HomeMy WebLinkAboutLA079259 PERMIT
City of Lakeville Permit Type: Plumbing
20195 HOLYOKE AVE Permit Number: LA079259
LAKEVILLE, MN 55044
(952) 985-4440 Date Issued: 07/22/2004
Site Address: 16839 EDTNBURG WAY
Lot: Block: Addition:
PID:
Use:
Description:
Sub Type: Comm/Muti-Family Lawn Sprinkler
Work Type: New
Description: MALLARDS SHORES 2ND DOG HOUSE
Meter Size Type Manufacturer Meter Nbr Remote Number Line Size
2" TURBO INVENSYS 63097935 55894057
Remarks: BILLING INFORMATION:
WRIGHT HOMES INC
14420 GLENDA DR
SAVAGE, MN 55378
Fee Summary: Surcharge (.50) 0.50 1000-2127
PL-Commercial (Minimum) 39.50 1000-4152
MXU 130.00 7600-5163
Reducing Valve 212.00 7600-5165
Water Meter 875.00 7600-5161
$1,257.00
Contractor: -Applicant - Owner:
SALZER PLUMBING WRIGHT HOMES
6549 147TH ST W St. Lic.: PM003753
PRIOR LAKE, MN 553720000
(952)447-8025
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/Perrnitee: Signature Issued By: Signature ,
PLUMBING PERMIT APPLICATION
'~x~. Permit Number
• CITY OF LAKEVILLE a
' BUILDII~IG INSPECTIONS DEPARTMENT
~ , 1 20195 HOLYOKE AVENUE eived By
. x~/ LAKEVILLE, MN 55044 ' ~~~~D j
. ~ 952-9851t44U 'T
i ~`-~--r'~ www.ci.lakeville.mn.us Data Received
DATE / ! ~+~',~Dy YOUR E-MAIL ADDRESS
SITE ADDRESS /n4 ~l4 ~ cs`1-°~-"'~f
TENANT ~ SUITE NO.
THE APPLICANT IS: ? RESIDENT OWNER ON'['RACTOR
NAME -v-i-'-"' d
/~c~/ 6',~.~~_ ~S ye . cz 77 e n
RESIDENT OWNER ADDRESS.
II'
CpI'y STATE Z
DAYTav1E PHONE # WHERE YOU CAN BE HED ~3
i COMPANY NAME Wr'/~ ~ LICENSE #~o
ADDRESS G
CONTRACTOR CITY STATE N~L~ ZII' .~J
CONTACT NAME hl , J
DAYTIIvIE PHONE # WHERE YOU C BE REACHED G 3
COMMERCIAL ONLY RESIDENTIAL ONLY
? C£~lvflkt PLMBG SYSTEM ? LAWN SPRINKLER ? INSIDE PLBG
PERMIT TYPE ~Oh~IIvf/MUL,TI-FAMILY ? WATER SOFTENER CONVERSION
LAWN SPRINKLER ? WATER HEATER ? ADDN/REPAIR
? FIRE SPRINKLER ? MISC
~ ? RPZ fh+ailable ar-tine Reside ' 1 Pernuts fl>>ailable on-line
? NEW DTTION ? ALTER /REMODEL
TYPE OF WORK
? REPAIlt ? REPLACE ? DEMOLITION
JOB DESCRIPTION
RESIDENTIAL FEES: ~Q6~`^ ~ N ~l -1 ~S ~ ~
Repairs or Remodel $40.00 (39.50+ .50 surcharge) Water Softener & Water Heater $ IS.UO (14.50 + .50 surcharge)
COMMERCIAL FEES:
JOB COST: $
Ecample: 512,000 Job Cost
1-1/2% of contract cost up to $10,000 and $10,000.00 ~ 1.5% _ $150.00
1%of cost abo~~e $10,000 plus surcharge. + $ 2,000.00 x 1% = 20.00
(Surcharge =Contract Cost r .0005) + $12,000 x .0005 = 6.00
TOTS, _ TOTAL $176.00
Minimum of $40.00 (39.50 + .50 surcharge)
NO.OF METERS SIZE OF METER LOCATION OF METER
i~
Applicant's Signature Date
PLUMBING PERMIT APPLICATION PAGE 2
OFFICE USE
SYSTEM TYPE: INSPECTIONS:
NEW ROUGH-IN
ADDITION FINAL
REPAIR RPZ TEST REPORT
DEMOLISH COMBUSTION AIR
REPLACE
ALTER/REMODEL
PERMIT FEE:
PERMIT FEE: $
SURCHARGE: $ ~ s~
METER: $ SOD
REDUCING VALVE: $ Z { Z- OZ)
MXU $ ~ 3a• OD
OTHER: $
TOTAL: $
ISSUED BY: DATE:
COMMENTS:
Revised 03/01/2(?U-t