HomeMy WebLinkAbout2003-P06640 - plumbing PERMIT
CITY.OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P06640
Crystal Bay, Minnesota 55323 Permit Type: Fixhues
(952) 249-4600 Date Issued: s�ii�2oo3
SITE ADC�RESS: 1405 Park Dr
Mound,MN 55364
P I D: 07-117-23-42-0016
DESCRIPTION:
Proposed Use: xesicientiai
Permit Class: Plumbing
Pernut Type: Fixtures Permit Sub-type(s): Water Softner
DETAILS:
Approved per resolurion#:
Separate pernrits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 15.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT' �lligan Soft Water Service Co. OWNER: Fred&Karen Shearer
� 6030 Culligan Way 1405 Park Dr
Minnetonka,MN 55345 Mound MN 55364
THE UNDERSIGNED 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 BUILDING CODE REQUIREMENTS.
�
����'l-�(.� t�l� G?y'YLeC.�1'L
APPLICANT PERMITEE SIGNATURE , ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Auulicant, 1-Monthlv Reuorts, 1-Assessins, 1-Finance Page 1
CYT'Y OF O�tONO APPLICATION FOR PLUIVIBTN'G PERIVIIT
Bo� 66 (2750 KeIley Parkway)
Crystal Say, 1VIN 55323
C;�'1tAT,.INFORMATYO
I, You may apply for plumbino permiu by mail or in person at che City offices.
2. Permit cards will be sent by re[urn mail after a review is completed. P�RMITS A.RE NOT VALYl�UNTIL
YOU REC�IVE A 1'EfL'VIIT. W012K MUST NOT BEGIN UVTIL THp pPRMIT CARD 1S pOSTED ON
TH�OB SITF_
3. Plumbing permits may be issued ONLY to licensed plumbius concractors and to properry owners residing
in che dwelling.
4, When aay new construction or remodeling is�mvolved, a separate building permit mus[be obtained.
5. All work must be done in accordance Wirh the: State Code requirements.
6. All work musE be inspected and air tested t�efore it is covered. Call (9>2) 2A9-4600. 24-hour norice
required.
Instructi�ns Complete a11 items on this application. Compute the perinit fee. Sign and date the
certification. INCO�IPLETE APPLICATTCINS WII.L NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: New _ Addition Repair � Replace
�Residential __ Commercial
�roB sr'rE:_��D� ��'��-- y �p���y
Owner's Nam • � �� Telephone Number• 95�,� t�7� '/(1>�I
Mailing Address: Cifiy: Zip:
Contractor'sName: CULLIGAit WATER CONDITiONINC�'elephoneNumber:
Mailing Address: 6030 � Cit�: Zip:
, ,
PL�2������rx� sc�oF:nul.E �
FIXTiJR� BSMT 1ST 2ND OTHIiR �'T.'YTURE BSNIT 1ST 2ND OTHER �
TypE FL FL TYF� FL PL
'GVater Closet F1oor Drains
Lavato Sewer �iectar
Bathcub Laundrv Tra
Shower W asher '
Kitchen Sink Water Heater .
Dis osat Water So$ener
Dishwasher wec�ar
Sillcocks Misc (Iist)
PERMIT E CALC�ATrON 5
20Q2 State Statute Yes, This Section Applies
The replacement of a Ttesidential fixture or a�pliance that meets all three of the following
requirements:
1) Does not require nlodificacion t.o electrical or gas service.
2) Has a cotal cost of$SOO.OQ or less; exciudina the cost o�the fixture or appliance:
and
3� Is i.mpraved, installed or replaced by the homeowner or licenced contractor.
Skip next secrson; Cost of Permit $ r5.00
� State Surcharge $ ._50
Mail Tn�ee $ 1.5�
If above does not apply, follow guidelines bela�v:
1. Contract �'rice* is .4125 70 of job with a Nlinimum Fee of ($35.00)
x .0125 $
(contr;tct price) (minimum$35.00)
2, State �urcharge. ** Add the State $uilding Code Division a (1Viinimu.m Fee of $ .50)
x ,OQOS $ �
(conr�•act price) (minimum$ .50)
3, Post�e and I�andlin� (Only mail-in applications) $ 1.50
4. TOTAY. PER'VIIT F�E (Add lines 1-3 above) $ � 7 - �� C1
* CONTRACT PRICE or 70B COST means thf: actual or esvmated dollar amounc charged for the permitted
work includiQ,materiais, labor,profit,and o�lier fixed costs. It is che amoun�to be eharged to die eustomer
for the work done. If any material, equipmecu, labor, or installation are fumished by the owner, tenant or
any other parry tht reasonable market value cf sueh i[ems must be added to ttze estimated cost or contraet
� price for permit fee purposes. In the event rha�[here is a dispute on che amount of the job cost, �he Ciry may
request the submission of a signed copy oP thc accual eontraet.
** The STATE SURCHARG�is .00a5 of the contract price under 51,000,000 or S.50 -whichever is greacer.
For valuations over�1,000,000 call the Dcpartmenc of Inspectioa Services for the price. .
The undersigned hereby applies to the City f��r issuance of a Plumbing Pennit, agrees io do all
wQrk in strict accordance with the ordinanc�;s of the City and the regulations of ihe State of
Minnesota, and certifies that all statements made on this application are coznplete, true and
correct.
Applicant's Signature: � ,��� Date: v �