HomeMy WebLinkAboutPlumbing Permit 11-0304 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Clibt"
ADDRESS 41 43 C t .
C r GJ <Li
OWNER CONTR.
PHONE NO. PERMIT NO. 11_
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ) 6(Y4.
INE A TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
.■ /
❑ WORK SATISFACTORY, PROCEED
'CORRE T ACTION AND PROCEED
❑ CORRE6T , CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr:
CALL 44 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
PRI; Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
3 ' "_ Amy /Thomas Parsons
4599 Parkwood Drive Southeast
Prior Lake, MN 55372 ^ �
1. Blue File
P ERMIT NO.
6125185599
2. Yel Airy // 3(J`T'
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
Lti ^ gq Pacrk rvoo d 'pr . .E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
O Na ,q�
WNER y,i► I / Th OM a s Pars (Phone)
(Address) 4 ✓ q 9 par k__ 147 0 0 Gf GF---_
APPLICANT
(Name) NUKBLOM PLUMBING CO. (Phone)
(Address) (61227.1033
290 r FIELD AVE. SO. (City) (Zip Code)
(Contact Person) l/ ► ► .. • _ t l ► ! II: (Phone)
APPLICANT SIGNATURE ■iiillig---- DATE i f / I &)
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher 1 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
Est $ 500 Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ //q 50
year effective STATE SURCHARGE $ §5
July 1, 2010, until June 30, 2011.
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ 54. &P-
i s ,s5, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid 5+ Recei o. / 2573
Date 4 77 / / By
Building Official Date i
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372