HomeMy WebLinkAboutPLMBG 06-0851
Date Rec'd
THIS FILE HAS BEEN
CLOSED DUE TO
INACTIVITY 4/18/2008
JMBING PERMIT
CI ;}<J ~ ob
D \.0- b -Ul .
l. Blue File I PERMIT NO
2. Gold City . 0/ _ 01"15/ I
3. Yellow Applicant , (e' _ 1:7, .
I ~Tff;;.~"~a en
S4
ZONING (office use)
AF
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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(Address) SIt m L
PID zS. 0 2-8. t), z., r ()
(Phone)
APPLICANT to . 1).
(Name) qe.J1z.- IS-tJ aV\
(Address) 21-0C) W. H"~j ~'l 1..3
, (Address) ~
(Contact Person) K--f 61
(Phone) or 02- f lf1 r I QuO
Btilfll1 SV I ( I C. fV\ N
(City)
APPLICANT SIGNATURE
(Phone)
,!uantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
Cl .c:oi \ LlYvtb I n LU'C~I VOV-ro\
APPLICANT PLEASE COMPLETE BELOW
F~EDU&
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
~ ~ p. e<;
Residential, New One & Two-Family $99.50 ~
Residential, Additions & Alterations $39.50
"
~ "'.,OV
'i,,1>
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Estimated Cost $
Building Permit #
3l6u
.., .50
---'i( - W
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
Building Official
Date
Paid ~ , cro
Date d ~
'~I
This Application Becomes Your Building Permit When Approved
i t No. 52-1"/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245