HomeMy WebLinkAboutPlumbing 03-0701
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
J54~
OWNER
CONTR.
PHONE NO.
PERMIT 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
COMMENTS:
II ~. 0'4.1 : ~J/
t/ ~V
DATE TIME
~
D0c.l1
3,',30
3-fOj
70)
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
~ 1.J....th~~
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>>ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~:t'f. CALL FOR REINSPECTION BEFORE COVERING
Inspector:. 11/ _ Owner/Contr:
. if-
CALL 7-~FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO~UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
HUmm
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(p, :? OJ
(Please tvQ.e or print and sim at bottom)
I ADDRESS
/54-/~ NODe>
!. Blue File !1'ERMIT NO
2. Gold C;" '03-070/
3_ Yellow Applicant
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7'7VV L-- AI t.)
./
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
PID 25'- .38'2- -I 04-()
J
(Phone)
A? ;{O"?
/..5-,//,r u:,,/ L:L f -;:::, /
(Address)
~",e A A'~-~ . (Phone)
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-~G~~C_ .
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
APPLICANT j/ /
(Name) _ /0// ;(:-:~
(Address)
(Contact Person)
.o\PPLICANT SIGNATURE
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
. (Phone) 7'')',,:). O?:;;c:; c. "6"8'<1
~,. r /j, /#II/_S--_s37 ~
(City) " (Zip Code)
S--", As //;;:.,.e
c:/j. k~-?
DATE
Type of Fixture
I
Rough.ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
/
Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit # 0;>,1'70/
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
I This Application Becomes Your Building Permit When Approved
Building Official
Date
3Cf.57J
,50
LJ,..rJ . (/U
I pai~t(O,-
I Date Co-I cr-3
Receipt N'(itlf)f('/
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