HomeMy WebLinkAbout1999-011241 - water heater 1 PERMIT
� CITY OF ORONO
2750 Kelley Parkway- P.O. Box 66 PERMIT TYPE: : .
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Crystal Bay, Minnesota 55323 Permit Number: {:;; ; :_:;��
(612) 473-7357 Date Issued: - _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE - '
� /.����g ��������
�E�B � � 1:9�9� I ���
C1TY OF URONO APPLICATION FOR PLU��",���'p
Box 66 (2750 Ke11ey Parkway)
� CrY�ta1 BaY� MN 55323
GENERAL INFORMATION,
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VAI.ID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTCD 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 construction or remodeling is involved, a separate building permit must be obtained.
5. All work must be done in accordance with the State Code requirements.
6. All work must be inspected and air tested before:t is covered. Ca11473-'7357. 24-hour notice required. `
Lnstructioii� Coa�plete all items on this applicarion. Compute the permit fee. Sign and date
� the certificatio�i. INC011TPLE'T� APPLICATIONS�VILL NOT BE PRO�ESSED. If you have
questions, call 473-7357.
Please check one: New Addition Repair � Replace
� Residential Commercial ,
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JOB SITE: �
Owner'sName:_�'D,�.ri �D.Pa.r,��� � TelephoneNumber:�. ��.- �.��-�
Mailing Address: /�7 �a�.�r,� G���, �� . ^ City: Q,/lo,v� -Z�p;�-�-'a��
Contractar'sName:/Z,� ��r,�=� � �"��,��.�� TelephoneNu�pber: ,�s^/-�as�1'�`
MailingA.ddr�:���` ��PH.f a� �i��'c �G Cit�: ��,f/�our�/ Zip:s-���/
� . . . . � . . . ". � f.�.,�t . . . . .
� - � � � � ' � . . �.., �. . . •.' e�,-.y:� r. . .. . - .' ._. .
PLUMBING 1��II�TURE SCHEDULE ` .
FIXTURE : BSMT iST 2ND OTHER FIXTURE : B5MT � tST 2ND OTHER
TYPE ;.. FL FL T'YPE .. � :FL FL
Water Closet °. F1oor Drains
Lavatory S�wer 'Ejector � '
Bathtub Laundry Tray.
Shower Washer
Kitchen Sink y , ' 'Water Heater � ;
Disposal Water Softener �
Dishw.,sher . Wet Baz ;: ;
Sillcocks �Mi�c (list) � .
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum F e 5.00
�`Oc'� x .0125 $
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
{contract price)
or $.5.0, wluchever is greater
3. Post��e and HandlinQ (Only mail-:in applications) $ 1.50
4. TOTAL PFRIV7IT FEE (Add lines 1-3 above) $ -
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
work including materials, labor, profit, and other fixed cosfs. It is the aznount to be charged to the.
customer for the work done. If any material, equipment, labor,or installation 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 contrac4 price forpermit fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ciry may request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contsact price under $1,000,000 or $ 50 ='�vhichever is
greater. For valuations=over $1,00O,OOU call the Department of Jnspectional Services for;the price:
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 Cit� and the regulations of the State of
Minnesota, and certifies that all statements made on this "application aze complete, true and
. .
correct. � � �
..� . _
- Date: �` /� 99 �
APPlicant's Signature;
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