HomeMy WebLinkAboutPlumbing Permit #03-1237
DATE
nME
CITY OF PRIOR LAKE
INSPECTION NOTICE
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SCHEDULED
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ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
,A- a GAS LINE AIR 7J.T
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COMMENTS:
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6'ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
4A-
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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REQUEST FOR INSPECTION
SENT TO HOMEOWNER.
FEB. 2004
lease type or print and si~ at bottom
ADDRESS
50/85
I. Blue File
2. Gold City
3. Yellow Applicant
PERMITNOa3-1;W1
An,bJ.ekJocd Drive. N. E.
ZONING (office use)
LEGAL DESCRIPTION (office use only) () ~
LOT 6BLOCK S ADDITION ~ j)~
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PID ~O-d-JS- 070-0
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(Address) 5'-/35" IlmhJewcxx:1 f)r. (V.E.
APPLICANT t\ \ \ "l:) \ \_
(Name) . 1\10( 'lOW\ r lMM.P~
(Address) 211)5; bJu-He J Co'! 4v~ r ~.
(Address)
(Phone) 1 t:t5Z) ,/'-/5, I ~ 5"3
(Phone)
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(CIty)
(<0 t"l) 827 - '-/033
55108
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE ~~4 - - DATE
r-- APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compa. Lwent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
1/1' /tJ.f
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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 Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERl\'lll FEE $
3'1. SO
.50
ql; . dO
(Office Use Only)
Building Official
Date
Paid itb . .---
Date q_/ 6- 3
Rel/~~s-~
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This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714