HomeMy WebLinkAboutPlumbing Permit #09-0192 � � �
� � pATE TIME
CIT'Y OF PRIOR LAKE ,._ �+
INSPECTION NOTICE SCHEDULED -.S'-S(`�_�
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OWNER CONTR.
PtiaNE NO. PERMIT NO. � C � J ����
❑ FOOTING 0 PLUMBING RI ❑ EXIGRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP � FIREPLACE RI
0 INSUl,ATION O SEWER HOOKt1P � FIREPLACE FINAl.
❑ FINAL ❑ PLUMBING FINAL � GA INE AIR TST
❑ SITE INSPECTION O MECH FINA�
COMMENTS: ? %''°`�'°°.:
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L� WORK SATISFACTORY, PROCEED
O CORRECT ACTION AND PROCEED
❑ CORRECT WORK, GALL FOR REINSPECTlON BEFORE COVERING
Inspector. OwnedCoMr.
CA�L 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSHOTI
4
PRIp v Date Rec'd
� �� CITY OF PRIOR LAKE PLUMBING PERMIT �"� �� �
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� 1. Blue File
2. Gold �,t PERMIT NO.� D
3. Yellow Applicant �/
d si n at bottom
' ' +�" ZO1vING (office use)
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LEGAL DESCRIPTION (oflf'ice use only) /
LOT BLOCK ADDITION " PID
OWNER
(Name) (Phone)
(Address)
APP_ CANT (�� � 4,
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( dress) (City) (Zip Code)
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APPLICANT PLEASE COMPLETE BELOW '
Quanti T e of Fizture Quanti 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
FEESCHEDULE
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 $ � ✓�
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ �$7j,
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid �f. "� � Rece' t o. S �
Date� � G
Buildine Official Date '
24 hour notice for all inspections (952) 447-9850, fax (952) 447 245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372