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HomeMy WebLinkAboutPlumbing Permit 14-1398 5 0 0 0 n 000000 "0 0 > ■ 0 § q a \ 0 0 � � k� o§ m 73 �Sel % r m m no � � § 22 k �� % t 13 J© § Q p Zk A' ee § 0 ■ a) n z z § ■ % ee g: 7 0 » k =c t § > > 0 Mm ■ r § 7 m k k k ,...Z.z nn % 000000 �. qm m ® -0 ® ■ a -0 E 3 ° . qc JR5 lI f m . zx � 7dM � § 0 0 § m k § rmOO xi § FP ►� - . § rti § Z $ �� zr kg # r � m p . § ■ q ■ m ■ c 2 2 A00000 1 � 71il � n § > § Dcmmvm m 4 En cm00m _I � En m2.12 E 2 r § 04?Rlp4 Date Rec'd a� CITY OF PRIOR LAKE PLUMBING PERMIT v 4r oo I. Gd i 2.Gold City PERMIT NO. !� 4T7-1 t 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING[office use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNEamo P~ t (Phone)C\0� n (Address) VA ,)e(-Ctt)0.b. 3E, p,\. APPLICAN� • n - (Name) l J\, (Phone=\L4J -5Kci (Address) `A b , � M'Nr- . W\ '311 01 I, (Ad• k.) (City) (Zip Code) (Contact Person) 1 (Phone) I I f APPLICANT SIGNATURE ® _ // ;/!� DATE L l `1 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher 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# l ne Minnesota statutes s3Zbti.141f "SURCHARGE"has been extended PLUMBING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ "fixed fee" ermit is 15.00 TOTAL PERMIT FEE $ L/ . 5 b P (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt Date By Solidin¢Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372