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HomeMy WebLinkAboutBathroom 14-025 E O o 0 OOOOOO o a En k 2§ o g ■ § m�� 0 2q cz > O A f 8 8 8 m in x n o k r / m §�� § §2 z $ § -0 t -1 m o -, � o ip K > ■ © z 0 § xi s. k xi > � � m U I. m ; 2 22 (. QQOO � 41 k m m r mom® @ aW On Z � _ %� § § �� m § 0 B k M ® 0)X X 1 @ m Fl c NI ' Z D — f c c k B m " o ` d 2 \ ■ < \ DQOQOO Q ■ 2 �® g § ƒ _ g / ��2 rl » § 2 g2 m "11 ■�F I.Z\ § kr. 0 r °`` jNel, CITY OF PRIOR LAKE PLUMBING PERMIT U •yy NN 6801r• I Blue File PERMIT NO. /L , 6 2S —* 2. Gold City 3. Yellow Applicant 'lease re or • rin[ and si . at bottom ZONING (office use) ADDRESS `4,5 ' 5 Cat :LE /:.1 - 7;; : dc-t LEGAL DESCRIPTION (office use only) PID LOT BLOCK ADDITION OWNER Mite" $i;44.„-41,14.. s- '(Phone) (Name) (Address) /�_" `` G�^ �/c} �2 �^^T T r' A ATT / 7y�c 7D.'S int, ,.,o\ / / / J� O � d (Name) ,., - • `�`� -- /fit eF.�u - � ..,. / � ..,_ - - �� S S � S �- �! Das Gam./ . - - 0 ,L (Zip Code) (Address) (Address) (City) p�.4 -ems-/ (Phone) Li/ ^ 21-- -r - 3 (Contact Person) / !� ��?. 7 7�.� -- --- 4 -- 6‘‘. DATE / APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BELOW Type of Fixture Quantity Type of Fixture Quantity yp Rough-ins / Bath Tub with or without shower Roug Dishwasher _ 11111111111 Water Softer Drain Stand Pipe (Washing Machine) / Lavatory (Bathroom Sink) Sewage Ejector Laundry Tray (1 or 2 compartment sink Backflow Assembly ,-_ Shower Stall IIIIIIIIINIIII. Backflow Assembly Test Sinks t Bar Sink Lawn Sprinkler 111111011111110111 , Water Closet (Toilet) 1111111111111111 Ot er ' FEE SCHEDULE Residential, New One & Two- Fatuity $99.50 Industrial, Commercial & Mufti- family I% of job cost with a $39.50 minimum Residential, Additions & Alterations 539.50 � Estimated Cost $ � Building Permit # /Y MO�L PLUMBING PERMIT FEE $ 50 STATE SURCHARGE $ TOTAL PERMIT FEE $ i 4 (Office use Only) Receipt No. This Application Becomes Your Building Permit When Approved Paid a-3 i Date i � 6 , / Building Official Date la 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245