HomeMy WebLinkAboutPlumbing 03-1072
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
(~ t1/j/:7
SCHEDULED l:I~~~~
(5~(Jar
CONTR.
PERMIT NO.
f!)3-I07~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
,C::; P 'r I< / r
{'I (
/;) I. s e/
l 0)((/ , fin
~ j/-'-
l -
o EX/GRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: @ Owner/Contr:
CAI.L 447-9"50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
_.._._-'--"._-----_.~---~.._.
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO d+
'Gold Ci<, '0 3" /^ 1
.1 Yellow Applicant I C/
(Please ~e or vrint and sign. at bottom)
ADDRESS ZONING (office use)
'301'" f.x:Jbec...-t IV-~ I ww 12/
LEGAL DESCRIPTION (office use only)
lUjd:J ~ nf7).
PIv?5- 3fJ-
Off-b
, LOTY'! BLOCK ..~ ADDITION
OWNER
(Name) ~p <.lou
(Address) "'LJIS l';o\-,ca:t Iv-rlil \JW
(Phone) (C\<:rcl) 40 d' 015\ c;
APPLICANT
(Name) 1\1\0'''' ~lloi,~ PlWV1bl~
(Address) 5Cl:>, (' I.YTtYal ""~l
(Address)
(Phone) (qc;d)~S''3t1~q
OsSt'"D
(City)
c;,c;,"%"l
(Zip Code)
(Contact Person)
- "PLICANT SIGNATURE ~~C~k\'~:>\.Dlk-
(Phone)
DATE d LlVLL c:n 'dOOo;;
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compartment sink
Shower Stall
Sinks
I Bar Sink
Water Closet (Toilet)
\
Type of Fixture I
Rough-ins I
Water Heater I
Water Softner I
Stand Pipe (Washing Machine) I
Sewage Ejector I
Backflow Assembly - ~ SI,...in\Ac~ <;'\jc;.~iVYl
Backflow Assembly Test 1
Lawn Sprinkler 1
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Residential, New One & Two.Farnily $99.50
Residential. Additions & Alterations $39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ .-aq5t)~u'L8'
$ -" .50
$ L//r ~.~
Estimated Cost $ _":F,o ,C(j
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid I/tJ,---
Datea ' /10
yr / tf-r:,L::>
Receipt NJ;;53/Cj
By 4-
n
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
.,