HomeMy WebLinkAboutPlumbing 03-0437
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL~D
0" TE TIME
1:,- /1
ADDRESS
! 7J.tl W('(~"rn<s.s 1Y1
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:
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3--4?7
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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o W~ATISFACTORY, PROCEED
,Ja"'CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: '/IIf {, r (7- {/} Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Il'iSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
..'
Date Rec'd
CITY OF PRIOR LAKE PL6MBING PERMIT
; ~~~ ~:;y I PERMIT NO. /\ 3 - / 13m
3. Yellow Applicant u.... ~ J
ZONING (office use)
1'72'2 L.JILDt-RNCSS ,Rl
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LEGAL DESCRIPTION (office use only)
LOT '3 BLOCK 2 ADDITIONt:>e E R F I e L- j)
PID
(Address)
vAVl [)
J7,-~Z.
BRv\oN
tv IL DE~ fiBS
(Phone) q 5"2.-22 b '-/72 (,
OWNER
(Name)
T-RL
s~
APPLICANT ... \"'-0
(Name) (9 W ,,"'c "-
(Phone)
(Address)
(Address)
(City)
(Zip Code)
'PLICANT SIGNATURE
(Phone)
(Contact Person)
-
DATE
Quantity 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 J Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
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 $
0q~stJ
.50
Llf). Ou
paiW L/O Q;
Dat~~/~_c) .3
s
_..1.0flice Use Only)
es Your Building Permit When Approved
tf/I'tJ'-03
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714