HomeMy WebLinkAboutPlumbing Permit #03-1039
Date Rec'd
CITY OF PRIOR LAI(E PLUMBING PERMIT
REQUEST FOR INSPECTION
SENT TO HOMEOWNER.
(Please type or print and sign at i FEB. 2004
ADDRESS
3~}1
I. Blue File
2. Gold City
3. Yellow Applicant
PERMITNO.!)3---IO~9
Lot/4 'B~CA'1U,^- N. JJ
LEGAL DESCRIPTION (office use only)
LOT8li?LOCK I ADDITIoNJ{~@a./1<JGf ;;t tvrl PID!15- 3?I-03C-O
,
ZONING (office use)
1/50
~=~R (J:rrlfN IfoAJ Cl (fhone) q<;2 -If</o -16?8
(Address) ~ d-! -z... LPtu.. rs'1t Cd~A tJ. J .p~O'" ~tu..
~;~~ANT cJ~ tfvN() (fhone) 7r'J-Yl/o-/{gt
(Address)3J...JL10~ fl.;/HlL Uttt.L^ jJ"lJ f"",\o'"\"~_ rr~T!~
(Address) '\AHt'b ~ (City) (Zip Code)
(Contact Person) Doi:iteJ -1/.0 tJ LS (Phone) C](} -YI./ f).... /.(, ~ f'
l'PLICANT SIGNATURE'~lltrlf ~_~- 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)
Quantity
Type of Fixture
Rough-ins
Wate~
<Wafer Softner~
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Ba~flow As~mbly Test
(....-Law~~_~rin~ler )
utner
FEE SCIIEDULE
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
(Office Use Only)
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $ 3 9-- ~ U
STATE SURCHARGE $ .50
TOT AL PERMIT F]]:E $ tLfJ w ---
Building Official
Date
Paid Llo ;::---"
Dr/5~3
Receipt NO".. I"//.:. r-
UL/X77
B~_' -
"his 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.~I Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
;2.-25'-0,
JL\0~~~lv+('-
SCHEDULED
ADDRESS
OWNER
CC.NTR.
PHONE NO.
PE:RMIT NO.
"5- /0)(
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 EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
A~~~
COMMENTS:
/
l /
/~) I L,..-
V
/ C I
L./
V
/"
'-7
D ". 19-
i^ 1/
1..J
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT. LL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CAL..
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODll REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
.rI'iSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DRESS 32 ~ '2- UJ..<-, ~(
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 O~
COMMENTS:
DATE TIME
7-'5
{',r
S /' L0.31
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
E GASLlNE AIR TST
~ Ltw...~ ~~
IU~ ~t+______ ~~ cyL-~
/
o ~SATISFACTORY, PROCEED
~~~;ECT ACTION AND PROCEED
~ORREZ2!<' C LL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL ~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~MENTS ARE Fo.R YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl