HomeMy WebLinkAboutPLUMBING 07-0830
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
JLllL-o hsL
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
L(-V!~
7-Y7D
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
__~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~R~ ~OR REINSPECTION BEFORE COVERING
Inspector: f 1/ r /' Owner/Contr:
(
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
1 Yellow Applicant
PERMIT NO.OZ 083~
(Please type or orint and sign at bottom)
ADDRESS
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f(~he.-r
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J(E'"
ZONING (office use)
t-C
LEGAL DESCRtt'uON (office use only)
LOT BLOCK ADDITION PID Z~ 094-. OOlf. ()
f
OWNER Pa.t- 1< e. (/ Lf 96J. - 4'-15- ~9~2
(Name) (Phone)
I Prl""r La.k..e \
(Address) 'LfI~O FI- sh er Ave tV E /41\ 6537-:;'"
APPLICANT
(Name)
Champion
SS 1-365--1340
3670 Dodd Rd. .100
~dr~~ S5123--133G (City) (Zip Code)
(Contact Person) \/(\ ~ O\~ (Phone) ~~\- ~1pC)- \ -:i-{ u
APPLICANT SIGNATURE ~AJ ~~ DATE 9v \l0- Cy)
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
I Sinks
I Bar Sink
I Water Closet (Toilet)
(Phone)
(Address)
Quantity
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 $
TOTAL PERMIT FEE $
.3q.50
.50
Lf~,.~o
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid ~,OO
Date 8, !(J. d{
/J
Rece,No.S f5'f~
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714