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HomeMy WebLinkAboutPlumbing Permit 11-1194 - 00� 1 0 000000 ti 0 > zg 1 0 5 0 q§ 0 izc O 0 z A k � § / / 7373 C �rc §f z ■ 2 n\ m m m Z z 0 )3 •IIMIIIIN tvl 10 ' � j 0 0 C � 0 © a z 0 q § & -�' § n z a \ \ > 0 ni m E 0 0 - - n 71 m 2 3 3 000000 z q§§ �r ®�Cr r. 2 ® _ E o o nc § -1§ 2 2 i $ § m 0 ? ; \ > §oo § 2 m xi .1 % 0 \ 0 r Ikk ® ■ E C. § } �k% P § i x I m c o i 'M00000 § 7 a2]0 k v 0 � com§3® \ z § 005- ) R -nx a- -I cA tn z m -1 r- 0 0 PRIp Date Rec'd 9 CITY OF PRIOR LAKE PLUMBING PERMIT I x 41I NNESP I. Blue File 2. Gold City PERMIT NO. / / / / Q4 3. Yellow Applicant / T (Please type or print and sign at bottom) ADDRESS ZONING (office use) � o \KYI LJ 3 I �c� LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID 1 OWNER r lLi / r r WD i (Name) i (Ph one) (Address) a Fri or ,a,6 , 1 Y 1 Sg5 APPLICANT Champion Plumbing (Name) # 61770 - (Phone) 651 -365 -1340 (Address) 3670 Dodd Rd. Kii (Address) Ragan, MN 55123 (City) (Zip Code) (Contact Person) � (') . (Phone) APPLICANT SIGNATURE / . --/ DATE �� APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher t Water Heater Floor Drain Water Softener Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi- family 1% of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 '^` - -- ' "ost $© • W Building Permit # The Minnesota Statutes § 326B.148 "SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ year effective STATE SURCHARGE $ 50 July 1, 2010, until June 30, 2011. TOTAL PERMIT FEE $ 'S "/ St) The minimum surcharge fora "fixed fee" permit is Ls, beginning July 1, 2010 - 1 His Application Becomes Your Building Permit When Approved Paid ` _ _ pt Ns . A , (J r (� a ) Date / Building Official Date , L. 4 L I 1 IMIIMII 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 I 0 42 5 eftr