HomeMy WebLinkAboutLA191345 PERMIT
City of Lakeville Permit Type: Plumbing
20195 Holyoke Ave Permit Number: I.A191345
Lakeville,MN 55044
(952)985-4440 * L R 1 9 1 3 4 5 *
www.lakevillemn.gov Date Issued: 06/O1/2021
Site Address: 7098 181st St W
Lot: Block: Addition:
PID: �
Use:
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Description:
Sub Type: Comm/Multi-Family Lawn Sprinkler
Work Type: New
Description: Deduct meter not allowed.
Meter Size Meter Tvne Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: Description Amount Revenue Code
PL-Commercial(Minimum) $40.00 1000-4152
Surcharge- $1.00 $1.00 1000.2127
Water Meter $1,115.00 7600-5161
Total: $1,156.00
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Contractor: - Applicant - . �Wner:
Flow Right Plumbing LLC
10303 Kahler Ave NE
Monticello MN 55362
(763)228-7972
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.
Please provide a minimum of a 24 hour notice to schedule inspections. BUILDING INSPECTIONS: (952)985-4440,8 am-4:30 pm,M-F
ELECTRICAL INSPECTIONS: Call Brian Grey at(507)381-1791,7-8:30 am,M-F to schedule appointments
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ApplicandPermitee: Signature Issued By: Signature
Office Use Only
PLUMBING PERMIT APPLICATION
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CITY OF LAKEVILLE Permit Number
BUILDING INSPECTIONS DEPARTMENT `� \ � '�, L 1.`.l� � �
t ' 20195 HOLYOKE AVENUE Received By
LAKEVILLE,MN 55044 � �
952-985-4440 t.1 � � �l-�
�ca„ latir�ill�nm eu� Date Received
Submit to: ermits p.lakevillemn ov � C�`
e--�-------y- o.00�I 1 `�(�
u�1 Permit Fee '
DATE � � YOUR E-MAIL ADDRESS ��� r�C , ��� ';, �a. �,.,;
SITE ADDRESS ��I I ;
TENA �d SUITE NO.
THE APPLICANT IS: ❑RESIDENT OWNER �ONTRACTOR
NAME
RESIDENT OWNER ADDRESS
CITY STATE ZIP
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME ��(x,.� ��A�4`�- �`UJ�t�i nc! LICENSE #��c!
CONTRACTOR ADDRESS��7 �Q 1,� �Z�T
Company name must be as CITY �����;/��..,,� STATE_��/v ZIP ���(J/
appeazs on State License OFFICE PHONE# �l�3 �"ZZ ts '7�j 7? FAX#
CONTACT NAME �—�','�'Z- ��S� PHONE � �
COMMERCIAL ONLY RESIDENTIAL ONLY
❑COMM PLMBG SYSTEM ❑LAWN SPRINKLER ❑INSIDE PLBG
�.COMM/MULTI-FAMILY ❑WATER SOFTENER CONVERSION
PERMIT TYPE LAWN SPRINKLER ❑WATER HEATER ❑ADDN/REPAIR
❑FIRE SPRINKLER ❑MISC(fill description)
❑BACKFLOW
INSTALLATION Residential Permits Available on-line
TYPE OF WORK °K�W ❑ADDITION ❑ALTER/REMODEL
❑REPAIR ❑REPLACE ❑DEMOLITION
JOB DESCRIPTION_ ��ll� ��( � ��, �Gf
RESIDENTIAL FEES:
Repairs/Remodel,Water Heater or Water Softener$40.00+State Surcharge($1.00)
COMMERCIAL FEES:
JOB COST: $ Example: $12,000 Job Cost
1-1/2%ofcontract cost up to$10,000 $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 = $0.00 = $176.00
Minimum of 540.00+State Surcharge($1.00)
NO.OF METERS SIZE OF METER LOCATION OF METER
I hereby apply for a plumbing permit and I aclrnowledge that the informarion above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Lakeville and with the Minnesota Plumbing Codes; that I understand this is not a
permit but only an application for a permit and work is not t start without a permit;that the work will be in accordance with the approved plan
in the case of all work which requires review and approval pl
NAME OF APPLICANT(Please Print) Date (� / Z
SIGNATURE OF APPLICANT:
PLEASE NOTE: SEPARATE PERMITS ARE RE UIRED FOR ANY BUILDING MECHANICAL&ELECTRICAL WORK
PLUMBING PERMIT APPLICATION PAGE 2
OFFICE USE
SYSTEM TYPE: REQUIRED INSPECTION:
� NEW �COMBUSTION AIR
� ADDITION �FINAL
� REPLACE �OTHER
� ALTER/REMODEL �ROUGH IN
� REPAIR �BACKFLOW TEST REPORT
_� DEMOLITION �UNDERGROUND
PERMIT FEE
PERMIT FEE: $
SURCHARGE: $
METER: $
REDUCING VALVE: $
MXU: $
OTHER: $
TOTAL: $ 0.00
ISSUED BY: DATE:
COMMENTS�