HomeMy WebLinkAboutPlumbing Permit 11-0050 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ��
ADDRESS � � o � �J'�� p �
OWNER CONTR.
PHONE NO. PERMIT NO. ��'� OO��
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMING Q WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FtNAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINA� ❑ I�Y�., f�"'
COMMENTS:
G
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwneNContr:
CALL 44 - 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTI
, o � pRj�� Date Rec'd
� � CITY OF PRIOR LAKE PLUMBING PERMIT
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1 Blue F�le pERMIT NO . I/ D U �O
2 Gold CiTy
3 Yellow Applmant
lease ar'nt and si at bottom
ADD SS � ZONING (oflE'ice use)
�co �'� n�,r��W � C� �T�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ��) c
(Name) V � J (Phone) �
(Address) � �r e L,� 1�—� � .
APPLICANT Champion Plumbing
(Name) # 61770-PM (Phone)
651-365-1340
(Address) 3670 Dodd Rd.
(Address) agan, MN 55123 (City) (Zip Code)
r
(Contact Person) • (Phone)
APPLICANT SIGNATURE DATE � �� � I �
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fixture Quanti T e of Fizture
Bath Tub with or without shower Ro -' s
Dishwasher Water Heater
Floor Drain er
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
The Minnesota Statutes � 326B.148 �ost $ �� Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ .50
The minimum surcharge for a"fixed fee" permit TOTAL PERMIT FEE $ �
is �, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid �¢ �� Receipt No. /_ � Q Z L
� (Y
Date f L � `/ By
Buildin¢ Ofticial Date � °
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
10�8� �