HomeMy WebLinkAboutPlumbing 03-1343
DATE TIME
CITY OF PRIOR LAKE
INSPECTtON NOTICE
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
3 -t3t.t$
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
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v ~
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
I. Blue File PERMIT NO
2 Gold City . A 3 - 13' ,~
J . Yellow Applicant L,..I" 7'-/
(Please type or print and sign at bottom)
ADDRESS
4-~15 Coac/1. m (if) Lane,
NfY
ZONIN G (office use)
LEGAL DESCRIPTION (office use only)
LOT, ~ BLOCK q ADDITION f!ta,ucl4h ~ I S1"
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OWNER
(Name)
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1+2-1 ~S
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CDaf/nm IlJI/
(Phone) (q5~) l/!iJJ- '61/7
(Address)
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APPLICANT
(Name)
(Address)
NORBLOM F'LUMBINO CO.(Phone)
(fl 12) 827-4033
(Addre2905 GARFIELD AVE. SO. (City)
MINNEAPOLIS. MN 55408 (Phone)
(Zip Code)
(Contact Person)
"JPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
I Water Closet (Toilet) 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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
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.50
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JOffice Use Only)
fhis Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 10 -;'
Date I. ~
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ReceiE753<1/
By a~.
o '
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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