HomeMy WebLinkAboutPlumbing 03-0416
SCHEDU~D Wo?, +~
(4t~Zdr~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION ~d~ -Ln 0 SEWER HOOKUP
~NAL V'o'ff 1 00-- 0 PLUMBING FINAL
o SITE INSPECTION ~ 0 MECH FINAL
COMMENTS:
/1
"(OS#r
~-
-
fl
3 - 4tb
.
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
t ~
l k:1.
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION A'ID PROCEED
o CORRECT r.7!r.' J ,LL OR R~INSPECTION BEFORE COVERING
Inspector: {f..lJ ~ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INlNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
.
'"
.Permit#
-- _.- -- ,-- -- -~ -- --- ---- ---- ...........- ._. -....
(;(t'd j(lVJtll.
.HealingContrIlCtOfHE~~OL!~G TWO
.T esters/Signature /
.Job Address
.Gu Une
Pressurized
Inspected
· Percent CO2
.Percent 02
FinallnsP8Clion
'"
I'1Ll~1
.!2!!!!
Ii!!!!
PERFORMANCE TEST
790 .perc~t CO
e=6 9 C\
.Slack Temp.
Date
Pounds
Pressure
,4
, "'\.,;,1
' ..~l?~
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL ~y~ yr/
INSPECTION SENT TO 'l;
HOMEOWNER 5/03 PERMIT NOt>3_ L/ I~
(Please type or print and si2ll at L~.",.~)
ADDRESS
1442..4 'bY'Dok-me.re- ~\VZJl.
ZONING (office use)
R~
LEGAL DESCRIPTION (office use only)
r
L01:.5~LOCK / ADDITION ~~V~
PIDfO""'<r1RLJ- &SIc.-'O
OWNER
(Name) --oebDYtLYI ~U~
(StlYYlL as tLbo vu
ftlI!hM~
- [j-
(Phone) tlS2-4DZ.-Qt0C6
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City) (Zip Code)
.>PLICANT SIGNATURE
5~~
(Phone)
(Contact Person)
/-
DATE
3-/2-0.3
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
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 $ ~D
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3C1,50
.50
An . nt::L
..l()ffice Use Only)
Building Official
Date
paid#ift? / O{J
Date L(-/()-_~
~ifg~s-
By t;I6!-
v
fhis Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714