HomeMy WebLinkAbout2007-P11223 - water softner • PERMIT
CITY OF ORONO
275d Kelley Parkway- PO Box 66 Permit Number: p11223
Crystal Bay, Minnesota 55323 Permit Type: Fuctures
(952)249-4600 Date Issued:
7/17/2007
SITE ADDRESS: 4209 North Shore Dr Unit#
Mound,MN 55364
P��� 07-117-23-43-0005
DESCRIPTION:
Proposed Use: Religious
Permit Class: Plumbing
Pernut Type: Fixtures P�it Sub-type(s): Water Softner
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 15.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: Richard's Custom Water OWNER: William&Mary Titler
6121 Excelsior Blvd.#206 2184 Shadywood Rd
St.Louis Park,MN 55416 Wayzata,MN 55391
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 PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSepric, 1-Septic) Page 1
s � �'
;
FOR CiTY USE ONLY
� City af Orono
� O�' �O P.O.Box 6b Date Raeived: Permit# -
2750 Keltty Pedcway roved By. Amount S:
�t �.. r Crystal Say,MIr'S5323 APP
���'�.b� (4S2)249•4600
CYTY OF ORONO—PLUMBING PERMI'I'
(Ail Commercial permits must be approved bY the 8uilding Officiat w lnspector)
GENERAL INFORMATION
�
1. You rnay apply for plur►tbin�permits by mail or in person at the Ciry a�ces. Ap�l�cations will be
reviewed and a permit wilt be issued within two working days.
2. Permit cards wilt be sene by retum mail after a review is completed. PERMITS ARE NOT
VALID UNTIL 1lOU ItEGEIVE A PERMIT. :�+'::-K MUST NOT BEGIN 11NTIL THE
PERh;IT CARD IS POSTED ON'fH�JOB SITE.
3. Ptumbing permits may be issued ONLY ta licensed plumbing contractors and to property owners
rosiding in the dwelling.
4. When any new construction or rerr.odeling is involved,a separate bu;lding permit must be
obtaineci.
5. All wark must be done in accordance with State Cade requirements.
6. Al{work must be inspected and air tested before it is covered. Ca11(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
� (Check All That A 1
�Residential ❑Commerciat(Approval Required}
f�'New ❑Additiona! ❑Repairs �]Replace
❑ ln�ccessory Structure?
�you w�g� peed oric�aoor4val and may need C�I�1 .(Per Orono City Code,Ch�pt�t 7�,Article IV)
Job Site!Owner Informatian:
Site Address: `f2oa No��—,S�•.�v� ���^a..
Owner: �►�'�su gill r�Llw� Mailing Address: . -
City: Zip:
Home Phone: �Sz--26l—ZZ(/ Alternate Phone:
LContractor Informati�n:
' �ntact Person: ►`-'l��
C�ntra�ctor: 1�-�a�s �u���..�`..�a�-'e' "���
Address: �I� `��s�� �3��d '�ZO�° State Bond#: Do�38'Z w�
City:�'(.�N�s p�� Zip�� Expiratian Date: t z•31.0�'
Phone: �j�'z..-��._��O Aiternate Phone: ,
� Insurance—Current:
1
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!
� ; , .. PLUMBING FIXTURES BEING IN�'i'AI.L�D -
FIXTURE BSMT 1 2 IOTHER FIXTURE BSMT' FL FL OT�R
TYFE FL FL a 'I'YPE '
1
, Water Claset Floor Drains
Lavatary Sewer Ejector
Bathroom Laundry Tray �
�Shower { ` i Washer
____.� � 1
Kitl chen Sink ^ � Water Heater ,
� (
Disposa! �. 1�'ater Softener { � '
Dishwasher , W'et Bar j
i
Sillcocks Miscetlaneous �
� � :�ERL'vIIT F£E CALCU�.ATIUN(S) ,:� �
u .
�
� � BAS£D OF� -20Q2 STATE STATUE . . . `� . . '�: � �:'.�
� Yes,this section applies
The replacement of a Rp���P^t��l fixture or aonliance that meets all three of the foilowing requieemenu:
l, gges►ot reqaire modification ta elecvical or gas service.
2. Has a tutal cost of$500.0�or less;excludin�the cost of the t'ixture or apptiance: astid
3. Is improved,installed ar replaced by the hameowner or licensed contracwr.
Skip next section,if this applies; Cost of Permit $ 1�.Ofl
State Surcharge � •SQ
Mail•In Fet{IfApplicable) S 1,54
Total Fermtt Fee � '� �
(P�rmif�ees Continued On Next Page) _
�
`
. • -
.
. ' �`. : :`:: f�:�MiT�EE GALCUI.ATION S �-J�BS (}'VER$5�DQ.aO
If above does not apply;follow guidelines betow:
1. CnNTit�►CT PRICE " is 1.25%of ca�tract price with a(NIinimum Fee of S35.OQ)
x.0125 S
(cantract price) (minimu:n t35.U0)
3. 3'I'AT�SLJRCHARGE "`Add the State Bldg Code Div.Surcharge t:►'Iiaimurn�ee of 5.50)
x.00OS S
� (conaact pria) (cninimum S .�0)
3. PUSTAG�&HA:�iDLI1�G{Only on Mait-In Applications) $ �•g�
4. 'fOTAL PERMIT FEE(Add Lines t-3 Above) � -
• " CONTRACT PRICE or JOB COST meatts the astual �r estimated doltar �maunt charged for the
permitted work including materials, labor, profit,anci other fixed costs. It is the amount to be charged
to the customer for the work done. If any materisi,equiprinent, labor or installations are furnished by
the owner,tenant or any other pariy,th� reasonable market value of such items must he added to the
estim�ted cost or contract price for permit fee purposes. In the event that there is a dispute an the
amount of the job cost, the City may request the suhmission of a si�ned copy of the actuai contract.
• •'" The STATE SURCHARGE is .0005 af the cantract price under$1,000,004 or$.SO—whichever is
greater. For valuations over$1,000,000 call the Building Deparnnent at{9e2}249-4b00 for the price.
�-: .;., .'PI.��?JCr�PERMIT'APP�,ICATIf3N AC�REEMENT`:�t; . ; , �
'The uadersigned hereby appties to the City for issuance of a Plumbing Permit, agrees to do alt
worlc in strict accordance with the ordinances of thc City and the regulations of the State of
Minnesota, and certifies that aIt statements made on this application are complete, true and
conect.
Applicant's Si$n�ture: Date: �•13 •6�
', �� Re�s�t Form
3