laundry 7ray
Shower Washet
Kitchen Sink Water Heater
Disposal Water Softener
pishwasher Wet Bar
Silicocks Miscellaneous
P�,,,� w��.�,��.���a��. a� ��'' ��, ��
�� �'�w'��"�lm'.. �^ aM 2��'1�."'EWI� +���.�.„iRL�7� i •`' n � ni���.. ?"�� e�'I'� ��.L... �� ,rv
7. CONTRACT PRtCE '' is 1.25% of contract price with a (Minimum Fee of$50.00)
X.01 Z5 $
(contract price) (minimum $50.00)
2. STATE SURCHARGE
x.0005 $
(contract price)
3. POSTAG� � HANDLING (Only on Mail-ln Applications) $ 2.00
4. TOTAL P�RMIT FEE (Add Lines 1-3 Above) � .�o�� �
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including rnateriais, labor, profit, and other fixed costs. !t is the amount to b�cF�arged to
the customer for the work done. lf any material, equipment, labor or installatians 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
�,'sg�Y'�.Pah��iR'vR�".'�.. . ` ak. ,.1.�1�'�S'W=."' ' ��'�'�� 'x,.���"!iE'`.�,.���+u" 4X,�:#�,GY+;l.l^�I"�^�+,,,��' I 'A '�.����II.�w� w �.
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
strict accordance with tlie 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 correct.
Applic�nt's Signature: Date: � � ���11.,
Building Of�icial/Inspector: pate:
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