HomeMy WebLinkAboutPlumbing 03-0457
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J CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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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:
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DATE
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~51R~ffLL :OR REINSPECTION BEFORE COVERING
Inspector: if fIT r 1 t }-rr? 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!
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
LEGAL DESCRIPTION (office use only)
LOT~LOCK I ADDITION !/J~jJfJI1d/1
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(Address)
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'PLICANTSIGNATURE ~ U Y DATE
APPLICANT PLEA~ COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Please type or print and sign at bottom)
ADDRESS
Ho5lu5 B\\rd LoJl~ \V\'
OWNER
(Name)
SCD \ \
(Address)
(Address)
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(Contact Person)
Quantity
I. Blue File
2, Gold City
3. Yellow Applicant
PERMIT NO. 0 3, Y,-51j'7
ZONING (office use)
R )51)
PID ;:;fi-, ~ 18- (){)d.-"O
(Phone)
(PI;) - dal -~o3(P
_ (Phone) 1o\d--80\-6~D
\-\~\t\i\~~ 65'YYJ
(City) (Zip Code)
(Phone)
5fJJV'J
11- ~-o3
Type of Fixture
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Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow 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 $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.-LOffice Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
~q,6D
. .50
,-\0,00
Paid A. ~
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DateLj_I'B'_03
ReceiPL)L; CJ f:/
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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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