HomeMy WebLinkAboutPlumbing 03-1465
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
.L.JJ..3/83
OWNER
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CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
'5 -lL{~5
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
jl! PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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pf WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ./J<1. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSl'IOTl
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/a:S/~03
~. ~ul~ ~i~y PERMIT NO. 03..//L65
3. Yellow Applicant -t"'r'
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
BLOCK
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146 (}V\
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ZONING (office use)
PID zS. /...17. () ze. ()
(Phone) 9 \') - '103 . y,,)o.~
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(Phone) Cf r d
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(City)
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(Address)
(3~(~~1
7~
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(Zip Code)
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(Phone) t. / ;) 31, C t/7.J I
DATE --.3) dc:.'\ ~
APPLICANT SIGNATURE
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Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other 9 ~"c)"""rA. 5)0/1.
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I
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 $
Jtt~
.50
4t'J" OD
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid vV
cfd..
Date/O,J!" OJ
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 N~()Iz.....
By M
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