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HomeMy WebLinkAboutPlumbing Permit 14-1397 5 0 0 n 000000 1) 0 > §0 § n k k k2 c rnkkkk � m § m o/ CI rR ■ ■ � s r sz § ■ -I -a r m m ■ m K ■ az 9 � p� % t � � q .mmlm k44.4uw Zk $ 73 § > j 0 m n 2 -9 z ] ° ' m K r Z r o 71 71 SI z 2 0 0 . 000000 0 .i x q m m ■ -0 ■ 1 ■ � \ ) u, nc mrizinc % E f - ■ ■ m ■ s -o n CO CI tfi m ' § • . OQO �c 73 k « � k C / 0 r2 § 2 ■ c III Z $ m r- 1) -o P ■ m I7 §0 I --- g § /Q BE 7 .k(01:11:3C10 e21 � n § % § R. 0 © Q omm30 V". \ oZ . / nn \k q m ■ r 2 ; - m -Ir B 0 0 PRION Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT 4 solo I.Blue File 2.Gold City PERMIT NO./4 397 3.Yellow Applicant • f I (Please type or print and sign at bottom) ADDRESS ZONING 1 orrice use) 81335 C>°d«r- d sf tiE LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITIONO PID (NaWNER n rL f1C Coarg 0-11 (Phone) 95a-445 V '/7 (Address) nekrri c. APPLICANT (Name) Appliance Connections Inc. (Phone) 12850 Chestnut Blvd. (Address) ko co, MN 55379 (`�S -4 5-4803 (City) (Zip Code) (Contact Person) Ja'l�)'!,[.� (Phone) APPLICANT SIGNATURE ' G../ ' ' DATE /2- 23-lit 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 $6.00.00 Building Permit# The Minnesota Statutes§326B.148 PLUMBING PERMIT FEE $ .00 "SURCHARGE"has been extended STATE SURCHARGE $ .50 The minimum surcharge for a TOTAL PERMIT FEE $ • "fixed fee"permit is$5.00 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. 1v Date By Building Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372