HomeMy WebLinkAboutPlumbing Permit 14-1344 DATE j TIME
SCHEDULED
CITY OF PRIOR LAKE `2, �� 1
INSPECTION NOTICE --C—ADDRESS
�110 s‘ ( � 1
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OWNER
CONTR. f
PHONE NO. PERMIT NO. \A
•EXIGRAD►FILLING
❑ FOOTING 0 PLUMBING RI OMPLINT
❑ FOUNDATION 0 MECH RI 0 WATER HOOKUP
0 0 OMCFIREPLACE RI
❑ FAMI0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ INSULATIONG SITE INSPECTION0 PLUMBING FINAL 0 GASUNE AIR TST
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❑ FINALp MECH FINAL
COMMENTS:
11
11ki
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WORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
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CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr.
Inspecto
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
I ISNOTI
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1RRiODate Recd
CITY OF PRIOR LAKE PLUMBING PERMIT
ECD1v '�nvEso'� 1. Blne File I PERMIT NO.i 4,. I ,
z.cew city
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1b 161 141 SCCL.- AV&
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PLD
(N OWNER Rp1oeQ--�' Sia . L' hct (Phone) 152-2210 —4 3 )
NI
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(Address) I le lei JF LSC& A Ve, S t
APPLICANT Appliance Connections Inc.
(Name) 12050 Chestnut Blvd (Phone)
(Address) Shakopee, MN 55379
(Addre`s 2-445-4803 (City) (Zip Code)
(Contact Person) ' .L4 . v. ► • (Phone)
•
APPLICANT SIGNATURE A' ' k' 4' / DATE r ILA I 114
I
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher ) Water Heater
Floor Drain Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit#
The Minnesota Statutes§326B.148 PLUMBING PERMIT FEE $
"SURCHARGE"has been extended STATE SURCHARGE $ .50
The minimum surcharge for a TOTAL PERMIT FEE $ ,SD
"fixed fee"permit is $5.00 '
Inn Application Becomes Your sunning Permit When Approved Pais S law_ceipt No..7 -p
Building Official Date Date I",(. 0.,( Ly
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372