HomeMy WebLinkAboutPlumbing 03-1148
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
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SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSIion
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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I. Blue File PERMIT NO r I
2. Gold City .0?-1/4
3. Yellow Applicant -'>'
(Please type or print and sign at bottom)
ADDRESS ?"? ! 0 J/lJ/V'~(' /J /frI7 ZONING (office use)
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
~;;~~ANT p~ :,~~.~_.-.
(Address) h ~ () /) ~
(Address)
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--APPLICANT SIGNATURE ~ e~-, ~
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(Phone)
(1.e 4
(City)
(Phone)
(Contact Person)
Quantity
)0
PID zs: 384--.053. 0
(Phone)
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C'iOJ/
(Zip Code)
DATE
<:,;-,-(-03
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimuIII Residential, New One & Two-Family
Residential, Addi~ns & Alt~ns
Estimated Cost $ Building Permit # {)J / Iff
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
l This APPIiCa;j. 'mo ef/s Your Building Permit When Approved
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Building Official Date
$99.50
$39.50
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.50
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Paid 10, t/O
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Receipt ~z..rt.
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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
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