HomeMy WebLinkAboutPlumbing 03-1147
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
g)4~' Il (p1,cJs ~:14-<-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
);;?"." '1"k/~
J
DATE TIME
J/J-, J.,r-f/3
s-!l41
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
/'
/
\
"'---
-h~l
/
-~
------
/ 11 /"Z-'
V~
If WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~ ~r. 03
(Please type or print and sign at bottom)
ADDRESS _
SD~JY ~//f/Ofe:vGb L-AI
I. Blue File I PERMIT NO I
2. Gold City . Ol? _ 'I '"'1
3_ Yellow Applicant ? II q-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2.6.399. OIB. 0
....
OWNER
(Name)
(Phone)
(Address)
APPLICANT
(Name)
<\PPLICANT SIGNATURE
Lt~ )
. ';, 'If) V~
(Address)
steLl c.. K u;a ri!-
A--
(Phone)
)~ 3-<(13--/$9;9
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
Quantity
K..d--
- - -
(/
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink I Sewage Ejector
Shower Stall I Backflow Assembly
Sinks .II I Backflow Assembly Test
Bar Sink -r I Lawn Sprinkler
Water Closet (Toilet) 'I Other
DATE
q-:L <i-'{)~
Type of Fixture
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
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # OJ - / / ~1
I
39.S:V
_.50
At). (/V
$
$
$
Estimated Cost $
(Office Use Only)
L This Application '~omes Your Building Permit When Approved
0tYw- ~.UJ.dl
Building Official Date
Paid oft), vV
DatY1
'0 . 7./tJ I <J 1
/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Receipt "r~
By ~