HomeMy WebLinkAbout2010-00016 - plumbing � CITY OF ORONO PERMIT NO.: 2010-00016
' 2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE IssuEn: OUi2/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1280 NORTH ARM DR
PIN : 07-117-23-41-0009
LEGAL DESC : SAGA HILL REVISED
: LOT 000 BLOCK 003
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 0.50
6030 CULLIGAN WAY
MINNETONKA,MN 55345 MAIL-IN FEE 2.00
(952)912-7379 TOTAL 17.50
PAID WITH CC# 0597
OWNER
PANCHYSITYN,TIMOTHY&JEAN
1280 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 does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this rype of work
shall be compied with whether or not specified herein.This permit will
expire and become nuli 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
revok at any time or due cause.
1 /l /a-l�D/v
Applic t Permi ee Signature Date �/�� �v/�
Is By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
O1/12/2010 09:50 FAX 9529335049 CULLIGAN MNTKA f�002
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� � .FO '� USE ONLX
0 City of Orono � ���-'�� �
O�" '�0 P_O.Box 66 ' Date Receive � � Permit�# I�" D��
2750 Kelley Pazkway �
Crystal Bay,MN 55323 Approv,ed By: Ainount S: �7 .
��� (9S2)249-4600 • . • ' .
CITY OF ORONO—PLUMBING PERNIIT
(All Commercial permitv must be approved by the Building Officiel or Inspector)
GENERAL 1NFORN�'ATIO�T' � • ,.,;:�� �� . �t. �.;�; , .
� 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed aad a permit will be issued within two working days.
2. Pertait cards will be sent by return mait after a review is completed. PF.RMITS ARE NOT
VALID UNTII,YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERNIIT CARD IS,�OSTED ON THE JOB STTE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to properiy 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. CaII(952)249-4600. �
(2448 Lour notice requirecn
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�Residential ❑Cotnmercial(Approval Required)
�New ❑Additiona] ❑Repairs ' �Replaee
❑ In Accessory Structure7 �
*You wi�l need orior aonroval and may naed C:UP,(Per Orono City Code,Chapter 78,Article I'V)
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Site Address: �a g C� � Arnn �f��
Owner:�2aY1 Pa nc.,�ny Shu v� Mailing Address:
. ciri: z�p: 55 3 6�f
Home Phone: _95� � `191 - a i o y Alternate Phone:
� ,�`�����tiox F,.Ii�fariiia�i'.o'xi:;:�,:�; :k..;- ;�� �-,:,';
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ontractor: Contact Person: c� �k�D
��L`I�'AN Wp�EA CONDI�`IONIN� . 9
030 CULL�GAN qy Sta.te Bond#:
Add�e.� ��r KA� MN 55345
City: ��5�') 9�9-72pp Zip: Expiration Date:
Phone: Alternate Phone: 9 5 a- �i a-7 3� 9
❑ Insurance—Current:
. 1
O1/12/2010 09:50 FAX 9529335049 CULLIGAN MNTRA 1�003
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..�R r!!�j;F„�{i�.���M'���'•d=��k't•!•.iy.s�a� �'�` .�'�,T,` A7:Y��i'J�� r. `�'��':�$'�''�t1`.'�^`.,'�'.�:��Sii2�R�K�7F;�:Z,'`��,i��S✓i��,
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 O'THER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
I.avatory Sewer Ejector
Bathroom Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
' Sillcocks Miscellaneous
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Yes,this section applies
The replacement of a Itesidential fixture or appliaace that meets a!1 three of the followiag requirements:
1. Doe require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the wst of the fixture or appliance:and
3. Is improved,installed or replaced by the homeawner or licensed contractor.
Skip next section,if tEvs applies; Cost of Pera�it $ 15.00
� ' State Surcharge $ .50 �
Mail-In Fee(If Applicable) $ 1.50 �
Total Permit Fee �
(Petmit Fees Continued On Nezt Paae) �
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O1/12/2010 09:50 FA% 9529335049 CULLIGAN MNTRA f�004
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Tf above does not apply;follow guidelines below:
1: CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of 535.04)
x.0125$
(contrect price) (minimum$35.00)
2. STATE SURCHA�RGE '*Add the State Bldg Code Div.Surcharge(Minimum Fee ofS.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) S --i� �. 0 O
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �1 • 5�
� ■ * CONTRACT'PRICB or JOB COST means the actual or estimated dollar amount ct�arged 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 fumished by
tha owner,tenant or any other party,ti�e reasonable market value of such items must be added to the
estimated cost or conhact price for pemut fee purposes. �n 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.
� *''The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whiehever is
greater. For valuations over$1,000,000 call the�uilding Department at(952)249-4600 for the price.
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agraes to do all
work in strict accordanee with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application aze complete, true �and
correct.
Applicant's Signature: Date: �' �a - �
, I' .
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