HomeMy WebLinkAboutPlumbing Permit 04-0437
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIt
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ADDRESS
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).. Yellow Applicalrt . I '7 J I'
3 q ~ 3 co"') 7\ (' D.XilO\ r-e, + r
LEGAL DESCRIPTION (office use only) - _ '1 -'
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ZONING (office use)
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OWNER
(Name)
(Address)
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(phone) Cf-6d - L/.fl ~ (tb ~
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APPLICANT I\ '-' t\ -
(Name) tJ\a:dY't'~ ~\il/'(\Jw~
(Address) ~ r', ~ h V}-W ~
(Addres~
(Contact Person) J,~(\ (\J1\ /)
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Quantity
96J - L/Y1 ~6991
5StJL/'1
(Zip Code)
(Phone) OJ.~:) -qjg --6Cjqr
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l\PPLIC..6rr PLEASE COMPLEu. BELOW
Type of Fixture Quantity
Bath Tub with or without shower -
Dishwasher
Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (L or 2 compat Lment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(phone)
Lo/
(City)
~PLICANT SIGNATURE
Type of Fixture
Rough-ins
Water Heater
Water Softner
. Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
X Lawn Sprinkler . - '\rI;l {' IJ mQ,~
~ Other
FEESCI1JLDULE
Industrial. Commercial 8r. Multi-family 1% of job cost with a $39.50 minimum
Residential~ New One 8r. Two-Family~
Residential, Additions & AlterationC $39.S0~
Estimated Cost $ Building Pvuuit #
PLUMBING PERMIT FEE $ 39 f:)O
STATE SURCHARGE $ ~. ,,- 1_ ~:50
TOTAL .r '~~.lJ..l' "~JL $ "I",r j urv
(Omte Use Only)
rThiS Application Becomes Your Building Permit When Approved
Building OfIIdal
Date
. Paid iIlJ~' ~L?~~~-
Dateff-;j-ot-/ By ~ ~
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24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE nilE
CITY OF PRIOR LAKE
INSPECnON NOTICE
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
LI.-O 7
o FOOTING
o FOUNDATION
a 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
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: It' J-(J ;;- t7r1"kU--
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fiRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wc;!;K,~R REINSPECTION BEFORE COVERING
Inspector: )/ V r Owner/Contr:
II
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl