HomeMy WebLinkAboutLA184271 PERMIT
City of Lakeville Permit Type: Plumbing
20195 Holyoke Ave Permit Number: LA184271
Lakeville,MN 55044 �
(952)985-4440 * L Fl 1 8 4 Z 7 1 *
www.ci.lakeville.mn.us Date Issued• 10/09/2020
Site Address: D6 Grumman La
Lot: Block: Addition:
PID: �
Use: Jay Jenkins Hangar * *
Description:
Sub Type: Commercial Plumbing System
Work Type: New
Description: Install Mop sink,toilet,lav and shower
Meter Size Meter Tvne Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: Descri tn ion Amount Revenue Code
Valuation: 4,500.00 Commercial Plumbing $67.50 1000-4152
Surcharge-Based on Valuation $2.25 1000-2127
Total: $69.75
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Contractor: - Applicant - Owner:
Perfect Mechanical LLC
9850 Iteri Ct W
Lakeville MN 55044
(507)581-1082
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO: (1)THE APPROVED PLANS&
SPECIFICATIONS;(2)THE APPLICABLE CITY ORDINANCES&CODES;AND(3)THE MN STATE BUILDING CODE.
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ApplicanUPermitee: Signature Issued By: Signature
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PLUMBING PERMIT APPLICATION PAGE 2
OFFICE USE
SYSTEM TYPE: REQUIRED INSPECTION:
,i�NEW COMBUSTION AIR
ADDITION _� FINAL
REPLACE OTHER
ALTER/REMODEL ��ROUGH 1N
REPAIR BACKFLOW TEST REPORT
DEMOLITION �UNDERGROUND
PERMIT FEE
PERMIT FEE: $ `7� ,�
SURCHARGE: $ a-, �j�
METER: $
REDUCING VALVE: $
MXU: $
OTHER: $
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TOTAL: $ _� , ��
ISSUED BY: V n/]� DATE: R � ��
COMMENTS:
(Revised 12/28/2017)
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'-���1 r tS � p�,Ul°�'Y�Il'd�PER%�IT APPLICATION !o,�use�nly
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��'"'�., �r � Perntit Num er�
,, ;`�' '� �� � CITY OF LAKEVILLE ,�
':,,, �'� `'- � BUILDING INSPECTIONS DEPARTMENT
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'p ���,� �3 20195 HOLYOKE AVENUE Received By
� �� y�,�, ,,, � LAKEVILLE,MN 55044 e� � �
,�w : 952-985-4440
;� Date R eived ,�-.
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�Pe it Fee
DATE '�'�'� �y �2'0 YOUR E-MAIL ADDRESS�J�Q 91'ri�.�I. �rn�
SITE ADDRESS 1��rs C-�,�J�n�M�vv+. �-
TENANT SUITE NO.
THE APPLICANT IS: RESIDENT OWNER t'nNTRACTOR
NAME
RESIDENT OWNER ADDRESS
CITY STATE ZiP
DAYTiME PHONE#WHERE YOU CAN BE REACHED
COMPAN�'NAME � ���� � LICENSE#��(p7.�
CONTRACTOR ADDRESS / �SO /�j�'Gh �'
Company name must be as CITY��,�/� � STATE '1M� ZIP �S�
appeat�s on State License OFFICE PHONE# ��7�.S�I'�OS3--FAX#
CONTACT NAME �S ��z+ rl,s.,. PHONE :�7��'��
COMMERCIAL ONLY RESIDENTIAL ONLY
COMM PLMBG SYSTEM LAWN SPRINKLER INSIDE PLBG
COMM/MULTI-FAMILY WATER SOFTENER CONVERSION
PERMIT TYPE LAWN SPRINKLER WATER HEATER ADDNJREPAIR
FIRE SPWNKLER MISC(fill description)
BACKFLOW
INSTALLATION Residentia!Permits Available on-line
N�EW ADDITION ALTER!REMODEL
TYPE OF WORK
REPAIR REPLACE DEMOLITION
JOBDESCRIPTION IYIS� �I WlOr� �`h�, �j� Lal/ ,S'��,t/�G✓
RESIDENTIAL FEES:
Repairs/Remodel,Water Heater or Water Softener$40.00+State Surcharge($1.00)
COMMERCIAL FEES: '
JOB COST: $ 'y�(;�j. � Example: $12,000 Job Cost
1-1/2%of contract cost up to$10,000 � (J $10,000.00 x 1.5%_ $150.00
1%of cost above$10,000 plus surcharge + $ 2,000.00 x 1% _ + 20.00
' (Surcharge=Contract Cost x .0005) • + �.� $12,000 x.0005 = + 6.00
TOTAL ��' � _ $176.00
Minimum of$40.00+State Surcharge($1. )
NO.OF METERS SIZE OT METER LOCATION OF METER
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I hereby apply for a plumbing permit aad I acknowledge that Uie information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of U�e City of Lakeville and with d�e Minnesota Plumbing Codes; that I understand this is not a
permit but only an applicarion for a pennit and work is not to stari without a permit;that the work will be in accordance with the approved plan in
the case of all work wluch requires review and approval of plans.
NAME OF APPLICANT(Please Print) ��G�,Ny` /� � � � OZO
�Z✓�ts— Date
SIGNATURE OF APPLICANT: �
PLEASE NOTE: SEPARATE PERMTTS ARE RE UIRED FOR ANY BUILDING MECHANICAL&ELECTRICAL WORK