HomeMy WebLinkAbout2010-00285 - plumbing CITY OF ORONO PERMIT NO.: 2010-00285
• 2750 KELLEY PARKWAY
, ORONO, MN 55356- �ATE [SSUEn: 04/29/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 550 OXFORD RD
PIN : OS-117-23-41-0026
LEGAL DESC : FOX HOLLOW
: LOT 041 BLOCK 001
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NO"I'E: 2ND FLOOR: BATHTUB
VALUATION OF PLUMBING 3800
APPLICANT PLUMBING FIXTURE FEE 50.00
GENZ-RYAN PLUMBING&HEAT STATE SURCHARGE PLBG (VALUATION) 1.90
2200 HIGHWAY 13
BURNSVILLE, MN 55337 MAIL-IN FEE 2.00
(952)767-1000 I MISC FEE. _._ _ _ 0.00
TOTAL 53.90
OVF/NER
KNUDSON, DOUGLAS&MARY
550 OXFORD RD
LONG LAKE,MN 55356
AGREEMENT AND SWOIdN STATF,MENT
The work for which this permit is issued shall be performed according to
the approved plans and specificaYions,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this t�pe ofwork
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections ace
requested in conformance with the State Building Code.This permit may be
revoked a[any time for due cause.
��LY(l,(,� « � � ���)� l l
Applicant Permitee Signature Date Issue Signature ate
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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� FOR CITY USE ONLY
� �Gr� ,¢�� City of Orono
O O P.O.Box 66 Date Received: Permit#
9y,,.,_ 2750 Kelley Parkway
� ��'� Crystal Bay,MN 55323 Approved By: Amount$:
�_,,�:i�}�� (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial pcnnits must be approved by the Building Official or Inspcctor)
GENERAL 1NFORMATION
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 RECENE 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)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
Check All That A 1 )
�Residential ❑Commercial(Approval Required)
❑ New �Additional ❑Repairs ❑Replace
/
❑ In Accessory Structure?
*You will need nrior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address: ��� ����� �
Owner:��'L^ � 11 ' Q/ Mailing Address: � � � �
City: ��V Zip: �._.)�iC�
Home Phone: Alternate Phone:
Contractor Information:
��
Contractor: '� " Contact Person: ��Ll, ������
Address: r �1' � ' v State Bond#: ��� ��
City: �; � + Zip: ��J�xpiration Date: � �1 �
Phone: ���� •(I,IJV Alternate Phone: ��������g�'o
� Insurance—Current:
1
EING INSTALLED-
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1�� 2�D OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub ; Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF- 2002 STATE STATUE
❑ 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 total cost of$500.00 or less;excludinQ the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Pennit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
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PERMIT FEE CALCULATION(S —JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
fi � � ,�
� J��`,��, X .oi2s $ � .
(contractprice) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
.�
�) x .0005 $ � .C1 �
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
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 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.
■ ** 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 Building Department at(952)249-4600 for the price.
PLUMBING PERMIT APPLICATION AGREEMENT
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 Signatu �.� � � Date: �'i '�� �
�a, Reset Form
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