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HomeMy WebLinkAboutPlumbing Permit 04-0203 . ..,.. . .;1 . .';0~,~~l':~lt~~lili~t)x CITY OF PRIOR LAKE PLUMBING PERMIl' '::.;,~,;,:,,,'i:~~;~~;~'" '::""":"'~;i,~\t~:,;;':i:i;~~ . . , '" , ~'::.'''::: ~~~~/;; ~; .,'. : . .:.-.;.'s,.,'~'ff~ I'r"'~~' . -, ~J~~~~~ifi~l~f;{~jl'( . . .,~g:,:L~~~t~!.\r;{f .. (Please 'tYPe: or'i)nnt and sim at bottom) :ADD~~S:: ' ~~i:{7.'4!J ) 0/ I. BIu, PII, 20 Gold City 3. Yellow Applicant PERl\tu,~,:.;N9<8!J~?~~~": "1' ." ~: d,.. '''~l:t, , . " .._ :,,',~. , . ~.' .:. ".:' ~"'.. - " ; " '. "'.: .:'-'. ...~~.' : ,r. ,",..' . . <{.};./'i~i~~~;'~~;:~~.'.. :'.. .. .'.. 'M.i~(t'r"!'~'l,u'!""'t.. ,'.o.;:;...r;.::....f~;.i {:")!.f~:?::~~;F: ,,(J () (J/.,JJ /? tI, ;P/floR .' C/l1C6 , :i LEG~ p,ESCRIPTION (otlice UJC only) LOT'j";LOCK 5' ADDITION kvob #;/1 ?;vd- PID~5-73-Cj~ ~FJ-() &~~::::}'~ ~oy . (Adch-eSs) c.5;#~.€ e lI~dotfJh',ee.ro~ ,.. (phone) ?Sal- cV~S' -;??,7o APPLICANT (Name)' ,{IfK,t, SI/)~ 1'?(.)1'l{8/~ I> . (Address), /~t:/&7 Z/NtIi/l~ /9//;e (Address). ~IfL (phone) d~V#~ (City) (Phone) 9501 - J't~- 76aO . c5$"3 7~ (Zip Code) 9SJ- tP9'/- 7600 ~ntact Person) ( ":....; r':",',,":: iLICANT SIGNATURE ~~ DATE - Quantity 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 I Water Closet (Toilet) Type of Fixture .. I Rough-ins Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly I Backflow Assembly Test Lawn Sprinkler ','''',r->~""'>"~,'~-,,,~':',:;,;,~",,~:,~,,, .. .Other , '.. ;,' ~.~f. I . / FEE SLJ:U!iDULE . Industz:i.al~.Commercial &. Multi-family 1% of job cost with a $39.~O minimum Residential. New-One & Two-Family $99.~O Residential. Additions &. Alterations S39.~O PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTALP~u~FEE $ ~7.~ .50 '11'0. fIJ4Q ~iJ~ Estimated Cost $ Building Permit # /~mee UseQDly) This Application Becomes Your Building Permit When Approved . BuUdlna Omdal Date Paid t/ ~ If) .; Date' . 3 "~i-(JLf Rec~tCit/ I By 6-- u 14 hour Dotice for aIllDSpectiOQ (952) 447-9850, fax (951) 447-4145 16200 lape Creek Ave., S.I., Prior Lake, MN 55372..1714 DATE TillE CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS !~4 'J(l( SCHEDULED If -t-ol{ ~dbEY1 ;U OWNER CONTR. PHONE NO. PERMIT NO. 4 -)-8J o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WAfER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILUNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASUNE AIR TST o COMMENTS: ~ ~Y?1Ald~r ~ ,.-- ..-......, " -......... ///;/ /~ t-~lv~) \ t-/ ~. - // '" ~ 'WORK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT W07 ~R REINSPECTION BEFORE COVERING Inspector: / fI Owner/Contr: CALL 447-9850 FOR THE NEXT INSPESCTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI /NSNOTl