HomeMy WebLinkAboutPlumbing 03-0799
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
<
J IS1- ~Lc~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
COMMENTS:
"
DATE TIME
7..2~~ Irr
5.... 7t(?
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLIN~!~w~~ () _ ~
p(~~
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ,llJ /'7 Owner/Contr:
CALL-f!;'. FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
tNSNOTI
Dilt\i R\i\j'U
CITY OF PRIOR LAKE PLUMBING PERMIT
..
I. Blue File PERMIT NO
2 Gold City .()17_ ~
3. Yellow Applicant 'J 1771
(Please type or 1Jrint and sign at bottom)
ADDRESS
"3/~1 &&M
ZONING (office use)
I P-/t1 L
AJ I~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
:To~ ~:8J '1
31~'1 Bo~
(Phone) (q)L) 2-4. --~~07
OWNER
(Name)
.JP-..tt, '-
NiAJ
APPLICANT
(Name)
tv\. ll"'6t4
M~DW
(Phone)
,J"P-I);r-J
(City)
&5~
i..f'-lC:;- - ~ '7 i/ if
,
(Address)
(Address)
(Zip Code)
(Contact Person) /7 (Phone)
'PLICANT SIGNATURE~.z .~ DATE
APPLICA 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
I Water Closet (Toilet)
Quantity
Type of Fixture
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 $
!/l. ~ a
.50
4(),. fh,
..--lOffice Use Only)
'his Application Becomes Your Building Permit When Approved
~Offif,~. Ie{D.l!J3
Date
1lff dO
h/17/tJ3
Receipt No.
L..f '-I (., '1-9
, B~y~~
Paid
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714