HomeMy WebLinkAboutPlumbing 07-1117
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
{7 OlD
r'f7YOn4n
f-
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
DATE TIME
7,1t~
l~
7-(117
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: /1J-tJ Sr@
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o WORK SATISFACTORY. PROCEED
~ORRECT ACTION A~ROCEED
o CORRECT WORt<. 6'u(FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 8< SAFETY!
INS/iOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIt
I Blue File PERMIT NO 1
2. Gold City . 0 7. III
3 Yellow Applicant
(Please type or print and sie;n at bottom)
, ADDRESS
17Df{) 7O!2{)nft) Hl/C....
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER'" .
(Name) IlZi?rYf/j
I
(Address) ) 76/ D -773!l on-/!)
~~;~~~ ~/lLJN. fA. tALley F11u.~)M.e~PhOne)/15 (3du 81p{c /
(Address) 573 ('-h; m! H (Y-/f ILV/ ffltrr,-V-)n /i)J ,cyj{)Jt.o
(Acffiress) (City) (Zip Code)
(Contact Person)<.... h /Yl (Phone)
?PLICANT SIGNATURE /J ./ _512/;LbL~ DATE
~PPLICANT 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)
tSfU/lC/l1. fcid (Phone{/5~ tll/"73996
Io/z;-e PRiCe LO/zs
11/57 ()7
r
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
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
Building Permit #
( "j 450
_ .5..0
<(1) uU
$
$
$
Estimated Cost $
(Office Use Only)
Building Official
Date
Paid 1-0, 0 ()
Date It . l (.; . 0/
RecpPt No. [;;ro4'(;
G
~his Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714