HomeMy WebLinkAboutPLUMBING 07-1181
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
ilWJ
P -(c3Cvt. A- 51
CONTR.
OWNER
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
~MECH FINAL
/;V~Lv /,t!"I ~/
I
COMMENTS:
DATE TIME
!-)-{)g-
,...11 fd
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
O.
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( (..,/ U~ r (l.J J
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.IWORKSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~RK' C OR REINSPECTION BEFORE COVERING
Inspector: ) Owner/Contr:
w .
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
\2.7-0.07
I. Blue File PERMIT NO. O' 7. I /a / I
2 Gold City V
3 Ye\low Applicant
(Please type or print and si~ at bottom)
ADDRESS
J-f5CS 0 PJ eC1 S ant Sf-. Sf-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
Champion
851-se~ I~
3670 Dodd Rd. .100
~d'~~)55123- 1339 (City)
(Contact Person) KriS (,J i' e r--, '''' ~ ' (Phone)
APPLICANT SIGNATURE e~tI~if~
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
!jar Sink
Water Closet (Toilet)
LOT
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
Quantity
BLOCK
ADDITION
PID
Rn0lL\c\ \2.cdjfY'
~CLNIV
(Phone) ql~- L{1-.7~::{fj 5
Pri 0 r-
~a lL-€
(Phone)
( Zip Code)
DATE
/2- I 7- 0 '7
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
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
~q,'5o
.50
4n. LX)
. ~
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Paid 40 . cro
Date ~o 7
(1.... ~ .0
ReCeij No. 5S /0 Z- \
B2]-
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
~ 2 tf7 7
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