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Home My WebLink About2016-00932 - plumbing � ' CITY OF ORONO * 2 0 1 6 - 0 0 9 3 2 * 2750 KELLEY PARKWAY DATE ISSUED: 08/08✓2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 770 NORTH ARM DR PIN : 06-117-23-43-0009 LEGAL DESC : AUDITOR'S SUBD.NO.362 : LOT 006 BLOCK 000 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: REPLACE(1)KITCHEN SINK,(1)DISPOSAL AND(1)DISHWASHER VALUATION OF PLUMBING 802 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 0.41 AIR MECHANICAL,INC. MAIL-IN FEE 2.00 16411 ABERDEEN ST NE HAM LAKE,MN 55304 TOTAL 52.41 (763)4347747 Payment(s) Minnesota State License#:mech-MB005122 CHECK 048167 52.41 OWNER CARLSON,JEFFREY 770 NORTH ARM DR MOLJND,MN 55364- 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 permiu. All provisions of Iaws and ordinances goveming this type of work shall be compied with whether or not specified hereia 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 cause. ( cC� �-e.�� 1 (7 Applicant Permitee Signature Date Issue Signature Date �-� �� `�.,�:c,� . � 5a�'�� KCVtiV�I,J �i� ��o^,� city of orono pU� � $z�� FOR CITY U� o,�L`Y O ,, P.O. Box 66 Date Received: �- �i� I 1 2750 Kelley Parkway ' � �� Crystal Bay, MN 55323 CITY OF ORO{� Pe�mit# O��r �P '�d� \y�^!\ �% (952)249-4600-Main A r O v e d B : �<�H�� (952)249-4616-Fax pp y � Amount$: �� CITY OF ORONO — PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) http://www.dli.mn.qov/CCLD/PDF/pe plumbplanrevapp.pdf GENERAL INFORMATION 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 return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbir�g contractors anc� to property owners residing in the dwelling. 4. When any new construction or remodeling is involved, a separate building permit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. (24-48 hour notice required) TYPE OF PERMIT(Check Ail That Apply) --�Residential ❑ Commercial (Approval Required) [Backflow Device: ❑ AVB ❑ PVB� f ❑ New ❑ Additional ❑ Repairs �7teplace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV) Job Site /Owner Information: r. Site Address: ��-- ; � (�C �S� �`�('M ��-�. Owner: �� P�� . Sc�c� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ��< � ` � Contact Person:� < <� ��t('. C�.r Cc� Address: �� {��State Bond #: �C��S , �,, \ City: `.,�(�o1`C� 1 (�� s� v�c� Zip:�� Expiration Date: �Z 3�� Phone: ��,-5� a - �� Alternate Phone: ❑ Insurance — Current: Page 1 PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1sT 2"o OTHER TYPE Floor Floor TYPE Floor Floor Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink � Water Heater Disposal � Water Softener Dishwasher � Wet Bar Sillcocks Miscellaneous PERMIT FEE CALCULATION 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) � � � �{.��- x .0125 $ � l (contract price) (minimum $50.00) 2. STATE SURCHARGE ��" - X .0005 � . y� (contract price) 3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ �c� �� * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished 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. PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the �j dinances of the City and the regulations of the State of Minnesota, and certifies that all statements m�de on this lication are complete, true and correct. ,_/ ApplicanYs Signature: �� W Date: • ��-f' , Building Official/ Inspector: Date: Page 2