HomeMy WebLinkAboutPlumbing Permit 11-0302 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 5 _ (G
ADDRESS 28 (( Oc(ks L IA
OWNER CONTR.
PHONE NO. PERMIT NO. 1 ) — 302-
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLI E AIR TST
❑ SITE INSPECTION ❑ MECH FINAL X WO it{ r
COMMENTS:
C-16ce9 IN' g
X WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ COR W K, CALL FOR REINSPECTION BEFORE COVERING
Inspecto : Owner /Contr:
CA / 44 - 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
(rTeR/ Date Rec'd
9 CITY OF PRIOR LAKE PLUMBING PERMIT
�
I. Blue File PERMIT NO .
2. cold city // 3 O Z
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS , (office use)
151 GUSid5 Li. t LU
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) GAillne ecutad F- (Phone) 9_/(A W 03 7
(Address) d81Q(o W\ tcS L Lai 1 V VVV
APPLICANT
(Name) (Phone)
Appliance Connections Inc
(Address) 1 313 i i,
(Address) (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher / Water Heater
Floor Drain Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 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 $49.50 minimum Residential, New One & Two - Family $149.50
Residential, Additions & Alterations $49.50
The Minnesota Statutes § 326B.148 host $ Building Permit #
"SURCHARGE" has been changed for one /(7 r
year effective PLUMBING PERMIT FEE $ l-{`1'_ / 10
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ '111 -
The minimum surcharge for a "fixed fee" permit /r/ II
is $5, beginning July 1, 2010 TOTAL PERMIT FEE $ +
This Application Becomes Your Building Permit When Approved Paid 541. so Recei No. 6 73--
Date 4. Z' / / B
Building Official Date ,
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372