HomeMy WebLinkAbout2010-00502 - water heater , � � CITY OF ORONO PERMIT NO.: 2oiaooso2
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 06/2 U2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2640 NORTH SHORE DR
PIN : 09-117-23-13-0009
LEGAL DESC : COLWELL ADDN
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER HEATER
NOTE: WATER HEATER
APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00
NORBLOM PLUMBING CO. STATE SURCHARGE PLBG(<$500) 0.50
2905 GARFIELD AVENUE S.
MINNEAPOLIS,MN 55408- MAIL-IN FEE 2.00
(612)827-4033 TOTAL 17.50
OWNER
HODDER,KENT
2640 NORTH SHORE DR
,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 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 sepazate
permits. All provisions of laws and ordinances goveming 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due ca e.
. ��t�tLed� b�d�� �o ��a/� �o
Applicant Perm�tee Signature Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
R � �� RECEIVED
�F�'CI'PX YI�E�ONL'Y �
'' �J�` City of Orono '
. O4 `r� P•O.Box66 �,I .Dare�l2ece�ued; �� ' Ferrnix#�f(�'�� �o�"
2750 Kelley Parkway ��'v � � �O�O i
Crystal Bay,MN 55323 Ap,pxo�ed B�+ AmQunt� �,.
` � � (952)249-4600 CITY OF ORON ' ' :�'�'� , + ",'
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
>=G�ENE�AL• `lNFO `.Rf1VIA'T�ON
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a pernut will be issued within two working days.
2. Pernut 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 STTE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to properiy owners
residing in the dwelling.
4. When any new construcrion 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)
'�3��'E O,F�'ERl�lI� '
, � �. 1} „ � ,,� �
i ' ,� '�s G�hecic�All'k E�a.t:A ly) �
�Residential ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Shucture?
*You will need urior aparoval and may need CLJP.(Per Orono City Code,Chapter 78,Article I�
;��ob.rSa����%/C)�r�Qrmatian �.�: �.';,N,,4 f�T,r�,, .��; ,��
Site Address:
Kent Hodder
Owner: 2640 Northshore Drive ddress:
Orono, MN 55391
City: 9524762011
Home Phone: tiiiernaie Phone:
�Coritractor Tnformation:.
Contractor: Iv�rI��01'Y� P�UXnb�� Contact Person:
Address: Z���J ��Lr'Fl��d '� sti, State Bond#: ����!� �
� 9
City: � �S Zip�6$ Expiration Date: ( I v I V
�(�(2)$2�- `f03�3 --
Phone: Alternate Phone:
� Insurance—Current:
1
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater I
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ Yes,this section applies
The replacement of a Residential fixhue or annliance 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;excludin�the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the home�wner or licensed contractor.
Skip next section,if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $—��
(Permit Fees Continued On Nezt Page)
2
.
� If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contxact price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCAARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contractprice) (minimum$ .50)
� 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,�O
• * CONTRACT PRICE ar JOB COST means the actual or esrimated,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 puiposes. 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 STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 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 City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: Date: � � � � ` � �
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