HomeMy WebLinkAboutPlumbing Permit #14-250 C�TM OF PRIOR LAKE
INSPECTION NOTICE °ATE T�ME
SCHEDULED Z�j �� ---
ADDRESS
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PHONE NO.
PERMIT NO. ! �} 'Z,� U
O FOOTING ❑ PLUMBING RI
❑ FOUNDATION 0 EX/GRAD/FILUNG
� FRAMING � MECH RI O COMPLq�NT
❑ INSULAT�pN � WATER HOOKtlP
O FINqL � S�1NER HOOKUP � F�REPLqCE �
�/e`K�UMBING FINAL � F�REPLACE FINAL
O SITE INSPECTION O GAS�INE AIR TST
❑ MECH FINAL
COMMENTS: �
� �--�-
�RK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CqLL FOR REINSPECTION BEFORE COVERING
Inspector. �
OwneNContr.
CAIL 447.g850 FOR THE NEXT INSPECTIpN y4 HOURS IN ADVANCE.
CODE REQUIREMENTS,l� FOR YOUR PERSONAL ly
EALTH dc SAFETY!
Wsnort
o� p R r �.p Date Rec'd
� D� CITY OF PRIOR LAKE PLUMBING PERMIT
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,��� 2. c�b �; PERMIT NO. (
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(, . � 3. Ydlow Applicant
Please or rint and at bot�m
ADDRESS ZONING (ofliceuse)
���`� GRF'P_ j-� f�1 h`}S T�4� flor �
LEGAL DESCRIPT►ON (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) �011'1 � S��.S (Phane}
(Address) �J ODQ P � a� o �a r K t,� 2 C LZ f f' D I i�O►'� K 7 5 Of (�
APPLICANT ��� A � /� �GY 1.LGr `� CC�I.�. � ��J �I �V� l 1
(Name) "I 4 �/ l ����i_
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(Address) � �_ l I r l��L{-� L/« ���(�/ . I'' `�� 1 � L�� l C�� �� L�F%�p�
(Address) �� ���� (City) (Zip Code)
(Contact Person) - U��/ G" (Phone) � l.P J �I � � O � /
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APPLICANT SI }4Tf3RE ATE I
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fiature uanti T e of Fiature
Bath Tub with or without shower Rou -ins
Disi�wasl�er W ater �ter
Floor Drain Water Softener
Lavato (Bathroom Sink) Stand Pi (Washin Machine
Laund Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Si� Back£�ow Assembl 'I'est
Bar Sink Lawn S rinkler
Water Closet (Toilet Other j�� Z f�/�
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FEE SCHEDULE
[ndustrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
ltesidential, Add9tic�ns & Alte�^ations �49,50
Estimated Cost $ 3�`J� + D G Building Permit # _
PLUMBING PERMIT FEE $ Z- �—`��
STATE SURCHARGE $ � - n �U
TOTA�. PE�IT �EE $ .�c:7 „��
(01Tice Use Only)
This Application Becomes Your Building Permit W6en Approved Pai �� �--� R pt No. �����
Date /
Buildins Otflcial Date � - ? "' l � —
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota 5treet S.E., Prior Lake, Minnesota 5537Z