HomeMy WebLinkAboutPlumbing Permit 04-1012
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
L/3tJ~
DATE TIME
SCHEDULED ItJ - b .., 1/
~Iv'u-i
CONTR.
PERMIT NO.
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
~UMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL ..... 0
t2i'&a-Li vatIt.
~ ~ ~ O,-/-7h()
COMMENTS:
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORKfj~~EINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
'-""'"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
10 . ~ .04-
(Please type or print and si,gn at bottom)
ADDRESS
]/3oa C-1I€5rtJ~ Lt7tJt;,
I. Blue File
2. Gold City
3. Yellow Applicant
r/(,6 vJ / O~. ()7f,O
PERMIT NOt) 4-. 101 z..
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT !J' BLOCK 2 ADDITION C/~/e//U-€" /H(,..~J ~
PID Z~ :?OO .OcJ7. 0
OWNER
(Name) ~ f<EG W EI'GE: L
(Address) 1I30d; (!/-I €sT tV u:t- '- A-fJE...
(Phone) L/ '-I tJ - O'? C). (j
APPLICANT
(Name)
D&D MedumlcaI
9825 W 11__ J 101
Suite B
(AddreSJlVap, MN 55378
D At ~ I A I A 952-890-8.
(Contact Person) v ,-IV "'" (Phone)
APPLICANT SIGNATURE ~~.~ DATE
APPLICAN~; COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
I Dishwasher
I Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
Bar Sink
Water Closet (Toilet)
(Phone)
(Address)
(City)
(Zip Code)
)/}/I/O{/
Quantity
Type of Fixture
I
I
Rough-ins
Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
I Other
I
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 #
()4-, /0/2-
(Office Use Only)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3'1. So
.50
J/o.oo
Building Official
Date
Paid~,OO
Date /_ (J A.-
I IJ . fR - ..,--
Receipt No..f 7851
BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245