HomeMy WebLinkAbout2016-00390 - water softner ,
• CITY OF ORONO * z 0 1 6 - 0 0 3 9 0 * �
2750 KELLEY PARKWAY DATE ISSUED: 04/19/2016
ORONO,MN 55356-
(952)249-4600 FAX: 952)249-4616
ADDRESS : 3300 NAVARRE LA
PIN : 17-117-23-44-0098
LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: REPLACE WATER SOFTNER
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
SWANSON,MICHEAL
3300 NAVARRE LA
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 Ciry 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 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. ��n
f�.y�
` �,( � r •-�-� � f�i ��
Applicant Permitee Signature Da e Issued By Signature Date
04/19/2016 10:a1 FAg 9529aa5049 CtiLLIGAN MNTKA �002
FO�CITY US�ONLY
�p� City of Orono ���q���,,�
� O p.b.sox 6e Dau Received:��,"-,,f�-�„ermi[# Z D I(,� �j��
„�
a�;r,r,,,, 1�50 Kelley Parkway
a � C rystal Ba y,M N 5 5 3 2 3 A p p ro v e d B y: A m o u n t ffi:
���,� (952)249-4600 �
CITY OF ORONO-PLUMBING PERMiT
(All Commel'Cisl permits mus�be dpproved by the Build ing 011 icial or Inspecop�)
GEN�RAL INFO�ATION
1. You may spply for plumbing permiLS by m�il or in person at the City of�ices. Applications will be
reviewed snd a permiit will be issued withjn two working days.
2. Permit cards will be sent by rewrn mail at}er a review is completed. PERMITS ARE NOT
VALID UN'I'II,YOU REC�IYE A PERMIT. WQRK MTJSr NOT SEGIN UN7TL THE
PERMIT CA,RD IS POS7'�D ON TTiE J4�SITE.
3. Plumbing permits may bc issued ONLY lo licensed plumbing contraetors end to properry o'umers
residing in the dwelling.
4. Whcn any new construction or remodeling is involvc�a separate building permit must be
obtslned.
5. AII work must bc done in accordance witf�5zate Code requirements.
6. All work must be inspected and air tcsted before it is covered. Call(95Z)249-4b00.
(24-48 hour notice ircquired)
TYPE OF PERMIT �
� Check Atl That�1 1
��esidential ❑Commercial(Approval Required}
� _ cw ❑Additional ❑Repairs �J Replacc
/
i
[r.;lnAccessoYy Structure? '
*You will need nrior aoorovsl and may need CUP.(Per Orono Ciry Code,Chapter 78,Article 1'V) . '
. �
Job Site/Owner Infanmation: '
e
Site Address: �d 1;� )'1 • �
� S
���� '� Mailing,Address: �
c;ri: zip: � �
Home Phone: �� �� Alternate Phone: �
�
Contractor Information: 4
;
C���AN��g��N� Contact Person: � �
6030 GU��I�AIV VdqY `
Addres�INN�Qp��� • ���„� State Bond#: ;
(952) 933-72dQ ;
City: Zip: �xpiration Date� f
Phone: _ Alternate Phone: �_�-� �o�,-���' ;
�
❑ Insurance�Current:
�
l ;
�
04/19/2016 10:�1 FA% 9529�a5049 CULLIGAN M1VZ'KA C31003
N",^��ibl'�_;�`4"�„KI+"h,' (,:��,y%1.,ar.�S;��•L"�'� ,' }'�"�J�s��,1:7:�4��d+� ',�''"��, j .i,,1 •..., ,
y.i�,;':� i'�!•)�,;I.�•iii�*'�I�— '���'n 5 t� � 'r'�M'�,�t�;' j'i,' �-��;�.fl'ntui;,Y:���'i:^,i'����y'��
FIXTURE BSMr 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL T'YPE FL �'L
Water Closet Floor Drains
Lavatory Sewer Ejector
Bsthtub I,aundry Tray
Shower W�6�
Kitchen Sink Water Heater
Disposal Water Sottener .(
Dishwesher W�g�
Sil lcocks Miscellaneous
i'W7"^n!'r.'( ''J'.t�^[I�7Jl•C'�i^�°ul e GNnt2r11�J' I +� ���!�' � �����.����,����'.��µ�1 � � a
,J y�I:.iA� �°i'A, ��� ile- ,ip�.�y {, 1 � ���• 4 �. : �r.r���:xi I..a � J7 "F��:.�r':`„
.�'l'I��r `"''l.•1�5 �' ��,ti.�,,y� :�q• ,i. �il^.�L;�'�i,i;;!+';''�".��JU:+� '���I,'V�',w41�1 �e;'� ','�j.��:cdt!.'::�A�if ��•.y,�
� �P�,Jr-:ir, „�� "�I'M'i '„�fy'� 1� �ti�;� u,A^�.. �.r•� C •"� � r �,:4.�.���
"��• ���i�i.,� �� ..�!:' ,�i i;1�T 1�' � ,y-,��y�*�+ "�,{ .y 1 Y �' !r ' �•ii�; �I�F�i��„�1`/;:� y�u;
,y1 ,`ryy ;'/, �rti I'f1'r, „Tr:t. 1 �r�. �y��4:� + '�� •�,t=`�;
�� '�;r' �'fi+ �:'�, ��'. A��l'l,���JTT"�.:'L� ( � ;1�., f�..,.� r,
�L'���1�.1�G�����1,'U",L�!;� �'l'f:h.e �� ��M;�,����, ,'i;?_r,
❑ Yes,this section appiies
The replacement of a ReSidential fixture or appliancc that meets all three of the following requirements:
1. Does not require modification to electrical or gas serviee.
2. Has a total cost of SS00.00 or less;excludine the eost of ihe fixCure or appliancc:and
3. Ts improved,installcd or replaced by the homeowner or licensed contraetor.
Skip next section,if this applies; Cost of Permit $ ]5.00
State Surcharge S 5.00
Mail-In Fce(If Applicable) $_�
Tot�l Permit Fee $
(Permit Fees Cootinaed Qr�Next Page)
2
.04/19/2016 10:a1 FA% 95293a5049 CULLIGAN MNTKA f�004
.:�a�n;r' ���f'r•;r y ,p �p y� a yyy�7��� r ��,'�•A, Q1n , ";; „ �r�;:•"'a c 9,�,,;t�,�
,'S�y ,GV, ��i;"y�r'�f" ,yl �� 'i�PE�=f.i �', ��,�V+�y: �'�1��� � y r'1�'„��y�����;', '��u,-I� �F�M
`�� !. ��� o��•'r. ,�<<ti, 'S�!►��� '�����S�.�t�.� ���VJ,�' D�;y�,.
Yf above does not apply;follow guidelines below:
1,. CONTRAGT PK)C� *is 1.25%of Contract price w�(Minimum Fee o�$50.00��
x.0125$ ✓O
(contrac�pnce) (minimum 550.00)
2. S'I'A�'�SY1YtCHARGE **Add the Statc Bldg Code 174v.Surcherge{Minimum Fce of S5. )
x.000s $ ` 2
(ep�tfacz prix) (minimum S 5.00) �
3. POSTAGE&HANDLrNG(Only on Mail-In Applications) $ 2.00 ,�
y-� ��
4� TO'I'AL PERMIT FEE(Add Lines 1-3 Above) S V
■ "` CONTR.ACT PRICB or ]OB COST mesns the actual or estimated dollar amount charged for the
permitted work including matcrials, Isbor,ptofit,and other fixed costs. It is the amount tp be chargcd
to the customer for the work done. If any mattrisl, equipmen� Iabor or installations are fumished by
the owner,tenant or any other party,the raasonable market value af such items must be added to the
estimated eost or contract price for permit fee ptuposes. In the event that there is a dispute on the
amount of the job cost,Lhe City may request thc submission of a signcd eopy of the actual contract.
■ *'�Thc STATE SURCF3ARGE is_0005 of the contract pricc under$1,000,000 or 55.00—r�vhiehever is
greater. For veluations over$1,004,U00 call the Building Department at(952)?49-4600 for the price. .
������,'�.+����lrf+r'�"�O�I:ti7'bi1�, .�1!� ''�#r�1��C'� ����'R�'�� 'Y��.��di"i��1i1 �.+'���.al w�7�li'�l��h
�'`L•Yi
The undersigned liereby applies to the City for issuance of a Plumbin� Permit, agrees to do all
work in sirict accordance with th� ordinances of the City and the regulations of rhe State af
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: Date: �
�`�n�:�y�;�,,�F�f��
";;+rJ;�� r�n;'�}�.���^:!,c f.
3