HomeMy WebLinkAboutPlumbing Permit #14-088 CITY OF PRiOR LAKE DATE TIME
INSPECTION NOTfCE SCHEDULEO � j 7 �
ADDRESS � ; ��,� � � �� ��
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OWNER CONTR.
PHONE NO. PERMIT NO. �,� —� Y.�
O F0071NG 0 PLUMBING RI ❑ FJ(iGRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE Rt
O INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PI,UMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION �CH FINA� ❑
COMMENTS:
,L ��;� ` °, i _� �.
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� WORK SATISFACTORY, PROCEED
� O CORREC7 ACTION AND PROCEED
❑ CORRECT WO , ALL FOR REINSPECTION BEFORE COVERlNG
inspector: '��� OwneNContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUIe PERSONAL HEALTH � SAFETY.�
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� � pRip� Date Rec'd
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CITY OF PRIOR LAKE PLUMBING PERMIT
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i. Blue File pERMIT NO .
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3. Yeliow Applicani _ / _
lease or ' t and ' at bottom
ADDRESS ZONING �ot�ce ��
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ,. /,, 2 � ,^
(Name) (Phone)U/�J "" ���" � �v�c�
(Address) S Y�
APPLICANT
(Narne) _�;p P �� anc p connections Inc (Phone)
12850 Che��nut Blv�.
(Address) ��a,�(j�P_P� {�!��ef 553'J:�
(A� -t�$ �3 (City) (Zip Code)
(Contact Perso � � (Phone)
APPLICANT SIGNATURE DATE � �b � �
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Figture u�nti T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroorn Sink Stand Pi e ashin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Baz Sink Lawn S rinkler
Water Closet Toilet Other
FEE SCHEDULE
Industrial, Commercial & Multi-family i% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Aiterations $49.50
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $ ��
STATE SURCHARGE $
TOTAL PERMIT FEE $
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This Applicat3on Becomes Your Building Permit When Appraved Paid Receipt No.
�� �� G 7(
Date J � ` By '
Buildin¢ Of'ficial Date
24 hour notice for all inspections (952) 447-9850, fag (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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