HomeMy WebLinkAboutPlumbing Permit 04-0384
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Date Rec'd
CIli OF PRIOR LAKE PLUMBING PE~ll.
I, BIlle File
2. Gold Ci'y
1. Vellow AfpIicaat
, .('~AA....l NO.@-8..~t/ '
ZONING (office use)
(Please type or print and sip at bottom)
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LEGAL DESCRtt'nON (oflice _lXlIy) . - ()
LOT z.{ BLOCK3ADDlUON D~fydO(.,_
OWNER-.d ... () /I J~
(Name) U(0JJ..Ju.L \JQ;u)o~_
(Addr=) 17;10 tj ~ r/ VI (
~;~~f~ rfu (\ \) f'() (phone) 9 ~ ~'ftf} -If1!lI '
(Address) d., L L:c. ('i', 18 h II ,'tJ.1J ftc)p, L~j{() ,VlI1(?) 65cJZ/L!
(Address) (City) (Zip Code) ,
(Contact Person) jiM y (' . (phooe)
~L1CANT SIGNATURE L" J /h.!Yl^j {JOArlltlJlLJ. DATE
. JPLlCANT PLEASE COMPLI!.l~ BELOW
Quantity Type of Fixture Qu..~
Bath Tub with or without shower C
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 comp&uuent sink
Shower Stall ~ ~,
Sinks
Bar Sink
Water Closet (Toile9
(phone)
~w r? If' - :~ ')(9,- () 3.'1-0
'9 ~~~ -;)d0-'I(/7JY
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Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine )
Sewage EjeCtor -
Bacldiow~Assembly
Backflow Assembly Test
Lawn S.... ;..Ikler Va.t' 11m (...
Other
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FEE SC.iUtDULE
Industrial. Commercial &. Multi-family 1% of job cost with a $39.50 minimum
'2 CJO
Estimated Cost $ U 76"
Residential, New One &. Two-Family $99.50
Residential, Additions &: Alterations $39.50
Building P'.......,it ##
PLUMBING PERMIT.. be $
STATE SURCHARGE $
TOTAL PERhl.l FEE $
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........ .50
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(Office Use Only)
r This Applitation Becomes Yoar Building Permit When Approved
BuiIdiag 0fIida1
Date
Paid tI 0, ~
Date 5 r t;",o Y
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24 hour notice for all iaspectiODS (952) 447-9850, fax (952) 447-4245
DATE nilE
CITY OF PRIOR LAKE S-Jl""/
INSPECTION NOTICE SCHEDULED
ADDRESS 17)"OL( f)-t!~ h~ k /?"
OWNER CONTR.
PHONE NO. PERMIT NO. ~ r 3jJC{
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
......
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~RK SATISFACTORY. PROCEED
~ ~~RRECT ACTION AND PROCEED
o CORRECT WO FO REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447..9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!