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HomeMy WebLinkAboutPlumbing Permit 14-1295 5 0 0 n 000000 V 0 > E n k a 0 0o . /K� °k m �o o » o 7373 ■ s rC . MI ■ 01 O� % r m m m § § ■ § ■ o :-.1 .0 Kb t * > a -I m 0�� � �0 % k k o k '. o \ k t o g § k 0 6 m m ■ r o 6 q El -n '0 '0 I m 2 0 § i 000000 41 X §m m a "o ® * cam >4 = § o o nc § -{ 0c % z A 11 x § mI ■ n ■ "rim PI Cn - -1 ` > °88 `) ° % k § / 4� r Ti■ m ■ . § z n m r- $'0 P - m / X 73 § :a f K < . QOOOo E 0 § ' g # < Q � � § C -o -o � © NA a — § � � �§ > mmqm % I 23 m .. r .-1■ § �,§ § ; Oi "IQ Date Rec'd 0t~ CITY OF PRIOR LAKE PLUMBING PERMIT v I. Blue File PERMIT NO. 14'i Z 2.Gold City 3.Yellow Applicant I. (Please type or print and sign at bottom) ADDRESS ZONING office use) I ( 1o1 61 )iri .ci LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER � ._- (Name) �L 4 5 lel (Phone)De' 40— C (Address) 5 On-12-- APPLICANT Appliance Connections Inc. (Name) 12850 Chcstnut Blvd_ (Phone) (Address) Shakopee, MN 55379 (Address) (City)4803 (City) (Zip Code) (Contact Person) h, 11 t• 'OF ' t (Phone) APPLICANT SIGNATURE I r, .A_ �� / / DATE A /APPLICANT 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# The Minnesota Statutes§326B.148 PLUMBING PERMIT FEE $ , , i "SURCHARGE"has been extended The minimum surcharge for a STATE SURCHARGE $ . TOTAL PERMIT FEE $ _4 "'I "fixed fee"permit is$5.00 (Office Use Only) AIN This Application Becomes Your Building Permit When Approved Paid,�'I Ct.) Rec/'pt No. Buildinc Official Date Date f-2.. .4 b ' q., 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 / 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372