HomeMy WebLinkAbout2004-P07683 - plumbing , a
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CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: po�6g3
Crystal Bay, Minnesota 55323 Permit Type: FiX�ureS
(952) 249-4600 Date Issued: ��6�2004
SITE ADDRESS: 3950 North Shore Dr
Mound,MN 55364
PI D: 08-117-23-33-0067
DESCRI PTION:
Proposed Use: Kesidentiai
Pernut Class: Plumbing
Pernut Type: Fixtures Permit Sub-type(s): Water Heater
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DETAILS: �ce���.:;;: i���7683
Approved per resolution#: ���17� - ����- I
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Separate pernuts required: I@ 15.04 IS�,40 ''
r� Review �
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�: ir� Fees
NOTICES/REMARKS: ' ;�,� �u���rg¢ I.�4 i, —
0.�0 ti.:,:�
rhar e
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tr�vestigatior� Fee
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— ;il�T��AI. 17.
FEE SUMMARY: PernutFee: $ 15.00 '��� 0.
`,)TAl SALE 17,i
;neck Feceived 17.U��
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State Surcharge Fee: $ 0.50 '�� p•� �
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Misc. Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: Norblom Plumbing Co. �WNER: Raoul Booton&Molly Holcombe
2905 Garfield Avenue S. 3950 North Shore Dr
Minneapolis,MN 55408 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PE TEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Si�nitures Required), 1-Aoplicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1
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CITY OF ORONO APPLICA'���N F�O,�Z PLUMBING PERMIT
Box 66 (2750 Kelley Parkway) �;���,� r�l�`'U�
Y Y� : � ,c�ONO
Cr stal Ba MN 55323 O
GENERAL IIVFORMATION • �
1. You may apply for plumbing permits by mail or in person at the Ciry offices. ' •
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 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. Ail work must be done in accordance with the State Code requirements,
6, AII worx must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice
required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the
certification, INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: New Addition Repair �eplace
�/ftesidential Commercial
.T�B SITE:. HOLCOMBE,MOLLY
`, . 3950 NORTH SHORE DRIVE ; Zlpt ` �
4t�mer's Name:� ORONO, MN 55364 elephone Number• �
; Mail�ng Address: (952)471-3229 :it"�: ' �i
' Contractor's Name: ` ' �' '
� � � c Telephone Nwnber.�:� (��z��j2�-y�3_
i � Mailing Address: 2qOS e/✓ .So��• � City:�/S � Zip:� SS��`�'
;
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� PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2I�1D OTHER I FIXTURE BSMT I 1ST I 2ND I OTHER
TYpg FL FL
iYP� FL FL
Water Closet Floor Drains
Lavato Sewer E'ector
--- Bathiub Laund Tra
Shower Washer
Kitchen Sink Water Heater �
Dis osal .
_ _ ...
Water Softener "
Dishwasher_. . Wet Bar . __ . _
Sillcocks Misc (list}
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PERMIT FEE CALCULATION(S)
2002 State Statute � Yes, This Section Applies
The replacement of a Residential fixture or a�pliance 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 homeowner or licenced contractor,
Skip next section; Cost of Permit $ 15.00
State Surcharge $ .SQ
Mail In Fee $ 1,50
If above does not apply, follow guidelines below:
1, Contract Price* is .0125 % of job with a Minimum Fee of ($35.00)
x .0125 $
(contract price) (minimum $35.00)
2. State Surcharge. ** Add the State Building Code Division a (Minimum Fee of $ .50)
x .0005 $
(contract price) (minimum $ .50)
3. Postage and Handlin� (Only mail-in applications) $ 1.50
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4. TOTAL PERMIT 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 costs. It is the amount 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 contract
price for permit fee purposes. In the event that there is a dispute on che 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 Department of Inspection 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 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: ��2��a"i