HomeMy WebLinkAboutLA085423 Y PERMIT
.City of Lakeville Permit Type: Plumbing
20195 HOLYOKE AVE Permit Number: LA085423
LAKEVILLE, MN 55044
(952) 985-4440 Date Issued: 05/25/2005
Site Address: 17172 EASTWOOD AVE .5
Lot: Block: Addition:
PID:
Use:
Description:
Sub Type: Comm/Muti-Family Lawn Sprinkler
Work Type: Addition
Description: DOGHOUSE FOR LAKEPLACE 4TH
Meter Size Type Manufacturer Meter Nbr Remote Number Line Size
Remarks:
Fee Summary: Surcharge (.50) 0.50 1000-2127
PL-Commercial (Minimum) 39.50 1000-4152
MXU 130.00 7600-5163
Reducing Valve 180.00 7600-5165
Water Meter 403.00 7600-5161
$753.00
Contractor: _ _ Owner:
A licant
pp
B. R. PLUMBING SUNSET HOMES
St. Lic.: PM003971
6250 INDUSTRY AVENUE NW NO 207
RAMSEY, MN 55303
(763)323-0776
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
i
• f PLUMBING PERMIT APPLICATION ~ff~ Oi1''
Permit Number
~ CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT
20195 HOLYOKE AVENUE Received By
:,.s:::r.,.•..:y,,:.,:•,•,.~~/ LAKEVII,LE, MN 55044
~ 952-98511440 ~l2 ~ -
~ Date Received
www.ci.lakeville.mn. us
DATE ~ ' ~ 5 ~ YOUR E-MAIL ADDRES
SITE ADDRESS ~ ~ / ~ oZ ' ~ ~Q !~'l.~up~ G~y.L ~ c~ lit D u S
TENANT S S ~ ~ Lt ~ v~ ~ ~ SUITE NO.
THE APPLICANT IS: ? RESIDENNT OWNER ? CONTRACTOR
NAME P t~ v ~ ~O Nw~ c^--~
RESIDENT OWNER ADDRESS
CITY ~e~ ~ ~ STATE V~~- ZIP
DAYTIME PHONE # WHERE YOU CAN BE REACHED
COMPANY NAME ~ ~ ~ ` ^ LICENSE #
ADDRESS ~ v~ X20`? -k-~`~S 74'°'Z-
CONTRACTOR CITY ~ w•M ~ STATE 1~ ZIP
CONTACT NAME ~®Q
DAYTIME PHONE # WHERE YOU CAN BE REACHED ~ L ~ ~ 3 ~ 3 ° ~ 1 1`
COMMERCIAL ONLY RESIDENTIAL ONLY
? COMM PLMBG SYSTEM ~-1,AWN SPRINKLER ? INSIDE PLBG
PERMIT TYPE ? COMM/MULTI-FAMILY ? WATER SOFTENER CONVERSION
LAWN SPRINKLER ? WATER HEATER ? ADDN/REPAIIt
? FIRE SPRINKLER ? MISC
? RPZ Available on-line Residential Permits Available on-line
W ? ADDITION ? ALTER /REMODEL
TYPE OF W ORK
? ~pAIR ? REPLACE ? DEMOLITION
JOB DESCRIPTION
RESIDENTIAL FEES:
Repairs or Remodel $40.00 (39.50 + .50 surcharge) Water Softener & Water Heater $15.00 (14.50 + .50 surcharge)
COMMERCIAL FEES:
JOB COST: $
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 1% = 20.00
_ = 6.00
005
(Surcharge -Contract Cost x .0005) + $12,000 x .0
TOTAL = TOTAL $176.00
Minimum of $40.00 (39.50 + .50 surcharge)
NO.OF METERS SIZE OF METER LOCATION OF METER
Applicant's Signatures ~ Date
PLUMBING PERMIT APPLICATION PAGE 2
OFFICE USE
SYSTEM TYPE: INSPECTIONS:
~NE W ROUGH-IN
ADDITION ~ FINAL
gEpA~ RPZ TEST REPORT
DEMOLISH COMBUSTION AIR
REPLACE
ALTER/REMODEL
PERMIT FEE:
PERMIT FEE: $
SURCHARGE: $
METER: $
REDUCING VALVE: ~ C~ -
MXU $ ~ ~
OTHER: $
TOTAL: $ .
ISSUED BY:~, DATE: ~ -~~7~
COMMENTS:
Revised 03/01/2004