HomeMy WebLinkAboutPLUMBING 08-0488
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
TIME
ADDRESS
\1 ~&f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
V_~~ULA TION
~~AL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL I
L,cr~N !!4t-
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
(t ~ ~... /'
'-.../ c.-t/ r
ro ~
t~ r c.C
,t'WORK SATISFACTORY, PROCEED
. '-
o CORREC~ACT or AND PROCEED
o CORRECT fIlC~~R REINSPECTION BEFORE COVERING
Inspector: IT Owner/Contr:
. I Y
,CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(please type or print and siJP;D at bottom)
ADDRESS
j' 7 bra I #QT'-1I1.,pS
; ~~~ ~~~ PERMIT NO. 08 ~ 6 A_S .h
.3 Yellow Appltcaut _ -,I V
ZONING (office use)
W4')
<.E
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER c:
(Name) .J /~L/~
/7broJ
APPLICANT //~ "7 D / {
(Name) /L..... ~ If' I ~ h (A../J
(Address) A / h () q let I ST Ilre
(Address)
(Contact Person) k'f' V" I ~
APPLICANTSIGNA~'U~ -
(Address)
/{,a..m.p!i.
JV #(+~Il~~
(Phone)
9~;J- Lfl.f7- t:, li.$
w....111
r
SE
~
(Pho.o) 0/.2 - 3 ;;2g--") %0 ~
!I/(v /~:u;u< /fJ1V ?){;,o7/
(City) . (Zip Code)
_ (Phone) bi.2 ~5:2g-~ 7 ~o $;-
DATE ~ I It? / O~
Quantity
APPLICANT PLEASE COMPLETE BELOW
T~'pe of Fixture Quantit~. I
Bath Tub with or without shower Rough-ms
I Dishwasher I Water Heater
I Floor Drain I Water Softener
I Layatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (l or 2 compartment sink I I Sewage Eiector
I Shower Stall I I Backflow Assembly
- -u1Smks--- -- -- I I Backflow Assembly Test
I Bar Sink I I I Lawn Sprinkler tV' / V' 4 Ct.+YIo<.
I Water Closet (Toilet) I I Other
T~lle of Fixture
13 tz It. fl
-j
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149,50
Residential, Additions & Alterations $49.50
Estimated Cost $
Building Permit #
(OfJ"lCe Use Only)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
1..(7 5-0
">0
.50
0('/
Buildio!!: Official
Date
Paid ) (/_
Date7 (8- () Y
Rec~ No, S7:. .$ yO;;-
18j I
(;
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372