HomeMy WebLinkAboutPlumbing 03-0665
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
OA TE TIME
SCHEDULED ~/I~
/hwh f~ ft'L J
1\/1<(
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
If)-o
tf..pa4r-
1-~~'~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~Ri1ALL FOR REINSPECTION BEFORE COVERING
Inspector: V'1' (0- (yO) Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH ({ SAFETY!
/l'iSNOTl
. ,
CITY OF PRIOR LAKE 'PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
'5J IS-
I. Blue File
2, Gold City
3. Yellow Applicant
PERMIT NO',JB '&105-
ZONING (office use)
12/SJJ
IV) cvri j ().s0Yl / f, / dKJrJ 1<0 a.d .AJ. b,
PPLICANT SIGNATURE ",~ _~ .---z'----,--
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)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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(Address) 15115 (V}ru-f-'YJSC/YJ bJa41d /(0/. N E,
~;;~~ANTt\\O r 6\0\I\/'\ Pl\UMb~~_
(Address) 2qo 5 b;a4'h'e / d YJy e. So.
(Address)
(Contact Person)
Quantity
PIDd5-- t135-0;)L)-'O
(Phone)
(%z) "~7.tf1S2
(Phone) (~12) 827 - '1/)33
MtJ /6 SStj()F
(City) (Zip Code)
(Phone)
DATE
5/2:5/"3
Type of Fixture
y
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
3'1. SO
.50
t-} () .00
I Paid '-/0.--
Date &,_ ) __ 3
. Receipt NOl/l"/ S ~h
B~
l'his Application Becomes Your Building Permit When Approved
Building Official
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