Permits - Permit# 03-10P - 2401 Black Lake Road - 1/1/2003CITY OF SPRING PARRK
4349 WARREN AVENUE
SPRING PARK, MEVNESOTA 55384
952-471-9051
APPLICATION FOR PLUMBING PERMIT
GENERAL MMRMATION
1. You may apply for pbmbing permits by mail or in person at the City owlets. PERMIT$ ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. w� O R( MMST NOT SMM UNTIL PIRA'
CARD IS PASTED ON THE JOB SITE_
3. Plumbic permits may be issued ONLY to licensed plambisM comractors and to property owners
residing in the dwelling.
4. When any new contraction or remodeling is involve(L a separate building permit must be obtained.
5. Ail work must be done in accordance with the State Code requlrament L
6. All work must be inspected and air tested before it is covered. Call 952-21946ft A 24-hour notice
required.
Complete all items on this applitatioa. Compute the permit few Sign and dace the
certitiecadom INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call
952-M-01 10.
Please check one: New Addition Repair Replace _
Residential )C Commercial
JOB SITE-. z 4a l 131 <-k Uk 'Ra -
Owner's Name <
Mailing Address _
Contractor's Name
Mailing Address _
r V 1
Number
to
FIXTM MIT iST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
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Pimnbmg p*mt Appbcatian
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2002 State Statute Yes, This Section Applies
The repinement of a tbat meets au throe of the following requiretneuts:
t) Does not require modWwatk electrical or gas service.
2) Has a Udd tl of SSM-00 Or leas lading the cost of the fixture or Appliance; and
3) Is unproved, installed or replaced by Vk1homeowner or licensed conk actor.
Sldp next section;
ff above does not apply, fallow guidelines below:
Cost of Permit S15.80
State Surcharge S , M —
Ma*U Fee S1,50
1. 1.25% Of CMradEda* or Minimum Mee (,S35-0)
jIde x.0125
Contract Price
2. &ate Sureha= ** Add the State Bollding Code Division
Surcharge to each permit x •0005
Contract Price
or $.50, whichever is greater
3, EmMy and UNWAM (Only ulsai 4n applications)
S
'ino. 2 5'-
4. TOTAL PERMIT FEE (Add Hues 1-3 above) S • G
* CONTRACT PRICE OR JOB COST means the actual or esdmated dollar amount charged for the
permitted work Including materials, labor, profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor, or installation are furnished by
the owner, tenant or any other party the reasonable market value of such Items must be added to the
estimated cost or contract price for the permit fee purposes. In the event mat there is a dispute od the
amount of the Job cost, the City my request the submission of a signed copy of the actual contract.
* * The STATE SURCHARGE Is AM of the contract price under $1,000,000 or $.50, whichever
is greater. For valuations Over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for Issuance of a Plumbing Permit, agrees to do all work is strict
seeordante with the ordlnances of the City and the regulations of the State of Minnesota, and certifies that
all statements mWe on this application are complete, true and correct,
Applicant's Signature late 23 B�
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iIH GRANITE COINTERTOP IN BATHROOM
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ABOVE STAIRWAY.
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91E BERBER CARPET IN BEDROOM
'CIE ALL OAK DOORS AND CLOSET DOORS
'CIE GRANITE COUNTERTOP AND VANITY
'AE CERAMIC TILE FLOOR IN BATHROOM
'CIE VINYL WALL COVERING ON BATHROOM W4LLS
'AE CARPET IN WALL
'AE CARPET AND CERAMIC TILE IN DEN
'CIE 92% EFFICIANT FURNACE WITH CENTRAL AIR
WATER NEATER WITH WATER SOFTENER
ilE FRENCH DOOR$ IN BEDROOM
Sent By: HP LaserJet 3100; +; Feb-13-03 9:03AM; Page 1
EXPRES,
1327 POST AVE - SU
TELEPHONE: (310) 3
TO: SCOOSSER
REGIS
FAX 962.947.7801 (TEL: 7867)
RE: Best Cuts -
Scott,
Please find the following corrections neca
three complete sets, signed and sealed to
Please: Call if You Have Any Questions or
Express Permits
Jake Pharr - 310.328.6300 - x 107
Please call if you have any questions or comments.
jhank Yom!
PERMITS
H • TORRANCE, CA 90501
300 0 FAX: (310) 328-0336
-DATE: 02/07
for the city of Uniontown, OI I. Please respond with
,,.5 Permits.
�-,u5-� Ply t
EXPRESS PERMITS I... because Faster is Better!