HomeMy WebLinkAboutPlumbing Permit 15-0142 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED
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ADDRESS S� 2 / 3
OWNER CONTR.
PHONE NO. PERMIT NO.
❑ FOOTING 0 PLUMBING RI
❑ FOUNDATION 0 EX/GRAD/FILLING
MECH RI 0CMPLAINT
❑ FRAMING
❑ INSULATION 0 WATER HOOKUP 0 FIREPLACE RI
❑ FINAL ❑ SEWER HOOKUP 0 FIREPLACE FINAL
❑ SITEINSPECTION 0 PLUMBING FINAL 0 GASLINE AIR TST
0 MECH FINAL
COMMENTS:
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a
NORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
0 CORRECT WORK,CALL FOR 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!
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4,
04 PRION - Date Rec'd
, AN CITY OF PRIOR LAKE PLUMBING PERMIT
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1.Blue
2. GoldCFit PERMIT NO.
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3.Yellow Applicant //C7
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type or print and sign at bottom)
ADDRESS1 ZONING(officeuse)
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LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID;5- 7 7
OWNER p
(Naf}T Eni q rLSOrJ (Phone) (o I a - J`1 - ge./0 y
(Address) /5 9x2 /fb.j,L.,,r, Ver....) red Pi-'! 0 r LiQ 1
APPLICANT '
(Name) /VW Pt-l)thg1,JG * Pear/ (Phone) (5 -INC— efig.
(Address) /(flo . ?r`i Vt, c/ klei/GOpe''e J6.7.2�
(Address) (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE6,-2
Gti ZODATE a/ -/t -/ S
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 I 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 -c c dt- s, LL. e 6 c et— f ►
v w-cri (w 64..e kJ o,-S to J3 re---,5-----,-.0,
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 $/So .- °= Building Permit#
PLUMBING PERMIT FEE $
STATE SURCHARGE • $ $5.00
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5,s) Receipt No. 6 70
Date /7 6� By %�6'�`'�---
Building Official Date /
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372