HomeMy WebLinkAboutPlumbing Permit #10-0477 CITY OF PRIOR LAKE � � �
lNSPECTION NOTICE DAT� TIME
SCHEDU�Ep j "� �
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ADDRESS ��(�% /� �
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�WNER
CONTR.
PNONE NO.
PERMtT NO. J '
O FOOTING ��
❑ FOUNDATION 0 PLUMBING RI
� FRAM(NG � �►'�ECH RI � �GRAD/FILLING
❑ lNSULqT�pN � WATER HOOKUP � COMPt,A�NT
C7 FINAL 0 SEWER HOOKUP � F�REPLqCE �
❑ StTE tNSPECTION � PLUMBfNG FINAL � FtREPI,qCE FINq�
O MECH FlNAt, � GASLINE AIR TST
COMlVIENTS:
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--�"WORK SATISFqCTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,, CqLI. FOR REINSPECTION BEFORE COVERING
Inspector: i �t
, - OwnerlContr.
CALL 44J'.gg50 FOR TliE NEXT INSPECTION 24 HOURS IN ADVqNCE.
CODE JQEQUIREMEN7SARE FOR YOUR pE
RSONAL qF�TH& SAFETY,�
1n'srvorf
V
� PRIp Date Rec'd
° � 9 CITY OF PRIOR LAKE PLUMBING PERMIT �� y ��
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I. Blue File ����r�. ��.��
2. Gold City I �� �
3. Yellow Applicant
' t and si at bottom
$ Z�NING (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) c� r� � � e�� (Phone)
(Address)
AP
am (� c.*'�' ✓ �, �L. Pho �S �^ �� � — .57� �
dress �O`� C�C� ; o . n�" �^a... . � /` , � �.-� L 10�
(A ess) (City) (Zip Code)
ntact Perso ) �.r c� (Phone) � I? - �(�3 � 9 d. �
CANT SIGNAT � ^ , ' I, �
APPLICANT PLEASE COMPLETE BEL
Quanti T e of Fixture uanti T e of Figture
Bath Tub with or without shower Rou h-ins
Dishwasher 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
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
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $ � J 5�
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 5�j.
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid�� � R c' t No.�
Dat !I
BuildinE Official Date - �• �v
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372