HomeMy WebLinkAbout2013-00039 - plumbing CITY OF ORONO I I'�� ''1 [ L1 0 0 0 3 9
2750 KELLEY PARKWAY DATE ISSUED: 01/15/2013
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2359 OLIVE AVE
PIN : 17-117-23-44-0076
LEGAL DESC : WILEYS NAVARRE ADDN LAKE MTKA
: LOT 018 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: PLUMBING FIXTURES:
(3)WWATER CLOSETS,(4)LAVATORIES,(2)BATHTUBS,(1)SHOWER,(1)KITCHEN SINK,(1)DISPOSAL,
(2)SILLCOCKS,(1)FLOOR DRAIN,91)WASHER AND(1)WATER HEATER
VALUATION OF PLUMBING 9390
APPLICANT PLUMBING FIXTURE FEE 117.38
SABRE HEATING&AIR COND INC. STATE SURCHARGE PLBG(VALUATION) 4.70
15535 MEDINA ROAD TOTAL 122.08
PLYMOUTH, MN 55447
(763)473-2267 PAID WITH CC# 1207
OWNER
Bamboo Properties LLC
1171 NORTHLAND DR
#100
MENDOTA HEIGHTS,MN 55120-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
(— l/ 45213 / /C9- /3
Applicant Permitee Signature Date Issued t Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
01/15/2013 TUE 11: 09 FAX 763 473 8565 Sabre Plumbing & Heating l005/007
R 1 USE ONLY
Ast.04, City of P.Box 6Grouo Date Received 12 ii Q90
Permit /3—
1 91
P- ° 2750,:dlley Parkway
kt%
;..i., ` Crystal Bay,MN 55323 Approved By: Amount$:
j "/ i. (952)249-46952)249-4606-F- ax
CITY OF ORONO —PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http:/Iwww.dli.nt a.eov/CCI..D/.)~'/De plum bpia n revapp.pd f
dENERAL 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.
1/t: /...^ - - 6, -All wark must be!inspected and•air tested-before-it is c veredr,Call(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
(Check All That Apply)
El-Residential ❑ Commercial(Approval Required)
® New 0 Additional 0 Repairs 0 Replace
❑ In AA_oessgx Structure? -
*You will fleet!odor annroval and may need CU1 .(Per Orono City Code,Chapter 78,Article IV)
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Job Site Owin�er Information: _. . ..
r, Nx t t
Site Address 2 1`x:3 1 ,C 1\14-' iAkii''u.& ..,
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Owner: :,Mailing Address: — x
City: ,I, Zip:
,. at,, t,. .. . . pc, t,c
Home P1ioti.e:'' Alternate Phone:
Contracto>:Information: ,
Contractor: )1,11.1a,0 \')L t• 11-1' ; :' Contact Person: ,: )tt;s,�,.it.�t..j
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Address It r=,%t 1A, t/Iliir Fit State Bond#: P('f(t4b?. 1
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City A 94\11.04,1-1/1 Zip: My\ Expiration Date: I 'L . I - '2-0 I')
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Phone: i. t0 ,/2::;)7..) 4-1 YY Alternate Phone:
Jit s tNt life 0 i, o )u ,'r- ,-i •.. . , , t. y,, h',, r. ; ,i.t_.ic ;V,
[]� Insurance--Current: _ 1 (,5
^G. ';tl I ,, vii Itl,t 111 ) 1;,
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01/1 /2013 TUE 11: 09 FAX 763 473 8565 Sabre Plumbing 6 Heating 0006/007
i it',I: 't:t Iiitr ;:� o a... c:E ��� G�1 tkAiF E
FIXTURE BSMT 1ST ell' OTHER FIXTURE BSMT 1'r 2N" OTHER
TYPE FL FL TYPE FL FL
Water Closet FIoor Drains
Lavatory. ( I ?) Sewer Ejector
Bathtub II Laundry Tray
Shower Washer
Kitchen Sink 1 Water Heater
Disposal Water Softener
Dishw her .F_. .,c e
'WCt'�iil�
Silloocks ..� Miscellaneous
❑ Yes,this section applies
The replacement of only one Residential fixture or appliance that meets all three of the following
requirements:
1.' Does no,t require modification to electrical or gas service.
2.1 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 tins applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
- -- Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Neat Page)
2 .
jk
01/15/2013 TUE 11: 09 F;X 763 473 8565 Sabre Plumbing 6 )Heating 0007/007
I
If above doesof apply;follow guidelin=s below:
1. ONTRACT TRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
( 1 ( J q D'CCcj x.0125$ I' 2') gJ (contract price) (minimum$50.00)
2. TATE SURCHARGE 1
I, (1 0''I1'' x.0005 $ 410
(contract pri
3. POSTAGE&FIA/111DLING(Only on Mail-In Ap, ications) $ yvV
i
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 1'2. 2 C.) ,.
% * CONTII;ACT PRICE or JOB COST means the actual orestimated dollar amount charged for the
permitted$work including materials, labor,profit,and oiler fixed costs. It is the amount to be charged
n 1/15/20V; x,r '.Ito cthe cusisotnarffor t1rNs wbrk dottssa i3f an terial egaiiptnerit;_labor or installations are furnished by Z007/007
the owner, tenant or any other party, the reasonable market value of such items must be added to the
estimated cost or contract price fo permit fee purposes. In the event that there is a dispute on the
amount of the job cost, the City m y request the submission of a signed copy of the actual contract.
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accor.. ce with the ordinances of the City and the regulations of the State of
Minnesota, and certif s that all statements made on this application are complete, true and
correct.
Applicant's Signature: -,.,,)It;QUI1)41 Ct,t.Ljc :i:�t,�. Date: /-/J. 20 L''',
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