HomeMy WebLinkAboutPlumbing Permit #03-0396
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.
ADDRESS
,SLSc..( ( -(" dw vvoo..L
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
DATE TIME
L/-l/
I
s- 39t
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
,If-I- ()
H6r-l:.t-(J)
\t!/
G f-e; ~
~
9'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: tIYf L.{ - L {-cJ>awner/contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
-~_..._---~--~._,..._,_._-_.~._~._..
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
I. Blue File I PERMIT NO 0 ~
2. Gold City '03 - ? I
3. Yellow Applicant V
ADDRESS
sros'-l Ceda/wocd Slxe~i AJ. b.
ZONING (office use)
PlUJ
(Contact Person)
/__APPLICANTSIGNATURE ~~--
(:/
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
Bar Sink
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only) ~
LOT / bBLOCK l ADDITION 0/J/rvd
p~
OWNER /' . j
(Name) VI api'1'SkJ / c_ ClA:12Je
(Address) 905''-/ ('.7P dt:vrw/')od ~i. N.';.
APPLICANT \ \ \.\ \) \
(N ame) I\J C> f P ovY\ t'~, IN'U0 ~ V
(Address) ZQ05" 6;~fr~IJ 4v~ - SO.
(Address)
5d
PI~S- o<3~- 0/6-0
(Phone) (cl';Z) 402 -Cj(, 7cr
(Phone)
tJ\~b
(City)
(tolL) 82/- '1033
551 0 ~
(Zip Code)
(Phone)
:3 j.J'!bJ
DATE
Quantity
Type of Fixture
I
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 $ L-(()1) ~
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
<J This Application Becomes Your Building Permit When Approved
Building Official
Date
3er .SO
.50
'/0.00
Paid 1/ Lf t);-
I Date il~ 3-03
Recet/!;o t/ tf
B~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714