HomeMy WebLinkAboutPlumbing Permit 04-0545
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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L Blue File
2. Gold City
3. Yellow ApplicllIlt
at bottom
I PERMIT NO,tJ4--, 05.fs1
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ZONING (office us,)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2.5'..$/1-. "o~.o
I OWNER
(Name)
(Address)
(Phone)
APPLICANT
(Name)
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7s-SI /70jj.
(Address)
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(Phone)
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(City)
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(Zip Code)
(Address)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
"7 (p' Or'
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough.ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.3 9. 6()
.50
-10. e/lJ
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid
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Building Official
By
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
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SCHEDULEO
ADDRESS
OWNER
CONTR.
4- . S~.s-
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
g' FINAL
ItJ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR . CALL FOR RElNSPECTlON BEFORE COVERING
Owner/Contr.
Inspector.
CALL 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4< SAFETY/
U<SNOn
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