HomeMy WebLinkAboutPlumbing Permit 03-0088
DATE TIME
a~ it-j,03 0/ 00
/I- :5 pe A.J /'t-v-€-.
,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1L/3oo
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/1-,)- ()
H+v
3 -~2'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
I. Blue File
2. Gold City
3. Ye!low Applicant
I PERMITNO'03~D()o9
(Please type or print and si~ at bVLMU)
ADDRESS
/1300 Asrvv' AveH\ue..- IV. E,*
LEGAL DESCRIPTION (office use only) {"
LOT/f:iBLOCK If ADDITIONJtvrtd fJ~
ZONING (office use)
(JuSD
PID :)5-d05-643-D
OWNER J J J D
(Name) n/Je"n(le. . i (.lA'1e.-
. .,
(Address) L!fJ 60 As()e/Y1 Ave. N . b.
,
APPLICANT t. \ b\ '7\\ b
(Name) 1'00 r (}YV\ r u.NV\ '\ ')1
(Address) 29()5 6U.Arlt~)J 4ve..'-t;o.
(Address)
(Phone) (&f5Z.lj()2. - C[1if>
(Phone)
~~t~~
llo\Z.) 827- 'f~33
55""'IoF
(Zip Code)
(Contact Person)
<~ 'PLlCANTSIGNATURE ~~~
//,
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
shower Stall
Sinks
tlar Sink
Water Closet (Toilet)
(Phone)
DATE
1/;~/P3
Quantity
Type of Fixture
~
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
31. s-o
.50
40 . 00'
(Office Use Only)
"his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid L/ 0/ --
Date I - J 3-tJ2>
Re~rylff
BY~
V
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714