HomeMy WebLinkAboutLA107505 . PERMIT
City of Lakeville Permit Type: Plumbing
20195 Holyoke Ave Permit Number: LA107505
Lakeville, MN 55044
(952) 985-4440 ~K L R 1 0 7 5 Q1 5
www.ci.lakeville.mn.us Date Issued: 08/14/2008
Site Address: 21338 Dodd Blvd
Lot: 001 Block: 001 Addition: Clemmer 1st Addition
PID: 22-17825-010-01
Use: Dick's Sanitation
*22-17825-(~ 1Q1-fd 1*
Description:
Sub Type: Miscellaneous
Work Type: Alter/Remodel
Description: Install Water Pressure Booster Pump
Meter Size Meter Twe Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary' Description Amoun Revenue Code
PL-Commercial (Minimum) $39.50 1000-4152
Surcharge (.50) $0.50 1000-2127
Total: $40.00
Contractor: -Applicant. - OWner:
State Mechanical Inc Richard J Clemmer
5050 W 220th Street 21338 Dodd Blvd
Farmington MN 55024 Lakeville MN 55044
(651) 463-8220
I HEREBY AGREE THAT THIS WORK WILLBE PERFORMED ACCORDING TO: (1) THE APPROVED PLANS &
SPECIFICATIONS; (2) THE APPLICABLE CITY ORDINANCES & CODES; AND (3) THE MN STATE BUILDING CODE.
Applicant/Permitee: Signature Issued By: Signature
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PLUMBING PERNIIT APPLICATION Use
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CITY OF LAKEViT S F• PernritNumbcr
BUILDING INSPECTIONS DEPARTMENT
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20195 HOLYOKE AVENUE gy
LAKEV]LLE, MN 55044 ,,11
952-985-4440 V
www.ci.lakeville.mn.us Date Received
~ ~
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS e5 _ ~ ~ J~~~ _I ~
TENANT SUITE NO.
TFID APPLICANT IS: ? RESIDENT OWNERCONTRACTOR
NAME
RESIDENT OWNER ADDRESS_~T"1=
1~~ ~ ~ -
CTIY ~n`~.P~y~ t~f
~ STATE Z1P
DAYTR~E PHONE # WHERE YOU CAN BE REACHED
COMPANY NAME: State Mechanical LICENSE 2096pm
ADDRESS: 5050 W 220' ST
CONTRACTOR CI7"I' STATE: MN . ZIP: 55024
CONTACT NAME: Helene Heintz or Megan Holland
' DAYTIIvIE PHONE # WHERE YOU CAN BE REACHED: 651-463-8220
COMIVIERCIAL ONLY RESIDENTIAL ONLY
? COMM PLMBG SYSTEM ? LAWN SPRINKLER ? INSIDE PLBG
PERMIT TYPE ? COIvIIv1/MULTI-FAIv1II,Y ? WATER SOFTENER CONVERSION
LAWN SPRIl~IKLER ? WATER HEATER _ ~~DDN/REPAIIt
CI FIRE SPRIA~R MISC
? RPZ Available on-line Residential Permits Available on-line
W ~ ADDITION ~ ALTER /REMODEL
TYPE OF WORK
~ REPAIR ? REPLACE - n DEMOLITION
JOB DESCRIl'TION 1 nS~c~l r 1'~ ~nl~l~'`~N
RESIDENTIAL FEES:
Repairs or Remodel $40.00 (39.50 + .50 surcharge) Water Softener & W ater Heater $15.00 (14.50 + .50 surcharge)
COMMERCIAL FEES`
JOB COST: $ f
Example: $12,000 Job Cost
1-1/2% of contract cost up to $10,000 and $10,000.00 x 1.5% _ $150.00
1% of cost above $10,000 plus surcharge. + $ 2,000.00 x I% = 20.00
(Surcharge =Contract Cost x .0005) + $12,000 x .0005 = 6.00
TOTAL = TOTAL $17b.00
Minimum of $40.04 (39.50 + .50 surcharge)
NO. OF METERS SIZE OF METER LOCATION OF METER
Applicant's Signature a Date ~ °~~'Z'JC7