HomeMy WebLinkAboutPlumbing 03-0528
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
( 7> 7ft
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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
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COMMENTS:
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o WORK SATISFACTORY. PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: .(Yf'7 Y-7-0? Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
lNSNOT/
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
-"
I. Blue File PERMIT N~'3 --~i3 ~
2. Gold City _
1 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
//7379
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LoBdBLOCK I ADDITION {,; )d~ k-j-
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OWNER /)
(Name) R 01 ,K:. J/<:. ~
(Address)
(Phone).
APPLICANT
(Name) A <;!~~ ''':...4('d /24~~h'~""fJ'r.../
(Phone) .,pf!?.;l- ~~~/.:;)~
(Address)
./ .;JS '7 ~/< r ~... 1"'1" ./;::>-/
(Address)
5''- .. Ie' o~ '-' " /U.X-J
(City)' /'
SS,3 '7<1
(Zip Code)
(Contact Person). .
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(Phone)
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Quantity
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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)
DATE
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" -1\PPLICANT SIGNAT.U~~
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Type of Fixture
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Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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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 $
3 Cf. 5"0
.50
'-f 0 ,.
(Office Use Only)
....L This Application Becomes Your Building Permit When Approved
Building Official
Date
pai~ t?-----
Datfj-
,~- 5::3
ReCq!;S-11
By fC/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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