HomeMy WebLinkAboutPlumbing Permit #13-0735 ra.
'�.�` DATE TII�AE
CITY OF PRlOR LAKE gCHEDULED � �
INSPECTION NOTtCE
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2h �� ��L.�/� lc�� //./'
ADDRESS J/ O ,
OWNER CONTR.
PHONE NO. PERMIT NO. � �' � ���
O FOOTING 0 PI.UMBiNG RI ❑ EX/GRADIFI�LING
❑ FOUNDATiON ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
D INSULATION ❑ SEYVER HOQKUP ❑ FIREPIJ�CE FINAL
� FINAL �°PLUMBING FINAL O GASLINE AIR TST
CI SITE INSPECTION ❑ MECH FINAL �
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COMMENTS �C-{��/�C ` �' ���
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�,WORK SATISFACTORY, PROCEED
� D CORRECT ACTION AND PROCEED
❑ CORRECT WORK, F REINSPECTION BEFORE COVERING
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Inspector: OwnerlContr:
CA L -9850 FOR TME NEX7INSPECTION 24 NOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTI
� � pR.i�� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT .
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,. B��e File pE IT NO /
2. Gold City • /� � (� /
7. Yellow Applicant / �/
lease or ' t and si at bottom
ADDRESS ZONING �o�ce ��
3 � � r �1 �
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT /I
(Naxne) � � � �L �L�'f'.e �f � � tt� �. �. � (Phone) � � 2 �� � � 7_3 �f �
(Address) r 2. �' / � 2 2 r� �� Z 3
( dress) (City (Zip Code)
(Contact Person) �c..��-- /' t (Phone) S 2�.e. a S�-�e�-�-
APPLICANT SIGNATURE DATE �
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fizture uanti T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
l Lavato athroom 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
FEE SCHEDULE
Industrial, Commercial 8c Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Resident'ral, Additions & Alterations $49.50
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended st $ Building Permit # ----
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The minimum surcharge for a pLUMBING PERMIT FEE $
"fixed fee" permit is $5.00 STATE SURCHARGE $ ���- .50
_ TOTAL PERMIT FEE $—�� �T J �
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This Application Becomes Your Building Permit When Approved Paid ���� Receipt No. /�, /
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Date � B
Bnilding Qfticial Date
24 hour aotice for all inspections (952) 447-9850, fag (952) 447-4245
4646 Dakots Street S.E., Prior Lake, Minaesota 553?2
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