HomeMy WebLinkAboutPlumbing 03-0931
.A LAKE
,..<:IN NOTICE
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
.!i"'FRAMING
o INSULATION
if FINAL
o SITE INSPECTION
COMMENTS:
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SCHEDULED
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
,. PLUMBING FINAL
o MECH FINAL
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DATE TillE
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT "'O~'>JALL FOR_REINSPECTlON BEFORE COVERING
Inspector; Y vr,/ tl...l b tf7 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .( SAFETY!
INS/'IOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1_ Blue File
2. (iQld City
3. Yellow Applicant
7,1-1-.03
r/ t.--6 I;J {j5-O 7tP I
I PERMIT NO. 03-093/ I
(Please t,;:pe or print and sign at bottom)
ADDRESS
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7"7U-
ZONING (office use)
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LEGAL DESCRIPTION (office use ouly)
LOT
BLOCK
ADDITION
PID ~. 17' 7" 0 0.2 . J
. OWNER
(Name)
(Phone)
(Address)
APPLICANT. () L
(Name) SC h.~/U F II'].....Y
(Address) l..f <:to.; Ad.'. "'",; CJ
(Address)
P, ,(/ -t.-,("'(
(Phone)
C
(City)
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(Zip Code)
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
I Bar Sink
I Water Closet (Toilet)
(Phone)
(Contact Person)
APPLICANT SIGNATURE
DATE
7- / f../.- ()3
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
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 #
03-0?J /
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:s?so
.50
4-rJ. 0 U
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I PaiCW vtJ
I Da~ /4.u?
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ReceyVN04-4971
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE '1-(L{
INSPECTION NonCE SCHEDULED
ADDRESS IG t10 Y ~~k1 ~ 1,../
OWNER CONTR,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
PERMIT NO.
~ PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
7- qr:; J
PHONE NO,
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: vvp 7 - I L{ ...{) 7Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ