HomeMy WebLinkAboutPlumbing Permit #11-0311 � 1 ��
� DA7E TIME
CITY OF PR10R LAKE
INSPECTION NOTICE SCHEDULED ��'�'"� ` � �
ADDRESS ! ���� ���'��'�� �� ��
OWNER CONTR.
PHONE NO. PERMIT NO. �� '� ��i �
D FOOTING � PLUMBING RI ❑ FJUGRAD(FILIING
❑ FOUNDATIQN ❑ MECH RI t� COMPLAINT
O FRAM(NG ❑ WATER HOOKUP � FIREPLACE RI
O INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL [J PLUMBING FiNAL � GA ' NE AIR TST
0 SfTE INSPECTION C7 MECH FINA�
COMMENTS• ��'��
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p'WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector: Owner/Contr.
CALL 447-98S0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMEN7SARE FOR YO[JR PERSONAL HEALTH & SAFETY!
WSNOT/
L/ Date Rec'd
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CITY OF PRIOR LAKE PLUMBING PERMIT ¢, �� �/
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� I. Blue File
z. �o�a c� PERMIT NO. `
3. Yellow nrru��
lease or ' t and si at bottom
ADDRESS ZONING (ofleice use)
1 �� SZ �--�.�..� . �.-� , g�
LEGAL DESCRIPTION (oflf'ice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
PLICAN ( � r Gj � Z'?� 7_ 7� rL
(Name) w ��'h b � �hone)
Address)� a • �� ! 6 �+ � �� °� � '� � � L
(Address) (City) (Zip Code)
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ontact Person) �' �� � (Phone)
APPLICANT SIGNATURE ATE " � g' �
APP CANT PLEASE COMPLETE BELOW
Quanti T e of Fixture Quanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Disl�washer Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEESCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimuxn Residential, New One & Two-Family $149.50
Residential, Additions & Alteraxions $49.50
Estimated Cost $ Building Permit #
PLUMBING PERMTT FEE $ �� �
STATESURCHARGE $ :�
TOTAL PERMIT FEE $ �� S
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid r�� Rec ' No. / L � / �
.7 �9
Date
Buildin¢ Official Date �� � � / �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372