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HomeMy WebLinkAboutPlumbing 03-1183 '\..... /~ CITY OF PRIOR LAKE INSPECTION NOTICE DATE TIllE SCHEDULED /()-C~tB ADDRESS If).{) ~ 1=lIYWA/ f.I. fs "Tr- ! CONTR. PERMIT NO. 3 -1/lr'Z. OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o L-u.UUA h'f~pJ, ~ / I ^~_ JUJC L-,' / I ('-(' ----- ~ SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT ~)f~' ~L FOR REINSPECTION BEFORE COVERING Inspector: V vy;, Owner/Contr: I CALL 447-9850 FOR THE NFlCT INSPFCTlON 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! uaNOn ~IY 31 O~ CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd 9. tf--. () 3 (Please type or print ~d s~gn at bottom) ADDRESS t'lIfV /5:.?OJ' /,9/,e" H.E/~H7J ~I ; ~::: ~:,: I PERMIT NO. Q"l? .-/I~ 't I 3. Yellow Applicalll 0 lJJ ZONING (office use) .. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID z.~. ?7" ' JiZ~. () , OWNER (Name) V~N.5H-'W~ HOHe.s (Phone) (Address) ~~;;~~AN}R.el. 5/0..t. f't.-B,(, f (Address) /,,2r/b7 Z/~"'AI ,AY'.t!- (Address) (Contact Person) CAlf!' L ..APPLICANT SIGNATURE ~~ /lr~ (Phone) 9_"-.z- R7V- 7600 5S3?,? (Zip Code) JAt/Atf~ (City) (Phone) J"A~~ 9'hVo? DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type-oiFixture Bath Tub with or without shower Dishwasher Floor Drain Lavatory (Bathroom SinK) .. I Laundry Tray (I or 2 compartment SIllK I Shower Stall I Sinks I Bar Sink I Water Closet (Toilet) tJuantity I Type of Fixture Kough-ins I Water Heater I Water Softner I Stand Pipe (Washing Machine) I Sewage Ejector I Backtlow Assembly I Backflow Assembly Test I Lawn Sprinkler PV~ t!hUIY 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 # ,'3. / / flY PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ ,~ 9, 5'"0 ,50 </CJ~ tAD (Office Use Only) _1 This Application Becomes Your Building Permit Wheu Approved Building Official Date I pai1tJ,(/l) I Dat~r. 6? ReCejpr!~ 7' By .dJIL-' i 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 .T~"_...LV.".