HomeMy WebLinkAbout2005-P08450 - plumbing ` � PERMIT
C ITY O F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P08450
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: 2�i6�2oos
SITE ADDRESS: 4215 North Shore Dr
Mound,MN 55364
PID: 07-117-23-43-0006
DESCRIPTION:
Proposed Use: Kesicientiai
Permit Class: Plumbing
Pernrit Type: Fixtures Pernut Sub-type(s): Multiple Fixhues
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 43.75 Valuation: $ 3,500.00
State Surcharge Fee: $ 1.75
TOTAL FEE: $ 45.50
APPLICANT' Lee Mechanical Inc. OWNER' Douglas Waldoch
� 8148 Everest Lane No. � 4215 North Shore Dr
Maple Grove,MN 55311 Mound MN 55364
TI�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 REQUIRIIVIII�ITS.
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APPLICANT PERMTTEE SIGNATURE I SUED BY SIGNATURE
Covi�:1-File(Si�nitures Requi�ed),1-Auulicant 1-Monthlv Ret?orts, 1-A�essin�, 1-Finance Page 1
. . .
CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may appiy For plumbing permits by mail or in person at the City 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. All work must be done in accordance with the State Code requirements.
G. All work 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. WCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions,
call (952) 249-4600.
Please check one: New Addition Repair Replace
�Residential Commercial
JOB SITE: ���,��_�� � Zip: ss �� L�
Owner's Name: Telephone Number:
Mailing Address: City: Zip: s�
Contractor's Name: � Telephone N mber: �l,?� Zl7����`�
Mailing Address: �" City: Zip: SS3// � � � �'
�'os-/�' �6'
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1 ST 2ND OTHER FIXTURE BSM 1 S 2ND OTHER
TYPE FL FL TYPE T T FL
FL
Water Closet / Floor Drains
Lavato Sewer E'ector
Bathtub Laund Tra
Shower Washer
Kitchen Sink Water Heater
Dis osal Water Softener
Dishwasher Wet Bar
Sillcocks Misc list
PERMIT FEE CALCULATION(S)
2002 State Statute ❑ Yes,This Section Applies
The replacement of a 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 tota( 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 $ .50
Mait 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)
���3�'�� X .o i z5 �
(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
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* CONTRACT PR[CE or JOB COST means the actual or estimated dollar amount charged for the permitted work
including materials, labor, pro�t, 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 the amount oF the job cost, the City may request the submission
of a sigr►ed 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 P(umbing 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 app(ication are complete, true and correct.
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Applicant's Signature: Date: � �
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