HomeMy WebLinkAboutPlumbing Permit #04-1148
ADDRESS
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DATE TIME
SCHEDULED ~~~~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
or-//YfY-
o FOOTING
o FOUNDATION
o FRAMING
o INSULA TIOH
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~... ~RK SATISFACTORY, PROCEED
/(p~ORRECT ACTION AND PEED
o CORRECT W' R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
tl.O;or
~ase type or print and sign at bottom)
ADDRESS
'tJArl!1; 1'-/"7 i I) ~
~:~: ~:~ PERMIT NO. O+-~ //+~
3 Yellow Applicant 0
G- e.n ~LR, AdO:.- S E
ZONING (office use)
X
\J,esKl n
G- / el1r1a..-/e: tINe .<) E
~~;~~ANT f) ('0, \ {\~ ~ 0 ) lilY)n;)1\ (Phone) qSd-.. -'-I fA -bq~9 .'
(Address) c2~ ;- -,oJ\ V I eo.. ) t..jJL La ~V I It e, ! m IlJ 55?JiI t/
J (Address) U (City) (Zip Code) /
(Contact Person) Q.J\f\~ " (Phone) q,>~-'/.UJ -wc;c; 9
APPLICANT SIGNATURE ....J.( /!~J..,uf.{YlJl/] DATE 1/- Lf-O.t/
APJ(ICANT PL~ASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compa. huent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LEGAL DESCRI.t'TION (office use only)
LOT X BLOCK ADDITION
OWNER
(Name)
JQ..f \U\
\ L '7 L)~
(Address)
Quantity
PID .::J~7-ld-O~(jL/~'-{)
(Phone)
440 - ~1 ell)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly T~t
X'" Lawn Sprinkler f..J V ..t3
, C>ther ·
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
J Residential, Additions & Alterations $39.50
Estimated Cost r1f ( -=?75- Building Permit # ()4- .I/~
6- {J
PLUMBING PERMIT FEE $ /~9
STATE SURCHARGE $
TOTAL PERl\'lll FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
. 1,50
LlO CJ 0
Paid 40. ~ 0
Date /1. 9. () ~
Receipt No. ~3~.3
By Iff.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714