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Home My WebLink About2015-01504 - water heater CITY OF ORONO * Z 0 1 5 - 0 1 5 0 4 * . 2750 KELLEY PARKWAY DATE ISSUED: i l/24/2015 ' ' ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 555 OXFORD RD PIN : OS-117-23-41-0024 LEGAL DESC : KLITZKE ADDN : LOT 001 BLOCK 001 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: WATER HEATER VALUATION OF PLUMBING 1700 APPLICANT PLUMBING FIXTURE FEE 50.00 STATE SURCHARGE PLBG(VALUATION) 0.85 BENJAMIN FRANKLIN PLUMBING MAIL-IN FEE 2.00 5718 INTERNATIONAL PKWY NEW HOPE,MN 55428- TOTAL 52.85 (612)238-9709 Payment(s) Minnesota State License#:plbg-PC643703,mech-MB004722 CREDIT CARD 0169 52.85 OWNER KLITZKE,CORNELIA 555 OXFORD RD LONG LAKE,MN 55356- 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 dces not grant permission for additional or rela[ed work which requires separate permits. All provisions of laws and ordinances goveming 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � �.� �/ ��.�-,�S Applicant Permitee Signature Date Issue Signature Date 11/24/2p15 TUE 13: 95 FAx 612 822 5G08 A1' p MdetOY Plumbimq ��Z�00� � JOB3A�6A�69 crrv s�o CC$50.85 Cicy otOrono �n�5 �`�d� �.o�f N.o,B�x 66 aota Raco�� i�� o� � � 2750 Kcllcy Parkway � y Cryslal Day,MN 55323 APProvnd By: Amount$:� � (951)249-4600-Muin �. (952)249-4616-rax CYTY OF dRONO—PLUMBING PERMIT P08fi0266 ��{qk sHo��``` (All Commercial Permiu Must be Approved by the St�te Prior to City Apptoval) � htt ://www.dli.mn. ov/CCLD/PD�/ e �umb lanreva . df ,�,C`rF;�f,�RAL INFORMATION 1. Xou�ay apply for plumbing permiu by mail or in person at the Ciry of�ices. Applications will be reviewed and a permit will bt issucd within two working days. 2. Pcrmit cards will be sent by retum mail after a review is completed. PERMITS A�NOT VALIA UN'!'II,XOU RECEI'VB A pEItMIT. WORK MUST NOT IiEGIN UNTIL THk PERMIT CARD 15 POSTED ON THE JOB SiTE. , 3. Plumbing permitS m�y bc issucd QNLY to licens�d plumbing ContraCtors and to p�operty owners residing in tl�e dwelliiag. 4. When any ntw construction or rcmodeting is involved,a separate building perniit must be ; obtsincd. � 5_ All work must be done in accordance with State Code requuements. 6. All work must be inspected ond air tested before it is covered. Call(952)249-4600. I (24-48 hoar noNce required) ;��,��;; , , ,, � � , 'TYPE';OF';PERMIT , , � � ' ' ' ' � Check All T�iat Pi, 1 � � �� ❑� Rtsidcntial ❑Commcrcial(Approval Required) , ❑New ❑Additional ❑Repairs �'Replace , � ❑ in Accessory Structuire? wYo�will neeU orior auurovs►I and may nccd CUP.(Pcr Orono City Codc,Chaptcr 78,Article IV) � ,Jqb!-Site/Owner'Intoxm'aitio�l:�`"�'' ,�� sitc Address: 555 Oxfard Rd __ ' Owner:COt'IC�/ KIItZI(2 Mailing Address: $�� I �1�,: Long Lake Z;p: 55356 952-476-QQQ 1 �--�� l�ome�'hone: Alternate Phone: �,�,�b�1tQaCto,r,pA�L��1�ni�:�,p;V'�,�i�J��'�bl';�I�i��l�vvi i l;'nP;Lli?� Iil�'�illl��' nin��,� �� ii � , , „ ,,, ,,,N'�r ,� `°``''�sg �°� c� Jennie Wood ' Sen Frankl�n Plumb�n Co�tact�ersor�: ` Contxactor: ; 5718 Intemational Pkwy PC643703 { Address: State Bond#: � ��y: New Hope Z�p:MN Expiration Datc: � 612-z38�9709 '� Phone: Altcrnatc Phonc: i �� Tnsur�nce—Currenl: Owner's Insuranee � 1 il/2a/2015 TUE 13: 35 FAx 612 822 5a08 A1' � H�btOr Plumbimq �OOa/00� � „ ' � ! �t� ��''�h �'�►��,. „ � ,��,��'a � ,�ti , i��►�G� i lf above doCs not epply;follow guidciincs bclow: 1 l. CON"M'N�AC'I'PRICE "'is 1.25%of contrsct pricc with a(Minimum Fee of$50.00) .j �' 1700 x.o�2s s 50min (ctmtroct priCC) (minimum SSO�Op) 2. STATE SURCHARC.E 1700 x.000s ��85 I (comracc pricc) I 3. POSTAGE&HANDLiNG(Only on Mail-In A,pplications) $ 4, TO�'.4,�.P�RNQT FEE(Add�.ines l-3 Above) S 50.85 ��` �� , ■ x CONiRACT PRICE or JOB COS'�means the actual or estimoted dollar amount charged for the 1 riermitted work including materials,labor,profit,and olher fixcd costs. It is thc amount to bt chsrged � to the customer for the work done. !f any malerial,equipmcnt,iabor or instsllations arc furnishcd by � thc owncr,tcnant or any other party,the reasonable market value of such items rnust be added to the ; estimated cost or contract price for permit fee purposes. ln the event that th�re is a dispute on the ' amount of[he job Cost,th�City may rcqucst the submissiqn of a signed cqpy qf the actual con�ct. , a, r �r � f ; The undersigied hereby applies to the City for issuance of a Plumbing Permit, agrees to do all wor�k i� sUricl accordance with the ordinances of the City and the regulations of the State of )vlitatacsota, and certifies that all statements made on this application are complete, true and , correct � Applicant's Signature� 17a[C: O`� (. � 3 I I 1 � , ; � i i1/2a/z015 xvE 19: 95 FAx 6i2 822 5a08 r�' b KAbter plumbimg �403/04a � ' Id�'�� ' � �i��' ;5��,",� E�JiI��`��`�I f�171if�i�N�l1f�'Gj rixruxE BSMT �� 2 0'�R FIXTURE BSMT � 2 OTHER I TYi'E FL FL TYPE FL FL i � Water Closet Floor Drains � L1vAtory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen 5ink ater Heat ,� Dispossl Water Softenet Dishwasher Wet Ber Sillcocks Misccllancous s ❑ Yes,this section applies The repIacement of only onc Residential fixture or a ' ce that meets al]three of thc following requirements: i. Do�not require modification to electrical or gas se ' e. ?. Has A totttl eost of$500.00 or less;excludine thc cost o c fixturc or appliancc:and 3. Is improvcd,installcd or replaced by the homeowner or licei d plurobing co�tU'actor. Skip nexl section,if lhis applics; Cost af Pcrniit $ 15.00 Srate Surcharge $ 5_00 Me;i-�rCC�irAppi►�biC� 2.00 Total Permit Fee $ (Pcnuit rccs Continucd On Next Page) 2 i � . . __ . _... .