HomeMy WebLinkAboutPlumbing 03-0533
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
/
DATE TillE
-
SCHEbULED S- - 2:$ -() 7 -.# I .
ltJ.' l&s ~ < l.J'd
CONTR.
PERMIT NO. '1 - <;"/)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ASLlNE AIR TST 1-'
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, ~K SATISFACTORY, PROCEED
~ ~.~~RECT ACTION AND PROCEED
o CORR!lW RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: If) Owner/Contr:
CA L'~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon
Date Rec'd
,
CITY OF PRIOR :LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
/5'6/'/ Lu/L-Os ?i:tJV
I LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER ~
(Name) /k'oy
(Address) /03/1,/
5~6k4N'
w/LOS ~"k'4.J y
. (Phone) 95..) - </</7- c;/6?O
_ ?~/()R c.A~"€
I
APPLICANT,
(Name) L4.Le:J/L:>~ ~LI3 b 9'-' ~6
(Address) /,;)~67 Z/~,eH~ At/,€'
(Address)
(Contact Person) - C'#~ L-
APPLICANT SIGNATURE ~ ~~
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity. I Type of Fixture
Bath Tub with or without shower I I Rough-ins
I Dishwasher ,I. I Water Heater
, Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink I / I Lawn Sprinkler
I Water Closet (Toilet) I I Other
S-. f~ d ~
I. Blue File PERMIT NO
2. Gold City . . 6s -0 c-::J?
3. Vellow AppliClllt ~
ZONING (office use)
PID
. (Phohe) 9s;J- J1H- 700
~t/#6; h,l.) SS'3"/tP
,
(City) (Zip Code)
(phone)
S/4k e
DATE
s-/s-/o.3
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 $
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
-I
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit # (J 3 - 6 Ss S
?t9.. ;$'e:>
.50
</l:t 4JIO
pa~, r.aJ
Dater _ ?
.:::. .5 ,() ,
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245