HomeMy WebLinkAboutPLMBG 08-0856
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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ADDRESS 't~t:t3 ~I/)b~
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OWNER Da.kU C)i~ CONTR.
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PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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PERMIT NO. 0 & ~ 08 Sto
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o PLUMBING RI 0 EXlGRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL 0
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o WORK SATISFACTORY, PROCEED
~CORRECT~ANDPROCEED
/ 0 \ORREC,1""'WORK.~ FOR REINSPECTION BEFORE COVERING
Inspecto( r--/ I /.J Owner/Contr:
Cj,LJ44:'O~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File PERMIT NO
2. Gold City . 0 o. 00 S J
3. Yello~.' Applicant IJ II 0
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ADDRESS U . "-X .
L\m~'J rY\A~\-e ~A- S7~. 7<\()\ Lf\t~ M\J-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
APPLICANT
(Name)
(Address)
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(Address)
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(Phone)
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(City)
(Zip Code)
Quantity
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APPLICANT 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
. Water Closet (Toilet)
(Phone)
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DATE iofi'1lfofi
(Contact Person)
APPLICANT SIGNATURE
Type of Fixture
Rough-ins
Water Heater
Water Softener
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
. Other J:?~pa"r-
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FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $
..5 () . c;</
Building Permit # ot. o,! 56
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
4'/. S"e>
.50
S'tJ, 0'0
(Office Use Only)
This Application Becomes Your Building Permit When Approved
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/ Buildine Official / Olife
Paid I _. Ii" ":pi-'"
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Date IP/ /..5/ ~
, ,
Receipt NOS I> 1 33
By -1 L.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372