HomeMy WebLinkAbout1994-006656 - water heater/water softner ,
PERMIT
� CITY OF ORONO PERMIT TYPE: ;:; ::
�750 K�tley Parkway- P.O. Box 66 � ��'�'� ���
� Permit Number: �.:��i:�,�__�:i��`����
Crystal Bay, Minnesota 55323 _
(612) 473-7357 Date Issued: _ _. . � .... _ .
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box b6 (2750 Kelley Parkway) ����� � l� 1�9�
Crystal Bay, MN 55323 �
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GENERAL INFORMATION
1. You may apply for plumbing pemuts by mail or in person at the City o�ces.
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 pemuts may be issued ONLY to licensed plumbing contractors and te 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call 473-7357. 24-hour notice required.
Instructions Complete all items on this application. Compute the pernut fee. Sign and date
the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 473-7357.
Please check one: New Addition Repair �_ Replace
Residential Commercial
JOB SITE: �`7/I% - f��-�-� ��.-sz�. Zip:
Owner's I�1ame• �J:e,��,.� i.,ee�,� Telephon�Q Nwnber: .5�/�- j�_
Mailing Address: '��— City: Zip:
Contractor'sName: G�i�crnv .�:�, ,z,-�.� TelephoneNumber:�qi�-�����
MailingAddress: %,Z 7i� �,�'.���� City:�,�_, Zip:�,,�5�.��—
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PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower W asher
Kitchen Sink Water Heater �
Disposal Water Softener �
- `�: Dishwasher Wet Bar
' � ' Sillcocks Misc (list)
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PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
x .0125 $ .35",�G'
(contract price)
2. State SurcharQe. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ .�2'
(contract price)
or $.50, whichever is greater
3. Posta e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ���, �t t'
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged 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 installation are furnished by the owner,
tenant or any oiizer p�cy� ih.: r;.;se^.�h?e m�rkPr �a1,zP of such items must be added to the estimated cost
or contract price for pemut 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 Department of Tnspectional 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: ������?ti Date: %/—�—�'�