HomeMy WebLinkAboutPlumbing Permit 04-0030
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERM..
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ADDRESS ~ J I't /) c;l'). --
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I. Blue File PERMI NO
2. Gold City 1. OL. 00' 0
3. Yellow Applicant -r ~
Ci rV/& 68
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
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OWNER
(Name)
(;J Lass rna:A1) V i ~,'
I LP~51,- frtUtlt~t:n CA rcAb
(Phone) (qfJZ) Lf47 - {PJ 7 I
(St'.
(Address)
APPLICANT
(Name)
(Phone)
NORBLOM PLUMBING CO.
(Addret~33 (City)
~905 GARFIELD AVE. SO.
/.-.(Contact Person) MINNEAPOLIS, MN 65408 (phone)
. APPLICANT SIGNATURE .tJII:l~ 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 compa. t..uent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Address)
(Zip Code)
I I ~ / Ptf
Quantity
Type of Fixture
Rough- ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEESCt1.~DULE
Industrial, Commercial & Multi-family 1% of job cost with a 539.50 minimum Residential, New One & Two-Family 599.50
Residential, Additions & Alterations $39.50
Estimated Cost $ 400. ~
Building Permit #
tkI-.()Q30
3-1. eb
.50
'-fO .09
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERl\'ll.1 FEE $
~ffiee Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
paid~. () 0
Dai. -uJ.. 0 1
Receipt ~ z. ~
_By 1
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
DATE "~. ,
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ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
rrJ-,o
I
4-30
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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III WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor: 111 $
fI V(
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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