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HomeMy WebLinkAboutPlumbing Permit 04-0205 :. .' . . '. :~. .', ~': :.... I~:<<r:",\.'-",~,:: ': . , , ; 1,'1 \1 . CI1y,OF PRIOR LAKE PLUMBING PERMI!' , ' ~,...~,' I ';,":'; '" ' , " , ;y XOf";. I. 81\11 'lI. 2. 00Id Cll)' 3. Yellow ApplicaIIt ;, c.3~/'?v~ ~c ,;.S~i'H!~:>:':':.t:,t: ~';\,:,- , .:' \:930~~~CRIPTION (ofBce \J1e only) '_ _ "~~;'g';~oc6 ADDmON (b~-t fJdto };(I" :'~ PlodS,' fI7~~01 ).-() : - , OWNER:,~\6~~: :~,,' (Nairie)'t,L~;\::}: t/fJ.#AJ /'1/)t,E,i? . . \:: ". ;:A1- ... -".. rf/4N& (phone) 9S""~- Y"~.? -/?61' " ,,",.,. ", ,':.x:.'r,,;(~. i :,,:i:~::~j:~;:":~~ ." . ,~ . '. :. I (Add.!~}.~":'~{, , 'IW~, ',',' A!-';!"wCAN'r '(Name)""" ~IfK~ SlI)~ 1'''-(.)1&(8/,1.) 6 (AddresS) /';W6'7 Z/;l/I?"'~/ AJ/~ (Address), \ ~19)eL , , ~nta~P~~n) ( '<';'~~'If.,.j;:~: , PLlCAN'r SIGNATURE (phone) 950J - ~tY'- 7600 S",..3 7~ (Zip Code) , 9Si- Jl9t/-7~oO , (phone) d~V#a' (City) ~~ DATE - Quantity APPLICANT PLEASE COMPLETE BELOW Type oCFixture Quantity Bath Tub with or without shower Dishwasher Floor Drain Lavatory (Bathroom Sink) I 'Laundry Tray (1 or 2 compartment sink Shower Stall Sinks Bar Sink : I Water Closet (Toilet) Type of Fixture . :, '.. . :..<1'.:..;.......:..'.,.,.:... I I I ~ I I.., ' .- ' j'.. ',.I..t. .'..'""'. ,'... .' ,I Rough-ins. Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly , Backflow .Assembly T~st. . .:' . ,I Lawn Sprinkler. " ,.:..',~;~.,;"'~;,;,..,:.".....;.;;.,~;..:,~,:.i... ',. ,;,..",~~ 'I! ,Other, ' ... ',:;'~.;".;';::;,~:'1!(;)H.',..~.~:;.::j~i!.'A"!.,~: ~"" ',' .: ' J" / ';. "'. .,'." FEE Sl.;.t1JjDULE , In~~, C~mmcrcial & Multi-family 1% of job cost with a $39.'0 minimum Residential, New.One &. Two-Family '$99.S0 . :1, '. Residential, Additions & Alterations $39.S0 : 0om~U~.RDIy-)', ,This Application Becomes Your Bulldiul Permit When Approved PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL P:ED.u... FEE $ Building Pennit # c.n.ro .50 ~O. tIAQ ~tJtfJ Estimated Cost S ~\ \.\ . I:. \ ~, " '; _dell.. Omda. Date Paid Lit) J -- Date 3 -3 )-tJL( Recei2;J~ ~L/I B I' (r- "'. 24 hour DOUce for .IU...pecUo~ (952)4047-9850, fu (95%) 447-4%45 16200 'lap. CnekAve., S.E., Prior Lake, MN 55372-1714 .,. i."" . '''. ~ ........ .. .. .. .. .. ...... ..... .. .." .. ".. . .. w ... .. ." ." . - CITY OF PRIOR LAKE INSPECTION NonCE ADDRESS i{!J L/ .3 OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: DATE TIME SCHEDULED c::'...e ,0 ( 3 ~ llJ ~CJ2.J~ CONTR. PERMIT NO. l.( - ~ o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL 0, GASLlN,E AIR TST,"' /,,' &. tAJ~ "~f>>"1~ x'ORK SATISFACTORY. PROCEED o CORRE9"\ACTION AND PROCEED o CORR~T :-'~ALL FOR REINSPECTION BEFORE COVERING Inspector. ~ I () Owner/Contr: CALll4~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE. -1\ CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &I SAFETY! INSNOTl