HomeMy WebLinkAboutLA066331 PERMIT
City Of Lakeville Permit Type: Plumbing
20'95 HOLYOKE AVE Permit Number: LA066331
LAKEVILLE, MN 55044 Date Issued: 05/24/2002
(952) 985-4440
Site Address: 17070 EMBERS AVE
Lot: Block: Addition:
PID:
Use:
Description:
Sub Type: Lawn Sprinklers
Work Type: Addition
Description: CORNERSTONE LAKE DOG HOUSE
Meter Size Type Manufacturer Meter Nbr Remote Number Line Size
Remarks:
Fee Summary• surcharge (.50) 0.50 1000-2127
PL -Residential (Minimum) 39.50 1000-4152
Reducing Valve 180.00 7600-5165
Water Meter 403.00 7600-5161
$623.00
Contractor: -Applicant - OWrier:
ROSEVILLE PLMBG & HTG St. Lic.: 2318PM TOWN & COUNTRY HOMES
65 SOUTH OWASSO BLVD
LITTLE CANADA, MN 55117
' 6514844086
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. A
SEPERATE ELECTRICAL PERMIT IS REQUIRED
Applicant/Permitee: Signature Issued By: Signature
j
PLUMBING PERMIT APPLICATION
CITY OF LAKEVILLE
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BUILDING INSPECTION DEPARTMENT
20195 HOLYOKE AVENUE
L LE MINNE OTA 55044
AKE VIL S
DATE: - O 2 (952) 985-4440
JOB SITE ADDRESS: / 7~7 C~ rcm~ Cars ~
BUSINESS NAME: ~',.r.,.e~ Sin La/~ e ~nk.~ horn ~ c ~.o.,°l~,~m p,~
APPLICANT: .OWNER OR CONTRACTOR (circle one)
OWNER OR BUILDER: / PHONE:
STREET ADDRESS: CITY: ZIl':
CONTRACTOR: ~;~gpJl~~e P~~,~~,n o.~ PHONE: (o S(- ~1~~(~ ~fU ~b
CELL /a gs--~ ~ ~ gDS- PAGER FAX (oS/ ° ~lS ~ ~ 7 $ 7~
STREET ADDRESS: s~ • CITY: ZIP: ssr !7
ONSTRU R EXISTING (circle one)
COMMERCIAL PLUMBING SYSTEM (20) PLUMBING SYSTEM (21)
SOFTENER (22) FIRE SPRINKLER SYSTEM (23)
LAWNSPRINKLER (25) INSIDE PLBG CONVERSION (26)
ADDN/REPAIR (27) WATER HEATER (28)x_ RPZ (29)x_ MISC (30)
FOR: RESIDENTIAL. COMMERCIAL
JOB COST: ~ ~ ~ (To be completed for commercial & fire sprinkler systems)
JOB DESCRIl'TION: T7'„ w~f~rr- Yn~P~ cahd a'~ RQ.z., Lo~~ lrr ig Q•~,®/~
PLUMBING FIXTURES: (Indicate the number of fixtures installed)
WATER CLOSET (O1) MOP SINK (12)
LAVATORY (02) WATER SOFTENER (13)
DISHWASHER (03) URINAL (14)
SHOWER (04) OTHER (19)
BATHTUB (OS) RAIN LEADER (16)
LAUNDRY TUB (07) SUMP PUMP (18)
KITCHEN SINK (08) DRINKING FOUNTAIN (11)
FLOOR DRAIN (10) WATER HEATER (23)
' LAWN SPRINKLER (25)
Applicant's Signature Date.
~ PLUMBING FEE RATES
Residential: Commercial.
Repairs or Remodel $40.00 1-1/2% of contract cost up to $10,000 and
(39.50 + .50 surcharge) 1% of cost above $10,000 plus surcharge. +
(Surcharge =Contract Cost x .0005) +
Water Softener & Water Heater $15.00 Includes Sprinkler Systems
(14.50 + .50 surcharge) TOTAL =
Minimum of $40.00 (39.50 + .50 surcharge)
0
PLUMBING PERMIT APPLICATION PAGE
OFFICE USE
SYSTEM TYPE: INSPECTIONS:
NE (81) ROUGH-IN (64)
ADDITION (82) FINAL (65)
REPAIR (83) ,~l~
~ RPZ TEST REPORT
DEMOLISH (84) (70)
REPLACE (85)
ALTER/REMODEL (86)
PERMIT FEE•
PERMIT FEE: $
SURCHARGE: $ ~ S~
METER: $ D , ~ ~
REDUCING VALVE: $ ~ ~
OTHER: $
TOTAL: $ ~ ~ ~ O~
t ° ~ i
APPROVED BY DATE: ~ r
COMMENTS:
Revised 12/18/2001