HomeMy WebLinkAboutPlumbing Permit #03-0901
. Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO /I ":J a
i: ~:~w ~~~licanl . · V :;-' 7~ I
(please type or print and sign at bottom)
ADDRESS ZONING (office use)
t?3(6 J70~r /",r/!
LEGAL DESCRlPTION (office use only)
LOTtf~LOCK ( ADDITION ~ ()~
PI~5- 38L/-()LI71:)
OWNER
(Name) JU<J-:#A-l h.e:ec~ (Phone) 95,2-dZ.?3 -:;JdJ/J
(Address) 23y'{ J/~uecs-~ /397"#.. /,~/t::;~ ~N~e-
,
APPLICANT '_
(Name) Z.AA:L cPLU ~L?6 r/ /Y?6
(Address) /d)V69 ?/.,LJe'~~ /1~
(Address)
(Contact Person) C ",PC- <.
.PPLICANT SIGNATURE IV ~
(Phone)
9S:J-cf9tV-76o~
5S3)g'
(Zip Code)
J~V/P~L€"
(City)
(Phone)
9S;Z-d7~- 76'00
DATE 7A/GJ3
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity .
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
Water Closet (Toilet)
Type of Fixture
.
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
I .
I
I
I
I
/
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERlVuT FEE $
~ ~o
.1 r,
.50
~O,~
_(Office Use Only)
This Applica.tion Becomes Your Building Permit When Approved
Paid
L/t~ ----
I-~" 3
~e.:.~iPt NO,Cj qf5()
BY~
0<i -)
Date
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS $'5cfj" ~8V\erV~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
(2/1 by 11 ArK
5 -'1ftt
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
LtJ.-WA._ :E'w~ ':J.vt.,~~
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: .~
Owner/Contr:
CALL 447-9850 FOR TH~ NEXT INSPECTION 24 HOl,RS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI