HomeMy WebLinkAboutPlumbing Permit 03-1004
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
17()~o wild-t-;\8.s~
OWNER
CONTR.
DATE TIME
/O-;Lq-t/j
1-
PHONE NO.
PERMIT NO.
3 ~/oo'1
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
,
9", ""tll-r .,..
COMMENTS:
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~L FOR RElNSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
_OTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File
2. Gold City
3. Yellow Applicant
I PERMITN003-1t70'tt
,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
./
LOT BLOCK -J:J ADDITION
PID
OWNE~\""..J' .
(N ame) u..u \ Y'Vl.LV-
LeJ i uJ<h
Pv ~V loJ0
~~:~;ANT t)E-\Jt-J~ "hJE-\'i bE
(Address) \0\4 2> A\J't SJJ
(Address) .
(Contact Person) {J~
'PPLICANTSIGNATURE ,,~~
(Address)
(Phone)
M'tJ
q ad- ddfo' O?y)Cf
55o~d
(Phone) ~\(j.~O ,. QdlPO
\-\u..~ ~~O
(City) (Zip Code)
(.q \J- 80\ - 6dLol)
(Phone)
DATE -7. LS-O_~
OMPLETE 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 (l 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
IlPOa)
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.?H. Ci)
.50
40.0()
(Office Use Only)
Building Official
Date
Paid .... ~
,'C') -"
Date I~ '30"3
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
-....." _......._. ..,,- T.