HomeMy WebLinkAboutPlumbing 03-0730
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
S;J(5
ADDRESS
!.lUll G-r"C(/A w(J()d
(4 ri,...-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
;6 - (30
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
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: tV-o fl<C{4-
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: [rV(J [;-- ](J/rf';; OwnerlContr:
II
CALL 447-9850 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
I. Blue File I PERMIT NO
2. Gold City . () -3 .-r7 :::2 o'
3_ Yellow Applicant " I J
(Please type or print and sign at bottom)
ADDRESS
4-2-14
tl rain vyood
CirCAv Nt;.
6 tCLr'1J U-OCJc/
~rk:-PIDdS-03c/' tYol- J
.
(Phone) (q5~)447 - 4 ?;~O
Nt
ZONING (office use)
f2lSD
LEGAL DESCRIPTION (office use only)
ADDITION Suhd ~ (J-F ()L,rfb+ft
LOT ~ BLOCK
Pfor(
(j rcu'rl vvO 0 d
~~;~~ANT Norl?lorYl PLLLmbli1q
(Address) tJl05 tAarA'eU /\YO. GO.
(Address)
(Contact Person) \. m No yl? t t5"YV'--
--"PPLICANTSIGNATURE f/I!1~ -
(Address)
Den n c s
Lf1-1 L-f
DrU6
OWNER
(Name)
(Phone) (lP/~) ~~7~Lf03?
mpl5. ,55LfOK
(City) (Zip Code)
(Phone) l LR I Z) g ~7 --4 D ? ?;
DATE 5/3110?
APPLICANT PLEASE COMPLETE BELOW
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 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
Estimated Cost $
t./VD. o~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3'1. 50
.50
'-1-0 . '!2
(Office Use Only)
/....l This Application Becomes Your Building Permit When Approved
l
Building Official
Date
Paid $> liD /00
Date W~-8
Recei~571
By 0cJ
o
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714