HomeMy WebLinkAbout2001-P03596 - water heater �- �- PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po3s96
Crystal Bay, Minnesota 55323 Permit Type: Fix�es
(952) 249-4600 Date Issued: 3i9i2ooi
SITE ADDRESS: 555 Oxford Rd
LONG LAKE,MN 55356
P I D: OS-117-23-41-0024
DESCRIPTION:
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PPOPOSed USe: nc�iucu�iai
Permit Class: Plumbing
Permit Type: Fixtures 1'ermit Sub-type(s): Water Heater
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 400.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Norblom Plumbing Co OWNER: CORNELIA D KLITZKE
2905 G�eld Ave South 555 OXFORD RD
Minneapolis,MN 55408 LONG LAKE MN 55356
'THE UNDERSIGNm 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 BUII.,DING CODE REQUIREMENTS.
ISSUED BY SIGNATURE
Copies:City,Applicant,Assessor,Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, NIN 55323
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cards will be sent by retum mail after a rev.iew is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTII.. THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Plumbing permiu 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 buildin�permit must be obtained.
5. All work must be done in accordance with the State Code requirements.
6: All work must be inspected and air tested before it is covered. Call 249-4600. 24-hour notice required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date
the certif'ication. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 249-4600.
Please check one: New Addition Repair Replace
Residential Commercial
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JOB SITE: �► 5 � �?L-t-vY� }�v c� Zip: ,5 535�
Owner's Name: � i-��Lv✓�-e�-� Telephone Number: (�j,z) y�� -��c�CJ�
Nlailing Address: SSS(���-�J ,�Q�,/. City: C'1'�v�v Zip: 5-535�
Contractor's Name: �o�b�crn���1��v��bi ti��-, Telephone l�umber: ((��Z)�Z?-`�033
Mailing Address: �y0�(�,cvr ,f/�✓/-�v� 5c. City: � �s Zip: .sSy�cF
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BS;�1T 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Ba[htub Laundry Tray
Shower Washer
Kitchen Sink Water Heater i
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Misc (list)
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PERMIT TEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
y�Z� `v x .0125 $ ,5 S .C�0
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. '�Uc `�' x .0005 $ ��
(contract price)
or $.50, whichever is greater
3. Postage and Handlin� (Only mail-in applications) $ 1.50 �
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ :3 7 .��'
* 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
customet for the work done. If any material, equipment, labor,or installation are furnisi�ed by the owner,
tenant or any other party the reasonable market value of such items mus[ be added to the estimated cost
� or contract price for pemut fee purposes. In the evenc that tnere is a dispute on the amount of the job cost,
the Ciry may request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contrac[ price under $1,000,000 or $.50 - whichever is
greater. For valua[ions over $1,000,000 call the Department of Inspectional Services for the price.
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: 2�Z��D/
DATE T ME
CITY OF ORONO -��-�'< < �
INSPECTION N I�E SCHEDULED �- -��/ • 3 �
PERMITNO. �" y COMPLETED �-�f ' "O
ADDRESS �-� s G� �' �� U�'� k�'
OWNER ;�/�� � z K � CONTR. 7 "�' -t'%
TELEPHONE NO. �
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
Q 07 DEMO-FINA_ L�' 15 SEPTIC INSTALL. 22 FOLLOW-UP
W�P�LUMB,i_NG R� 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 1- 0 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �(�'qVORKSATISFACTORY:PROCEED �AROJECTCOMPLEfE
W ❑`CORRECT WORK&PROCEED ��ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
0 STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector.�l'e�Zl7���s
White Copyllnspector's Ffle Canary Copy/Site Notfce