HomeMy WebLinkAboutPlumbing Permit #14-184 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS
OWNER CONTR.
PHONE NO. PERMIT NO. �_� �
❑ FOOTING � PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI O COMPLAINT
❑ FRAMING ❑ WATER HOOKUP � FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPIACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION �C MECH FINAL �
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COMMENTS• �M�, ,,,,
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�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE T W K, CALL FOR REINSPECTION BEFORE COVERING
I�spector. Owner/Contr:
CALL 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HE,4LTH & SAFETY!
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o � rRl CITY OF PRIOR LAKE nate Rec'd
�' -�� � H�ATING/AIR CONDITIONiNG/FIREPLACE PERMIT
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U �� � ir1 " "
-• �. P�n►c File PERMIT l�lU. 'I/
��NNESD�P 2. Green Cily / �_ZL�j �
3_ Ye�toa• Applicant � "� �
(I'[ease type or print and sign at botto�n)
ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (oHSce use only)
LOT BLOCK ADDITION pYD
OWNER (,��n ����
(Nai��e} (Phone) G "I
\� (1
Address
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APPLIC T ���p,
(Name) � .� � (Phane) IO���� �sU"�
(Address) � t� � �� � �
(Contact Person (Phone) l � � �
APPLICANT SIGNATURE - DATE �
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTIO ACE T ❑ALTERATIONS
FURNACE�MAKE AND MODEL S� O� �� ,� ��L
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OI' SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner
❑Wai7n Air Plants ❑Sfeam Units and Fireplaces Cannot Enc�•oach
❑Gravity ❑Hot Water into Required Side Yard Setbacics.
❑ Mechanical ❑ Radiation Fireplaces witii Box Additions or
�Air Conditioning ❑Special Devices Cantilevers to tlie Outside of Buiidings
❑ Vent Systein ❑Other Devices Requi►•e a Building Pern�it.
FIREPLACE MAKE AND M�DEL
FEESCHEDULE
Industrial, Commercial & Multi Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (Ne�v Constniction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Constructio�i) � 64.50 Residei�tial, AC Only $49.50
Cast $ °� Building Pennit#
�-IEATING PERMIT FEE $ -J�
STATE SURCHARGE $ 5.00
TOTAL PERMIT FCE $ ��,)
Tl�is Application Becomes Your Building Permit When Approveci Paid�� � Receipt Na
Date / By
Building Official Date
24 hour notice for all inspettious (952) 447-9850
4646 Datcota Ste•eet S.E., Prior Laite, Minnesota 55372
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4 PRIp CITY 4F PRIOR LAKE Date Rec'd
° � �` �' HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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v� : ns
1. Pink File pERMIT NO.
'��hNESO'� 2. Green Cily / / � Z�7
3_ Ye{to►v Apglicant / 7
(Please type or print and sign at bottom}
ADDRESS ZONING (office use)
� n �� �
LEGAL DESCRIPTION (oHSce use only)
LOT BLOCK ADDITION PID
OWNER /,�n �+�/,�—
(Name) A S (Phone)`�JL l"I`t
Address �� ��
APPLICAN
(Name) u� � (Phone} � � �; ��"" �
(Address) � _
(Contact Person) (Plione) �� ��
APPLICANT SIGNATURE • DATE �' U' l�'
APPLICANT PLEASE CUMPLETE BELUW
❑NEW CONSTRUCTION [�REP CE��T� n pALTERATION
FURNACE�MAKE AND MODEL �,X FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT �(Q IC,
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner
�Warn1 Air Plants ❑Sfeam U��ifs and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into ReqafrecE Side Yard Setbaclts.
�Mechanical ❑Radiatio�t Fireplaces with BoxAdditions or
❑Air Conditioning ❑Special Devices Canfilever to tiie Outside of Buildings
❑ Vent. System ❑Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
' FEESCHEDULE
Industrinl, Cbm�nerci�l & Mu�ti Family 1% of jab cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (Ne�v Const��iction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Constructia�i) $d4.50 Residential, AC Only $49.50
Cost $ �. �J� Building Pennit#
HBATING PERMIT FEE $�.�,
STATE SURCHARGE $ 5.
TOTAL PERMIT FCE $
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date y � By
Building Official Date
24 hour natice for all inspections (952) 447-9850
46q6 Da[tota Street S.E., Prior Lalce, Minnesota 55372
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS
OWNER CONTR.
PHONE NO. PERMIT NO. —' ��
0 FOOTING � PLUMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPIAINT
O FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
� INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL O PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ,�C MECH FINAL � -
COMMENTS' �rnl � � T � C-
� � ' vt.. c-�,.�.� : �
�s �,� r �i vv. �
1 n� C"�V� C.� �,! � 1�
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE T W K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr:
CALL 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTI
��� 5�.�� ���-� �oaa�, � ���5�a
� Q PRIp� . Date Rec'd
� �
CITY OF PRIOR LAKE PLUMBING PERMIT -
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ar� . _ . '
� z �,� ��, PERMIT NO. I L� � � � �
7. Ycttmv Applican�
2ease e or rint aad si at bottam
�D��� , ZONING (otttce use)
1�13a� �vbr� (�.d I� �
LEGA�. DESCRIPTION (oflice use oniy)
LOT BLOCK ADbITiON PID
� ��� t AA � (Phone) a5 a — � / � [ `7 y l0
(Address)
APPLIC T � � _ �
(Name)� h I,T 1n �il�ld��l � 1 T �� L) UYl b 1 nq (Phone) ���`" �o� a a y�
(Address) � % � �P ��� � � ,lV � /" L S �J` yl�
(Address} (City) (Zip Code)
(ContactPerson) �✓ 'C � �f I�LJ�� � (Phone) �l� '_ �O� � -- 5` a � a
APPLICANT SIGNA'T`C7RS DATE �l a ����
APPLICANT PLEA5E COMPLET� BELOW
uanti T e of Figture Quanti T e of Fixture
Bath Tub with or without sl�o�ver Rou h-ins
Dishwasher Water Heater
F1oor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laund Tra 1 or 2 com artrnent sink Sewa e E'ector
Shower Stall Backf�ow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Tailet Other
Tl�e Minnesota Stat��tes § 326B .1•¢$ � �'joli costwith $E9.50 nu�n mm� Residendal, New One &'ltivo-l�ami[y $149.50
" SURCHARG� " has been extended �� xesiaenciat Additions �t Altezations �49.50
� The mi��imum surcharge for a �.
"fixed fee" pe!•rnitfs �s.00 $ B��ilding Permit#
- PLUMBING PERMIT FEE $ • a
STATESURCHARGE $. X�� 5.00
TOTAL PERMIT FEE $ _ �"j (.� , �
{Otfice Uae Oaly� • -
This Application Becomes Your Building Pern�it When Approved Paid � �eipt No. �G �
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. ___ _ --
nat�-3 �3 � � B
Buildine Of(iclal Date �
24 hour notice for all inspect�ons (952j 447-9854, fax (952} 447-4245
sf646 Dakota Street S.E., Prlor Lake, Mlnnesota 55372