HomeMy WebLinkAboutPlumbing 03-0510
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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SCIjEDUlED
DA TE TIME
171~:r _ iN, ~~- L,_
CONTR.
-.!..-~ I L_
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PERMIT NO.
J- S"ID
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
-11.2.(} / $' dfi?;-(J)
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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aJScFr4--=-
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I2f WORK SA TIS FACTORY, PROCEED
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o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
'n.pecto" --V1f..5-ll-~ Owne"Con'" _
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CAll 447-'850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTs ARE FOR YOUR PERSONAl. HEALTH & SAFETY!
INSNOTl
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Date Rec'd
CITY OF PRIOR L~KE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
1.13(P5 WlldtVYUSS ~inlLu
I. Blue File I PERMIT NO
2. Gold City '()3- c-j 0
3. Yellow Applicant V .
( 3/i)
ZONING (office use)
j{~
LEGAL DESCRIPTION (office use only) .
LO~ BLOCK G ADDITIO~~
lJ
OWNER
(Name)
/J1JL
pu29S'" \.~Kl- Od/.1~')
~ ~ ILt 1~ "l)a viD
( sa il'LJ
(Phone) tfJz-ZZiP-3351
(Address)
(jS oJduvc-)
(Address)
CULLIGAN WATER CONDITIONING
6030 CUi' I(:;MJ \/jffN (Phone)
MINNETONKJ.\, MN 55345
.~a~?~ ~1J...?2{1~
(Address) (City)
(Zip Code)
APPLICANT
(Name)
APPLICANT SIGNATURE
iJdh' ~
(Phone)
(Contact Person)
DATE 2-/8.03
APPLICANT PLEASE COMPLETE BELOW
Quantity I 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
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
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Estimated Cost $ /7UU
Date
Building Permit # _ .
::('1. '5 U
-'.J-:-~
.50
AO.G2
paid$' t!O/jO
Date tj, 83 -iJ:!J
$
$
$
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
Building Official
Receipt NooO
UU(} ~I
BY~
V
This 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