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HomeMy WebLinkAboutPlumbing 03-0201 , OATE TIMe SCHEDULED q - n-03 \:36 LJ,'l~s LV) . CONTR. PERMIT NO. .3 - d..O I CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS AllY OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION 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 GASL.INEAIIUST ,1l(J6kI-... c:....~ COMMENTS: _ \rJ/ 1'1 \ / V /' /\ V,v; L/ ./ ~RK SATISFACTORY. PROCEED ~~RECT ACTION AND PROCEED o CORR0flC 'K. LL FOR REINSPECTION BEFORE COVERING Inspecto Owner/Contr: CA ~ -~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. ~REMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY! .. INvron Date Rec'd CITY OF PRIOR LA Kif. PI.TTMBING PERMIT REQUEST FOR FINAL INSPECTION SENT TO HOMEOWNER 5/03 /,~}~:~: ~::y I PERMIT NO. ,,1J...~ 70/. I QCt-11e:cr- 5a..Id the-II aKF~' J. Yellow Applicant Ir J (,),tV ~!e...~orDrintandsimatbotrom) Hom~ (0- b-OC8 . ~. ADDRESS (c,,2 '> G(oflicell$e) 2.1.4 ",rllds Ln. NW. P UD 5'SD1-0'~-O ={=I"=::n9~k r;~ OWNER ... , J. (\ i V (Name) VLfI)bt K.1e..tcL:t (.;5tLVYU... a5 M::o ye, J PI (Phone) /,,/2-2.10- 3'132- (Address) APPLICANT (Name) (Address) CULLIGAN WATER CONDITIONING 6~30 Ol.::"IJS.W-W:'Y MINNETONKA, MN 55345 (Address) \~D2,11')')'7'';''' (Phone) (City) (Zip Code) (Contact Person) 0T"/~ (Phone) APPLICANT SIGNATURE DATE /-27-03 ,. APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain Water Softner Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (I or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet (Toilet) 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 Pennit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ 40.0D .50 An. ':"f) (Office Use Only) .-1 This Application Becomes Your Building Permit When Approved Building Official Date Paid 1P '-10 ,-- Recei~; 1 q 0 Dat~_d5~;:) ~ ,~ 24 hour notice for all inspections (952) 447-9850, fax (952) 4474245