HomeMy WebLinkAboutPlumbing Permit #14-111 DATE TIME
CITY OF PRIOR LAKE .� �� ��
INSPECTION NOTICE SCHEDULED �
ADDRESS ,� ��' � l ��� G`��� 1 � � � �� ���
OWNER CONTR.
PHONE NO. PERMIT NO. �� -- l��
❑ FOOTING � PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ R HOOKUP ❑ FIREPLACE FINAL
❑ FINAL UMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION MECH FINAL ❑
COMMENTS: ,'-` ✓', ' �'-L _ _ �: ,,,
�
� ORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector;/� � '' _ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
o � g � o � Date Rec'd
� CITY OF PRIOR LAKE PLUMBING PERMIT �, l �� J
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��so'�� �. B�Ue File PERMIT NO. ,_.. � I
z. coia c�ty / '
3. Yeilow Applicant
lease or ' t aad s' at bottom
ADDRESS ZONII�TG �ot�re,��
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LEGAL DESCRIPTIUN (office use onty)
LOT LOCK ADDITION p��� ^� � D� �/
OWNER
(Name) (Phone)
(Address)
APPLIC �-; l � �-') �G� � _ �_�
(Name) ��:rf7� ' � T_,�c�a'!1�/2� (Phone) ��o� E��-=•
(Address) � ��J ���/I� ✓� L!� ��`��� ��� S�
(Address) (City) (Zip Code)
`.' ���1�����
(Contact Person) �,� � .A�� (Phone) � o ,---
APPLICANT SIGNATURE -^ DATE —'
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato athroom 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
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEESCHEDULE
Industrial, Commercial & Multi-family i% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ Building Permit #
PLLIMBING PERMIT FEE $ �� S�
STATE SURCHARGE $ �
TOTAL PERMIT FEE $ _�
�otrt�e u� oo�y)
This Application Becomes Your Building Permit When Approved Paid � O Receipt No. r/,�,�r
l ��
Date � � l By ��
Bulldins OflLciai Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372