HomeMy WebLinkAboutPlumbing Permit #03-0911
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
CONTR.
PERMIT NO.
3-C7t1 9/ I
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ~GASLINE AIR TST
o MECH FINAL
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ CALf FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~ Owner/Contr.
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CALL ~7-9850 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
--y C/. 03
I. Blue File PERMIT NO
2, Gold City . /'I ? - (J Cj' I I
]. Yellow Applicant (..LJ
(Please type or print and sign. at bottom)
AD/llSqSg ~5e.vJ(}(Jd ~o( IV E
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT / I BLOCK / ADDITION
PID Z. S . 3' 10. 6 II. cJ
OWNER
(Name)
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'"Pqcr ~
,/
(Phone)
7Sc:;.- '-It) 3-/7/ 7
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Phone)
(Zip Code)
(Contact Person)
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DATE
7/7/0 ~
I
-, <\.PPLICANT SIGNATURE ~
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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
Bar Sink
Water Closet (Toilet)
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
, Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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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 Penn it #
Os -()1/1
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
31.60
.50
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(Office Use Onty)
This Applica~~ ~i1OAn Your Building Permit When Approved
ICJI,/td- 1. '1. 03
Buitdfng Official Date
Paid .A A
QV ". f./V
Dat~7. Ii. 03
Receipt NOA::a '
4-7..1 ~
By ~.
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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