HomeMy WebLinkAboutPlumbing Permit #04-0718
ADDRESS
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CONTR.
PERMIT NO. ~r- 7/1
SCHEDULED
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~EWER HOOKUP
. '-PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS~ / / ,,/ / / /
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/~ WORK SATISFACTORY, PROCEED
I 0 'cORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
(,.,/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
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I S/J 96 4Jsh
LEGAL DESCRIPTION (office use only)
LOT XOCK K ADDITION
OWNER
(Name)
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(Address)
APPLICANT /? ~
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(Address)
(Contact Person) f?uj r~-- rel /,~";r) J
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APPLICANT SIGNATURE . " '-~t4V
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7. 15, 04---
~: ~~~ ~~~ PERMIT NO. 0 '1'. () 1/6
3. Yellow Applicant
ZONING (office use)
IUJO
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(Phone)
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(City)
(Phone)
DATE
(Zip Code)
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- -
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher X Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compalltuent sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
. Water Closet (Toilet) Other
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P Q v rJ M (phone)
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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
Building Permit # 6 'h 0 ,I f
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERl\'u J FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
39,50
.50
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pai~ (//)
Date ~
1.. I r,.' q..J
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Receipt No.
~1-r7 4'
By L
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