HomeMy WebLinkAboutPlumbing 03-1300
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~&l.(
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
cfJt-V).
(ilM,Jkd~t"
CONTR.
PERMIT NO,
'"(-/1n>
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
L. tf t-v VI
J;,"(Ptit_"~ ~
-----~
I
I /- /
\ ~
............. -------
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W':;RK,~LL FOR REINSPECTlON BEFORE COVERING
Inspector; Y V{/ _ Owner/Contr:
CALL 447,9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
uaN<>TI
-'_.~,,_.,' ".-. .. "."--_.,-~-_.._~".--.._--,- -.' - -"---.._~-,"_.,,-,-,- ---- _.-.._-._,,-~--,_.-
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
rJ Zr 0..1
I. Blue File I PERMIT NO D I
',Gold C;'y 0/17_('?/I.
3. Yellow Applicant L)..) -:> u
(Please tyEe or print and si2Jl at bottom)
I ADDRESS 5lJ& tf-' ,;JON OJ 6.0(;6 LA!
LEGAL DESCRIPTION (office use only)
(Address)
(Contact Person) ~ ~
'PLICANT SIGNATURE . ~~ ~
. V
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or withoul shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LOT
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
Quantity
BLOCK
ADDITION
p~ ~
6(;,0 /)~ /2.A.,
ZONING (office use)
o
PIDz[' 799. (j 2-0 [)
(Phone)
(Phone)
e~
(City)
/6)" -- 'If 3 / /g<j]
)' 5"011
(Zip Code)
(Phone)
DATE
9 - )'5"-() 3
Type of Fixture
, -
'X..-J
,
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
Estimaled Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
"his Application Becomes Your Building Permit When Approved
Building Official
Date
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit # O?-j.i' 00
3''1, JO
.50
~ (/tJ
I Paid
I Date
Receipl No,
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S.E., Prior Lake, MN 55372-1714