HomeMy WebLinkAboutPlumbing 03-0578
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CONTR.
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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 TIME
SCHEDULED
PERMIT NO.
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL J 0 G~E AIR TST
o MECH FINAL. k ! -
L~lf.-~l,{ "'i ,V'A~'" tlOv1
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
.'j' .T........---..--....
, CITY OF PRIOR LAKE PLUMBING PERMIT
.vau;; ..I.\.Cc'U
'~~e type Or pnn~ and Sign at borrom)
JDRESS
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LEGAL DESCRIPTION (Qffi.c~ use o11ly)
LOr/{SLOCK f ApDITION m~VI'~
I, aru~ File I PERMIT NO
!, Gold Coty "/'l 3
:I. Yellow Apphcll.m { .-/
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"
ZONlNG (office US~)
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PID~5-3f{l- 0/5<')
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OWNER .
(Name) 1fr!;:::1.7 /()-,...~^/ T
(Addre.ss; .I 1ft; ~JI_a- q -u~ 7.a::z-~-~~\C
G\P'PLICANT ----- ------ ---- ----------~-~
(Name). (j-r:-~~P/J:J\
(AddreS$) /':3'1ffe......~ ,,~~-'--L1-U-~ ~,.~ _ ~ ,____,_~_~- ~c7 C/
(Address) (City) (Zip Code)
(Contact Person) rt- -c- ~ . . (Phone) ? tb.:j '7 ~ ,C:; 9' ~ ?
APPLrCANTSIGNATURE_(~~~L~~ DATE LI}OJ-/tJ.:p
. ---.-----.---------.--.............---.....-...--
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture Quantity
Bath, Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Sa
Laundry Tray
Shower Stall
Sinks
Bar Sink
Water Closei-
!uantity
throom Sink)
(TOr'Z co-mparon~k ...........-------
-----_.._._-,-~.....- --
-.----..,- .---
(ToI!.:t) .~.---'-
--."-.---
(Phone) 9.5""'?-. !:2.g ~ g/:,4.r/
--...------ -----------
(Phone) ~ ~ ?L:s~)p
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backt10w Assembly
---BiCfaiow-Assembly lest
Lawn Sprinkler
~- -other
I
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FEE SCHEDULE
IndUStrial. Commercia! & Multi-family 1 % of job Cost with a $39.30 minimum Residential. New One &. Two-Family $99.50
Residential, Additions & Alterations S39.50
Estimated Cosr $
Building Permit #
PLU?vffilNG PERMlT FEE $
S:rATE SURCHARGE . $
TOTAL PERMIT FEE' $
(Office: U$I: Only)
LThiS APpli~ation Becomes Your Building. Permit When Approved
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.50
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BUiJdi"g QfficinJ
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24 hour notice for all inspections (952) 447-9850, fax (952) 447~245
16200 ElIgl~ Ct~(!k Ave., S.E., Prior Lake, MN 55372-1714
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