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HomeMy WebLinkAboutPlumbing Permit 14-1355 00 0 000000 0 > E0 2 0 O ■ -n - -n -n 'n § & § in_i k r I kkk 3 - rr ® 1.3 c) ho tri % * > a co k in 0 ��21 � �0 7 § § 9 s . qz § , % © § q § 5, % 7j r z m m Ni m o Z 2 Z 27 R R 0000 = 0 \ § � i mlicolam * ■ OS —10 ,C % § K ? m x § 73 § i § Di n - ■ % n \ k kBx§ �B - m r -n § o xi Z1 o 0 h 71 mTI � � � o I M ' CI 0 m 4 O ❑ OOQ , 0 ti E ■ o ik��§ �2 % z uri P. § 0 X22 % � �\ .1m ■ r 2 r B m 4 ?R10 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT 'ilorsOo I. Blue File 2.GoldCity (3 3.Yellow PERMIT NO.Applicant 1 (Please type or print and sign at bottom) ADDRESS ^ ZONING I:office use) 113/41 Rccwooct LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER p (Name) )`rayr- (Phone) ‘P1'2'° ri"el- °I 5-1 (Address) 11341 Zect C WOOd VI APPLICANT Appliance Connections Inc. (Name) 12850 Chestnut Blvd. (Phone) (Address) Shakopee, MN 55379 (Aaftr2s6.1. -4'!°3 (City) (Zip Code) • (Contact Person) t2 ` (Phone) APPLICANT SIGNATURE let I DATE I zl 5l 14 :"PLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher 1 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 Estimated Cost $ Building Permit# PLUMBING PERMIT FEE $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ 514. 51) (Office Use Only) This Application Becomes Your Building Permit When ApprovedPaid 54 Re t No. DateBy Building Official Date t L ` I\ (� 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372