HomeMy WebLinkAboutPlumbing Permit #04-0919
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
b/R/
6uc!;~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
..Jd"':PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
/,~#y
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASlINE AIR TST
o
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o t5f-~,,/-,
XWORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT WORK./C~.?jOR ~SPECTION BEFORE COVERING
Inspector: /Yt/!::f ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IJI/SIIIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
.......,
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec' d
9. 0 i 0 +-
,J.Jlease type or print and sign at bottom)
ADDRES~ lZ' ~llAC~ s:
I. Blue File PERMIT NO
2, Gold City . · 0 ti/-. 0 9/9
3. Yellow Applicant
~~
ZONING (office use)
)ez.~ 0
LEGAL DESCRIPTION (office use only)
LOT Y BLOCK V ADDITION W ~~ ti1:
., d)';:1.
PIn zr. z,oo . 0 Of). tJ
&~e~R ~ ~ \ to- K (Phone) qg. L./L/{Y / 3~
(Address) lo 1 'i5l ~lA.~ ~ ~ G
-
~:~~~~ Yra ~. u VY\~ ,(Phone) qSd- <J00 -f.t;C)qq
(Address) dL\\\1q ~.~~\~~j .~\J-l_ (\l9-~i \\1. '''''N .' ~64-J
_ . (Ad~) ) , . (City) (Zip Code)
(Contact Person) ~y\V) l-) /~ ~ ,ir\ (Phone) 05~- L1~Of- ~C(t?
APPLICANT SIGNATURE ~ \.\.. ~ '2 DATE 0; - 1-04
--~EA~~MPLETE BELO~- .
Quantity I Type of Fixture I Quantity I Type of Fixture
Bath Tub with or without shower I I Rough-ins
Dishwasher I I Water Heater
Floor Drain i \ I Water Softner
Lavatory (Bathroom Sink) .1 I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink i I Sewage Ejector
Shower Stall I I Backflow Assembly
Sinks i I Backflow Assembly Test
Bar Sink I I Lawn Sprinkler
Water Closet (Toilet) i I 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 # D4-. 09/9
PLUMBINGPERMITFEE $ 39. SO
STATE SURCHARGE $ J?\ ~
TOTAL PERl\'u 1 FEE $ l....f V _ .
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Pai~O . 6 0
Dater, 1.3. ()~
Receipt NO.4- 7803
BYp
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714