HomeMy WebLinkAboutPlumbing Permit 04-0807
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DATE TIME
CITY OF PRIOR LAKE 8{/~1
INSPECTION NOTICE SCHEDULED
I
ADDRESS ~q& ~i~
OWNER CONTR.
PHONE NO. PERMIT NO. 'i-e07
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AI~
o SITE INSPECTION o MECH FINAL )i( l " -....- C
COMMENTS:
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
.
o CORR~~RK' CALL FOR REINSPECTION BEFORE COVERING
Inspector: " Owner/Contr:
CALL ~9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
Date Rec' d
CITY OF PRIOR LAKE PLUMB1NG PERMIT
\Please type or print and sign at bottom)
ADDRESS
/ ~(, 9 ~ d ~ (/G:;:f' / /U;:? Y/t..<-,
LEGAL DESCRIPTION (office use only)
LOT / BLOCK 3 ADDITION
/(/VO b
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,
OWNER
(N ame)
(Address)
-
APPLICAN~ \ \--.... '\ ~ \ \
(Name) ace y'~~ 1 ~c ~ \ b OJ
(Address) -.2;). 7 ~ 0 ~ \ '" ~ '"1 r t 1 '
, (Address)
(Contact Person) . \ '0 ~
APPLICANT SIGNATURE ~f>-)-....7~h
j, 2" 04--
~.:~ ~!~ . PERMIt NO.OIL, 0 fl.A7.
3 . Yellow Applicant ,- {,,/ V
I
ZONING (office use)
PID ,~_ 3/0. OZ.l.. 0
. (Phone)
(Phone) 7 ~ 7- LJJJ-L/ D 06-
L q tz.o.. lJ \ )\-\. - , ~ S 0 '-f<.J.
(City) (Zip Code) ,
(Phone) J / L-?. ~ )-<5 ~7 ~
DATE.~00Y
,
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
I Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compa. huent 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
FEE SCttEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit # 0 f- ", 0 II -,
71, J 71
$
$
$
.50
~"'W
Paid 111,." vV
Dat;y, l..,; d 4-
I
ReCrJ t?751r
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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