HomeMy WebLinkAboutLA067109 PERMIT
Clty Of LakeVlll~ Permit Type: Plumbing
20195 HOLYOKE AVE Permit Number: LA067109
LAKEVILLE, MN 55044 Date Issued: 07/09/2002
(952)985-4440
Site Address: XX~~~~ EAGLEVIEW WAY
Lot: Block: Addition:
PID:
Use: DOG HOUSE FOR LAKE PLACE
Description:
Sub Type: Lawn Sprinklers
Work Type: Addition
Description: Applicant Must Call for Ins.
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 - OWller:
B R PLUMBING St. Lic.: PM003971 SUNSET HOMES
6250 INDUSTRY AVENUE NW NO 207
RAMSEY, MN 55303
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
SEPARATE ELECTRICAL PERMIT IS REQUIRED
Applicant/Permitee: Signature Issued By: Signature
PLUMBING PERMIT APPLICATION
CITY OF LAKEVILLE
BUILDING INSPECTION DEPARTMENT
20195 HOLYOKE AVENUE
LAKEVILLE, MINNESOTA 55044
DATE:~~ o~ (952) 985-4440
JOB SITE ADDRESS:
BUSINESS NAME: B I~ ~~u m ~ rn
APPLICANT: OWNER/~ OR (CONTRACTOR (circle one)
OWNER OR BUILDER: 17 ~ P/ Urrt.~ ~ ~c3, PHONE: 3 " `3~ o
STREET ADDRESS: a I P~ wa CITY: ZIP:
CONTRACTOR: ~temb~n xx PHONE:
CELL (o /v~' ai7,~~` D ~ PAGER FAX
STREET ADDRESS: CITY: ZIl':
NEW CONSTRUCTION OR 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) RPZ (29) MISC (30)
FOR: RESIDENTIAL~_ COMMERCIAL
JOB COST: (To be completed for commercial & fire sprinkler systems)
.JOB DESCRIl'TION:
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 , ~-~Gf~ Date / r ~o~
i 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)
7~~~
PLUMBING PERMIT APPLICATION ~ PAGE 2
OFFICE USE
SYSTEM TYPE: INSPECTIONS:
NEW (81) ROUGH-IN (64)
ADDITION (82) FINAL (65)
REPAIR (83) RPZ TEST REPORT
DEMOLISH (84) (70)
REPLACE (85)
ALTER/REMODEL (86)
PERMIT FEE•
PERMIT FEE: $
SURCHARGE: $
METER: $
REDUCING VALVE: $
OTHER: $
TOTAL:
APPROVED BY DATE:
COMMENTS:
Revised 12/18/2001