HomeMy WebLinkAboutPlumbing 11-0517 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED W_L
ADDRESS 5103(e 1,c
OWNER CONTR.
PHONE NO. PERMIT NO. J I — S
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL S
❑ SITE INSPECTION ❑ ME CH FINAL )1(.. ( ) IN — / r
INSPECTION i--
COMMENTS: �� ��..��..
„......._
o5-e_ ,
❑ WORK SATISFAC ORY, PROCEED
Ad CORRE I AND PROCEED
❑ CORR • - K, CAL OR REINSPECTION BEFORE COVERING
Inspecto / Owner /Contr.
CA ,.f OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE : QUIREMENT S ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Male n
. PR10 Date Rec'd
, `�� CITY OF PRIOR LAKE PLUMBING PERMIT
Q Robert Sasena
5636 150th Street
�I1VNESe' Prior Lake, MN 55372 Blue File City Geld City PERMIT NO / / 5/
9524473077 Yellow C Applicant
/
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5( . 15 D 112 St
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
ame t 50691 &) I (Phone) � ✓7-) 447 .3O l 7
(Address) 5 WC, 16 D�'' S . , Prior Lake, 55N2
APPLICANT NORBLOM PLUMB CO.
(Name) (Phone)
(612) 827 -4033
(Address) 29
MINNEAPOLIS, MN AVE. SO. (City) (Zip Code)
N 55408
(Contact Person) Arni (Phone)
APPLICANT SIGNATURE / DATE 0 ` I (pr 1
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
_ 00
The Minnesota Statutes § 326B.148 'ost $ �O • V Building Permit #
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ 44/ 50
year effective
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ 50
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ 5.9.
is SS beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid 54,g) R ipt No ( 1 1
DateI- r B
Building Official Date lf t • i 4
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4$45
4646 Dakota Street S.E., Prior Lake, Minnesota 55372