HomeMy WebLinkAboutPLUMBING 07-1007
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/[.( S ~6
//"c-~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o JNSULA TION
JtFINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/~ i-v-
COMMENTS:
kYJ
I
~------
/ /- ;
( I ' /1z -'
\. ~/ L/7L
~
---
DATE TIME
J (, )p4)
7 / (0 Of
L
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-.
----
~
\
J
~/
y/
fl la
---
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND ~CEED
o CORRECT WOR.K. cMf F.stR REINSPECTION BEFORE COVERING
I nspector: I I Owner/Contr:
I
CALL 447-98~O FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTJ
Date Rec' d
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
I~S~O (S)gr:_aJ0
I Blue File PERMIT NO. 07. l 0071
2 Gold City
3 Yellow Applicant
.
Av~ Sf
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
?(~ illfAf~n~(J"
\.s~ -PfI'or Late I MN,
(Phone) g~-J:J-7!-
5CJ 3 7 d-
(Address)
APPLICANT
(Name)
Champion
651-365-1340
3670 [)ood Rd. #100
~"l\cMNs5J)123-1339
(Contact Person) k' ( \ Sr.--O \ Q.,n
APPLICANTSIGNATU;E ~~~
----- v
(Phone)
(Address)
(City)
(Zip Code)
(Phone)
DATE _,\0 - \Cr-olJ
,
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
I Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I 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 $
TOTAL PERMIT FEE $
~q I '=b
.50
41j e 00
(Office lJse Only)
24 hour
162
I Date
City of Prior Lake Bldg. Dept.
4646 Dakota Street Southeast
Prior Lake, Minnesota 55372
Phone: 952.447.9850
FAX: 952.447.4245
1447-4245
.1714
o
Reiirt No.
B/ ~
0'
5 f?J4- /
This Application Becomes Your Building Permit When Approved
Paid
4-D ,00
It,jq. c/
Building Official
tl?{R I
Cp