HomeMy WebLinkAboutBuilding Permit 12.804, Plumbing, Heating 'i P110 Date Reed ° 4 : ,: CITY OF PRIOR LAKE PLUMBING PERMIT „:„s
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I. BI"° Fl° PERMIT NO. //y , //
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(Please type or print acid sign at bottom)
ADDRESS [ ZONING (office ,ue)
( r1 ,pmi\RJ Pfic,c tvid' [
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION YID
OWNER ~
(Name) (Phone)
(Address)
APPLICANT
(Name) GENZ -RYAN (Phone) 952-767-1847
(Address) 2200 HIGHWAY 13 W , BURNSVILLE, MN 55337
(Address) (City) (Zip Code)
(Contact Person) LISA HERNANDE (Phone) 952-767-1847
APPLICANT SIGNATURE ° f . _ ' It ! �/�, DATE
_ APPLICANT PLEASE CO ETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher Water Heater
Floor Drain _ Water Softener
1 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
t - Water Closet (Toilet) Other
e iM
FEE SCHEDULE S IA L L 0 F SOLD IN / I
industrial, Commercial & Multi - family 1% of job cost with a S49.50 minimum Residential, New One &Two- Family 5149.50 (pe ti
Residential, Additions & Alterations 549.50 r n
The Minnesota Statutes*' 32613.148 "'st $ - — Building Permit # T V �K.
"SURCHARGE” has been changed for one PAID
year effective PLUMBING PERMIT FEB $
July 1, 2010. until June 30, 2011. STATE SURCHARGE $ .58UILDING PERMIT
The minimum surcharge fora "fixed rre" permit TOTAL PERMIT FEE $
is S5. beginning Jury 1, 2010
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This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Building Official pate
24 hour notice for all inspections (952) 447 -9850, fits (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
?Rib CITY OF PRIOR LAKE Date Rec'd
° `' HEATING /AIR • CONDITIONING/FIREPLACE PERMIT • •
4,41vesotr x; et. C; ' PERMIT NO.
1. Please tyke or print and sign at bottnm) '.ff ,ippl sut
ADDRESS ZONING (office use)
3L2 01 PO ?'\
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION P1D
OWNER
(Name) (Phone)
•
(Address)
APPLICANT
(Name) GENZ -RYAN (Phone) 952 -767 -1847
(Address) 2200 HIGHWAY 13 W, BURNSVILLE, MN 55337
(Address) (City) (Zip Code)
(Contact Person ) LISA HERNAND Z
(Phone) 952- 767 -1847 •
APPLICANT SIGNATURE 1
tie DATE - 7 1 0 / 1'1-
APPLICANT PLEASE COM''iETE BELOW
Ia/ NEW CONSTRUCTION O REPLACEMENT — O ALTERATIONS •
FURNACE MAKE AND MODEL, FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
OWarm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
DGravity O Hot Water
0 Mechanical ❑Radiation into Required Side Yard Setbacks.
:Mir Conditioning 0 Special Devices Fireplaces with Box Additions or
OVent. System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL 'n + 6 �- r /�
FEE SCHEDULE T ' 41 AS h ► LL" U `/ SOLD O (00
Industrial, Commercial & Multi- Family I% of job cost Residential, Gas Fireplace $49.50c.Q l/
^ 7
$49.50 minimum �� 1
Residential, Heating & A/C (New Construction) $I49.50 Residential, Additions & Aitefatid Y Y 1 i t'�6 49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only BUILDING PE FfMit - �
Estimated Cost $ $19 D Building Permit # t V l IVI
The Minnesota Statutes § 32613.1411
HEATING PERMIT FEE S "SI;RCI•IARGE" has been changed I'or one
year elTcctivc
STATE SURCHARGE .50 July t, 211111, until June 311.21)11.
TOTAL PERMIT FEE $ The minimum surcharge for n "filed fee" permit
(Office Use Only) is KS heginning.inly I. 20111
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
%Udine Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447.4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372