HomeMy WebLinkAboutPlumbing Permit #03-1512
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR INSPECTION
SENT TO HOMEOWNER. I F'I
FEB. 2004 ~~w i~licant PEAAtl. NO'OB "151;).-'
(Please type or print and sign at b" ~~".. ..)
ADDRESS
Co231
FrOJf\K\\n C.re.\-e-
6. C,
ZONING (office use)
LEGAL DESCRU" lION (office use only)
LOT '1 BLOCK I ADDITION ~'Jl.
, , 'U
OWNER LI. i2_
(Name) nelnz. IV'tJ,Ce-
,
(Address) lbb37 FrMlkJanCtrde ~,,6.
APPLICANT \ \ _ \ l')\ I.
(Name)\JD(DCJ)'"<\ r()lW\~\~ r-
(Address) 2105 6J~'ei/ 4vPl1~<>- ~'U.
(Address)
6L.. J ~(/A PID ;;lS'-/51-()7''/-()
'! fl.Jd/~ 3 r J.- .
(Phone) ('f5Z) ~l/7-(,,835
(Phone) J("2~ ~7-YD33
PJpl.s 55'-//)8
(City) (Zip Code)
(Contact Person) (Phone)
;---APPLICANT SIGNATURE ~ DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
/0/31/fJ3
Quantity
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\'u 1 FEE $
3<=J,5"0
. .50
'-to ,,00
(Office Use Only)
"J This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 1./6:
Date/I_ / () -G93
Receipt NO,/5?al
By f) I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
""
.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
It 23/j
f r f1,,/d,;"\
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
rW>f4CL /
t
COMMENTS:
( 10 (/:7
/l J'----'
DATE TIME
2 -fHJcr
C-(~
"J-&::J
'" 1]~1
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/1;,tJ II--cA~,
.-
Z--;/~
I I '--
~ WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT ~~R~~L FOR REINSPECTION BEFORE COVERING
Inspector: Y V r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
IJlISNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"