HomeMy WebLinkAboutPlumbing Permit 04-0153
Date RK'd
ell i OF PRIOR LAKE PLUMBING PERMI I'
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ADDRESS
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I. Blue File PERMI NO ~l
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. ZONING (office use)
LEGAL DESCRIPTION (office use only)
Sf., Prior L~ .
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LOT BLOCK
ADDITION
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(Address) 11oO l{--c;1. Comb,idl}L Clrc.JJ 5.L -Prior LatIl: m 1165 37cJ-
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(Address) ~lolO J)Ddd Rd ~//)() ea~" 5SIJ 3
(Address) ~ity) (Zip Code)
(ContactPerson) ~ J-+-.e rd-"'I\Q (Phone) lt2S1 - ~5 - }.~''I-D
r--,PPLICANTSIGNATURE -h.b f-J.er'-a.ina DATE__8/ /9/6<t
APPLICANT PLEASE.COMPLEtE BELOW
Quantity I Type of Fixture
. Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
I Shower Stall
f Sinks
I Bar Sink
I Water Closet (Toilet)
Quantity Type of Fixture
Rough-ins
J I Water Heater
I Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEESCUR.DULE
Industrial, Commercial & Multi-family 1% of job cost with a 539.50 minimum Residential, New One & Two-Family $99.50
ReSidential, Additions & Alterations 539.50
Estimated Cost $ gOO -
Building Permit #
(Omce Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PEDllJ. ~J!,E $
r, This Applicat~on Becomes Your Building Permit When Approved
BuUdin. Oft1eial
Date
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Dat:r, 11,() tJ;
Re~..eiPtN '.
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By
14 hour notice for all inspections (951) 447-9850, fax (952) 447-4245
16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTiNG
o FOUNDATION
o FRAMING
o INSULATION
[] FINAL
o SITE INSPECTION
o PLUMBING RI
D MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
[] MECH FINAL
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DATE nilE
3-].-or
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o EXIGRADIFILLlNG
D COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
[] GASLlNE AIR TST
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COMMENTS:
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pfWORK SATISFACTORY. PROCEED
[] CORRECT ACTION AND PROCEED
o CORRECT;r?ORK. A FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOf'l
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!