HomeMy WebLinkAboutPlumbing Permit 12-0085 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 44122
ADDRESS 3 , l 1 7e
OWNER CONTR.
PHONE NO. PERMIT NO. 2 — 008C
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLIN AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ( Wafer /' 1---
COMMENTS:
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WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT ALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner /Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1NSNOTI
PRI0 Date Rec'd
,
A ,, CITY OF PRIOR LAKE PLUMBING PERMIT
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1. Blue File
z. Gold City PERMIT NO. /1 _ C
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
, _ o ■ ' ' 1 0 112 50
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
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(Name) I A Y , . _ _ , (Phone) l � dal -S, (L - d S"
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( Address ) vc) l( 7 6 1 I 9 5..j
APPLICANT
(Name) (Phone)
(Address) _ _ 1313 Danita Cr
( MN 55379 (City) (Zip Code)
(Contact Person) 952- 445 -4 (Phone)
APPLICANT SIGNATURE , , % I , / -__i94 DATE ( Mr N.
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
r Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
l 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 Est $ Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ .50
The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $
is E, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid 1/4,-0 e eipt No. r 2, ,V
Date ,1 �0
Building Official Date L . 1 • ( Z
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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