HomeMy WebLinkAboutPlumbing Permit 04-0544
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
t'7/Cf-
(Please!ypc:" or DIint and si2Jl at bottom)
ADDRESS r/
30 4-K tJ Off w::ff
I. Blue File I PERMIT NO I
2. Gold C;,y . 04-,0544-
3. Yellow Applicant
~
I ZONING(officeuse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2.5. "31'2.-,031-;0
I OWNER
(Name)
(Phone)
(Address)
APPLICANT <' j J
(Name) --.JT_
P/lA.",,}-y,/~"JJ- J-h.]In.. (Phone)
75"~1 /701J. :;--/ tJ ...J l..ejkl't/,'/t
(Address) (City)
(Contact Person) ~ 1'\ , ,~ (Phone)
APPLICANTSIGNATUR,F:._$ ~I DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture I Quantity I
Bath Tub with or without shower I Rough-ins
I Dishwasher I I Water Heater
I Floor Drain I I Water Softner
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink I I Lawn Sprinkler
I Water Closet (Toilet) I I Other
9S2 .2J"1 <tl)~
Ssvilr
(Address)
(Zip Code)
~-7-0Y'
Type of Fixture
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
E,timated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39. 57J
.50
4-'t). eft,)
(Office (lse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Pai~O, e/lJ
Dati. 7. u ~
I Receip~ fr ~
IBy ~,
{J
24 hour notice Cor all inspection, (952) 447-9850, Cax (9S2) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
>(-,)0 -0(/
ADDRESS
-.3 (; 1-8
BOI3Vfr ~
OWNER
CONTR.
PHONE NO.
4- . .5 4--1-
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)sf FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
(S1=HJ;~~
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COMMENTS:
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~RKSATlSFAcTORy,PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ Owner/Cantr.
I I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
INSIKlTI