HomeMy WebLinkAboutPlumbing Permit 03-0961
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
i ~~~: ~:~ I PERMIT NO'03- U'./I
J. Yellow Applicant -/tp
(Please.!VD~ or print and sign at bottom)
ADDRESS
/6-b 5L!
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LEGAL DESCRIPTION (office use only) .
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OWNER
(Name) (Phone)
(Address)
- .-
~:;~~UlAlV"'~ce IY~~ ~ :J~hOne) 7 (,3 -l{ 7ft, -1../ 't 10 I
(Address) 17 4 3~ 3 0 ~ ~ N ,,) ( ~ 'fWv.... :56 Cfy 7
/:J~Ad ss) ( ity) (Zip Code)
(Contact Person) ~XJ:> ,A -,(,l (Phone)
"PLICANT SIGNATURE )./~XI Ii ~ DATE 7 - d ~ - 0 "3
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APPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture Quautity
I Bath Tub with or without shower
I Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
~
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 $
?Sq,bO
.50
40.
(Office Use Only)
"his Application Becomes Your Buildiug Permit When Approved
Building Official
Date
I Paid L/rJ,.....-/
I Datei_ d--"d 5P3
ReceiPtlt'IJ ~~ 7
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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
SCHEDULED
DATE TIME
K'- ;) 0 -() tJ
ADDRESS
/5(,54- FUn~N/ r/Vb
OWNER
CONTR.
PHONE NO.
PERMIT NO.
.3 . 9(,1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
It" FINAL
11 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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(.,)' y \
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~. CALL FOR REINSPECTION BEFORE COVERING
Inspector. (fJ V OWner/Contr:
CALL 14;,9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
UUNOT'
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