HomeMy WebLinkAbout2014-00596 - plumbing iiiiiiiiiiiiiiiiiiiiiillillillillillillilliililim
CITY OF ORONO * 2 0 1 4 - 0 0 5 9 6 *
2750 KELLEY PARKWAY DATE ISSUED: 06/12/2014
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS 240 NORTHGATE RD
PIN 36-118-23-41-0050
LEGAL DESC NORTHGATE TWO
LOT 001 BLOCK 006
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE FIXTURES-MULTIPLE
NOTE: BSMT: 1 WC
1ST FLOOR:2 WC, 1 LAV, 1 SHOWER
2 SILLCOCKS
VALUATION OF PLUMBING 8000
APPLICANT PLUMBING FIXTURE FEE 100.00
EARL W.DAY&SONS,INC.
STATE SURCHARGE PLBG(VALUATION) 4.00 520 BRIMHALL AVE Payment(s)
TOTAL 104.00
P.O.BOX 294 ts)
LONG LAKE,MN 55356 CHECK 6021 104.00
(952)473-8403
OWNER
CARISCH, STACY
240 NORTHGATE RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any tinic.for due cause.
Applicant Pe itee Signature D to Issued By Onature Date
FOR CITY USE ONLY
A City of Orono
{V P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:
(952)249-4600—Main
(952)249-4616—Fax
L CITY OF ORONO—PLUMBING PERMIT
st30 (All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dii.mn.gov/CCLD/PDF/pe plumb lanreva pp.pdf
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 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 State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)2494600.
(24-48 hour notice required)
TYPE OF PERMIT
Check All That Apply)
®Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs 'Replace
le—
❑ In Accessory Structure?
*You will need prior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address:
0wner: 'S-j0C_ta Cha r ISC1-) Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information: I
r
Contractor: �w� W,7c1�o±&a nS Contact Person: TNane-30�1'Y1SQ P1
Address: F 0 • Vb x cd-5t State Bond#: PC `c4S r-7-7
City: LOYI K Zip: 535 Expiration Date:
Phone: 950,-W 71 R 40 3 Alternate Phone:
Insurance—Current:
1
IN }
FIXTURE BSMT 1 2ND OTHER FIXTURE BSMT IST 2 ND OTHER
TYPE FL FL TYPE FL FL
Water Closet F Floor Drains
Lavatory 1 t Sewer Ejector
Bathtub 1 Laundry Tray
Shower ` Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Z 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;excluding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip next 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)
2
• w
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
7c c o. x.0125$ 100 1
(contract price) (minimum$50.00)
2. STATE SURCHARGE �j
° WC,o Cl• x.0005 co
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ! q,
■ * 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.
` CAS
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: &h e
Iz3