HomeMy WebLinkAboutPLUMBING 07-1074
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS .1 q2.l~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE
SCHEDULED ) ~
Fo~~ H t 1 f., C-t
TIME
CONTR.
PERMIT NO.
I - (O)~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~GASUNE AIR T!5L
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~' CALL FOR REINSPECTION BEFORE COVERING
Inspector:) Owner/Contr:
CALL 7~OR 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
I. Blue File PERMIT NO
2. Gold City '7. /A-JA .
3 Yellow Applicant U /~
(Please type or print and si~ at bottom)
ADDRESS
ZONING (office use)
1'1d.\9
'F"o ~\I, ~ o:\V\
~~\Ls d-
fJt.
SS37~
LEGAL DESCRu' lION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
RovJer
Il.{ d- I 9 F() U-V\ \ 0-' \ V'\ \~ . \ \ \ S C -t
(.,u~t~ WATER CONnlTIONING
603o.eUI.;UGAN WAY
tvHJ~NE-rCNKAt M~1 ~~~4l;
(952) 933.7200
(Address)
(Contact Person) C) o..v"J) 1 S:-h \ ~ (e..~b ~; ....
"PLICANT SIGNATURE ..--C;~ ~~
I V
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
I<Q~n
(Phone) 9'5 ~ - ~ Lf S- dJ 0 L(
OWNER
(Name)
(Address)
Nc;
APPLICANT
(Name)
(Phone)
(City)
(Zip Code)
9'5 ~ - q I ~ - 737 )?'
10 - /7 - Dl
(Phone) _
DATE
Quantity
Type of Fixture
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 $ ~ 00 \ 0 0
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:2,'7,50
.50
LJf),110
.
(Office Use Only)
~his Application Becomes Your Building Permit When Approved
24 hour n
1620
n_<_ I Date
City of Prior Lake Bldg. Dept.
4646 Dakota Street Southeast
Prior Lake, Minnesota 55372
Phone: 952,447.9850
FAX: 952,447,4245
147-4245
714
R9iPt No. 5'J-()7J (p
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Building Official