HomeMy WebLinkAboutLA191274 PERMIT
City Of LakCVille Permit Type: Plumbing
20195 Holyoke Ave Permit Number: LA191274
Lakeville,MN 55044
(952)985-4440 �k L R 1 9 1 Z 7 4 �k
www.lakevillemn.gov Date Issued: 06/08/2021
Site Address: C1 Grumman La
Lot: Block: Addition:
PID:
Use: Airlake Airport * *
Description:
Sub Type: Commercial Plumbing System
Work Type: New
Description: Add inside hose bit to hangar
Meter Size Meter Tvne Manufacturer Serial Number Remote Number Line Size
Comments: HOOK UP METER AND 1 SILCOX
Fee Summary' Description Amount Revenue Code
PL-Commercial(Minimum) $40.00 1000-4152
Valuation: 535.00 Surcharge- $1.00 $1.00 1000.2127
Water Meter $335.00 7600-5161
Total: $376.00
Contractor: - appiicant - Owner:
Pressnall Plumbing Inc
2339 280th St E
Randolph MN 55065
(507)663-9044
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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Applicant/Permitee: Signature Issued By:Signature
,`-'�C�.;� �;�...�_.L,.r`4 C./� � �� ',
PLUMBING PERMIT APPLICATION\ o�ce use,only
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� CITY OF LAKEVILLE Permit NumbT—
BUILDING INSPECTIONS DEPARTMENT . C � '
20195 HOLYOKE AVENUE Recerved y
LAKEVILLE,MN 55044 ,�-
952-985-4440 � �' �� ' �.,
Website:www.lakevillemn.eov DateReceived
Email:permits@lakeviliemn.gov ��,'�`�.� ��� ��
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/J/� ) —T Permit Fee
DATE � ''l 2 � �f YOUR E-MAIL ADDRESS �2 I� / �i C�
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SITE ADD SS ' �bc,/I'1�'►'IGu-� �,..a,t-��2 {y- �p( ,ti G(,rt,�—
TENANT �j(L�'� SUITE NO.
THE APPLICANT IS: RESIDENT OWNER CONTRACTOR
NAME
RESIDENT OWNER ADDRESS
CITY STATE ZIP
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME }L LICENSE# b��'�S O
CONTRACTOR �D� Z �'�' 3' —
Company name must be as CITY _STATE ZIP �����
appears on State License OFFICE PHONE# Z-7�-'777j� FAX#
CONTACTNAME �t .,� �-�. PHONE��Z-�O%'"7�
C �RCIAL ONLY RESIDENTIAL ONLY
COMM PLMBG SY � � 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
NEW ADDITION ALTER/REMOD
TYPE OF WORK
REPAIR REPLACE DEMOLITION
JOB DESCRIPTION �'1 �� �L�j2_�j� � �Cc.
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%of contract 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 = _ $176.00
Minimum of$40.00+State Surcharge(S1.00)
NO.OF METERS SIZE OF METER LOCATION OF METER
.3 ar,
I hereby apply for a plumbing pemvt and I acknowledge that the informa6on 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 tlus is not a
pernrit but only an application for a pennit and work is not to 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 of plans.
NAME OF APPLICANT(Please Print) Date
SIGNATURE OF APPLICANT:
PLEASE NOTE: SEPARATE PERNIITS ARE RE UIItED FOR ANY BUILDING NIECHArIICAL&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: $ �/p�� D
SURCHARGE: $ :1,. a �
METER: $ '33 J� c��
REDUCING VALVE: $
MXU: $
OTHER: $
TOTAL: $ � 7 Co < (� �
ISSUED BY: VL �— DATE: �_` �7' �l
COMMENTS: ��,� f j� y„L.�}�� a w� � S�'J� X
(Revised 9/18/2020)