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HomeMy WebLinkAboutPlumbing Permit 16. 0077 O C) 000000 0 » E0 n n k 0O 0 - JB � oo z m k 24 k r � § rn � rt: Ck � 73 k �� � q a 2 $ !o � Q P §� 2 t 1� > - M 0 0 0 q ■ 2 �) --1 ,J 0 , zq z 0k \ o / § i$ m m xr ° : % x o z 7 f m Z 73 mm m OOO � � O q ■ � ■ E -i § 0 0m `I . M1 > Mr 7 2 K f m IIIMC MSC m 0 ' � CA o I m q zzX ■ � ■ ■ 0 z 01 -4 U 0 iii rZ§k - c ' o ' ■ >c c z I r z # m rII13 P ` m / 0 \ ■ o I 73m • 2 0 h. in' m cc ❑ ocO �. ti / z 022 §§ . § % 0 0 ■ mm ■ Q % m § m � m � -3 � � � m 0 if, § m 2] •ri ■ IC 2 . _ -Ii 0 0401 PARIo� Date Rec'd � ' CITY OF PRIOR LAKE PLUMBING PERMIT _ L �r U tri ' Q' rkiv E S O� 1. Blue File 2. Yell city PERMIT NO. y 'o©�� 3..Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) I 93 'I -1i ''g'A R2- LEGAL - LEGAL�D�ESSCRIP ION(office use only) /'/ /' LC4 'BLOCK DDITION lel e to ,) ,iE-�42, 6A) PID Z� 79 �� OWNER .-- `` `l (Name) l✓ k e a �a `t�t (k te., (Phone) (Address) APPLICANT HEATING &COOLING TWO INC. (Name) 10;130 County Rd. 81 (Phone) (Address) Maple Grove, MN 55369-9231 (Addr ,'763) 428 3677 ci5+tw.heatcool2.corn (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE Ilk _ r�I DATE 1 it 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 $ 4 q,5 0 Building Permit# PLUMBING PERMIT FEE $ "49, so STATE SURCHARGE $ $1.00 TOTAL PERMIT FEE $ v0 .,5Q (Office Use Only) This Application Becomes Your Building Permit When Approved Paid q.) Receipt No. 140 DateBy D t � Building Official Date \o � ,` �^-✓1 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372