HomeMy WebLinkAbout2012-00167 - replace water softner CITY OF ORONO * z 0 1 z - 0 0 1 6 � *
.. 2750 KELLEY PARKWAY DATE ISSUED: 03/O1/2012
ORONO, MN 55356-
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952 249-4600 FAX: 952 249-4616
ADDRESS : 2180 NORTH SHORE DR
PIN : 10-117-23-31-0098
LEGAL DESC : MARKVILLE
: LOT 000 BLOCK 003
PERMIT TYPE : PLUMBING (> $500)
PROPERTY TYPE : INSTITUTIONAL-SCHOOL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: RGPLACING EXISTING WATER SOFTNER
VALUATION OF PLUMBING 2500
APPLICANT PLUMBING FIXTURE FEE 50.00
BERGERSON-CASWELL INC. STATE SURCHARGE PLBG(VALUATION) 1.25
51 15 INDUSTRIAL ST. TOTAL 51.25
MAPLE PLAIN, MN 55359
(763)479-3121
OWNER
Creative Kids Academy Orono
2180 NORTH SHORE DR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this pennit is issued shall be perfonned according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenccd.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. %��
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Applicant ermitee Signature Date ]ssued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE.
FOR CITY USE ONLY
�� City of Orono
�� P.O.Box 66 Date Received: Permit#
��a;;,,.N �'i 2750 Kelley Parkway
�� �'1�;r ,1� Crystal Bay,MN 55323 Approved By: Amount$:
��'�,�riy o��/ (952)249-4600—Main
�\�e�so!�� (952)249-4616—Fax
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
htt ://www.dli.mn. ov/CCLD/PDF/ e lumb lanreva . df
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 UNT[L YOU RECENE 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 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 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 All That A 1
❑ Residential ❑� Commercial(Approval Required) No� nt�� �e� WV0.+Y
❑ New ❑Additional ❑ Repairs �Replace
(�1ohT (J� sncwll C45�ne.�r Tnn�te,�
❑ In Accessory Structure? ►�J�ws�.r S�F,�.�,,,f
*You will need arior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address: 2180 North Shore Drive, Orono, MN
oWner:Creative Kid Academy Mailing Address: $55 Village Ctr Dr,#382
c►ty: St. Paul Z�p: 55127
Home Phone: �612� 237-3769 Alternate Phone:
Contractor Information:
Bergerson-Caswell, �nc. Mark Klein
Contractor: Contact Person:
Address: 5115 Industrial Street State Bond #:
Maple Plain 55359
City: Zip: Expiration Date:
Phone: (763) 479-3121 ,4�ternate Phone: (612) 685-2528
❑ Insurance—Current:
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FIXTURE BSMT 1 2 OTI�R FIXTURE BSMT 1 2 OTI-�R
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener ,)
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ Yes,this section applies
The replacement of only one Residential fixture or appliance that meets all three of the following
requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip neact section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
2,500.00 X.o12s$ 50.00
(contract price) (minimum 550.00)
2. STATE SURCHARGE 2�5�0.�� � .25
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $51 .2'rJ
■ * 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.
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 City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
ApplicanYs Signature: � Date: 3��""l�
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