HomeMy WebLinkAboutPlumbing Permit #00-0486
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
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SCHEDULED ";I~GI~
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CONTR.
A.71
PHONE NO.
PERMIT NO.
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o FOOTING 0 PLUMBING RI 0 EXIGRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
, ~INAL 0 PLUMBING FINAL 0 GASLINE AIR TST
'J SITE INSPECTION 0 MECH FINAL 0
COMMENTS: 0.,.... ~It- ~( ~er2,...-
(1.~'~
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~ WORK SATISFACTORY, PROCEED
r; CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Tho Conlo' of lho Lob Counlry
CITY OF PRIOR LAKE
,. PLUI"'J!!!'NG PERMIT pp No.12D ,~(O '1'6 ~
Applicant: geri..2<frdH/ ~ Phone: 0,( p ,),(t:",- ~C:-'.){L
Address: ~;) (j )- _ (J uJ/Jk Iliff 11/ 4'/1Af ~ ~~.I"
Signature: ~ k ..s/rI./~1
Legal Description: Lot"'" Block.J. SubJb \ '1 n \.Oo..:kr <9rtU
Site Address: L"?:sJ & ~~rUh fA- Addn
Building Permit # 00 - q) 4f(, PID # as" - 3 b S- -lJ rO-()
NOTE: This permit will not be processed without complete information.
1. Blue
2. Gold
3. Yellow
File
City
AftIIcant
FIXTURE UNITS
Ouantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Ouantity
Type of Fixture
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$1R .SO
$ .50
GRAND TOTAL
$~. flf)
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing-;ncode the ame men s thereof.
:5 REC O. DATE
~ 1 ST
all fi r all inspec~ns 24 hours in advance.
16200 Eagle Creek Av. S.E. Poor Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
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