HomeMy WebLinkAboutPlumbing Permit #14-220 DATE TIAAE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS � r I Z-- �'I �o -�-�(' ���^" v` ��• r
OVYNER CONTR.
PHONE NO. �� _ �/�� PERMR NO.
0 FOOTING 0 PLUMBING RI ❑ EXIGRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL �7PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAI. � -
COMMENTS:
f-
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
I�spector. Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
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CITY OF PRIOR LAKE PLUMBING PERMIT
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����� 1. Blue File PERMIT NO .
2. Gold City � � �
3. Yellow Applicant 1 !/
ease or ' t and si at bottom
ADDRESS ZONING (oe'ice use>
� �
LEGAL DESCRIPTION (office use only)
LOT $LOCK ADDITION PID
OWNER /�,, `
(Name) (Phone) �� � � + C U � �J
(Address)
APPLICANT
(Name) liance Gar.nect�c-�s �nc, (phone)
(Address)
1 . MN 55379
(Addre - (City) (Zip Code)
�., �
(Conta.ct Person) (Phone)
APPLICANT SIGN � DATE �
APPLICANT PLEASE COMPLETE BELOW
uanti e of Fizture uanH T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato athroom Sink Stand Pi e Washin 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
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ Buitding Pe it #
PLUMBING PERMIT FEE $ �
STATESURCHARGE $ `
TOTAL PERMIT FEE $
�o�� uSe od�y)
This Application Becomes Your Building Permit When Approved Paid • Re t N. �
Date , � y � By
Bnildin¢ OfRciai Date � � "� � � -
24 hour notice for a0 inapections (952) 447-9850, fax (952) 447-0245
A646 Dskota Street S.E., Prior Lake, Mianesota 55372