HomeMy WebLinkAboutPlumbing Permit 14-1290 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED )L\1(. Il
9
ADDRESS S 7 2 to
OWNER CONTR.
PHONE NO. PERMIT NO. \2a
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
0 IC
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
9Inspector. Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
IXTNOTI
O PRI0 Date Rec'd
4%,„ CITY OF PRIOR LAKE PLUMBING PERMIT
CATEso.:0./
I.Blue File
2.Gold City PERMIT NO. '�1 ♦ gl
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING :office use)
5'$ C.rossa rid Sk
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PH)
O((NaWNE)R �� c V F r 1 Vh (Phone) 152- 1- -.1e J
(Address) 5$ 21 CrosSa.ltdra. cSt- SL=
APPLICANT
(Name) Appliance Connections Inc. (Phone)
12850 Chestnut Blvd.
(Address) Shakopee, MN 55379
(A` 0445-4803 (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE g:e4 DATE it l14-(ii
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher 1 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 joh cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ 1701 Gly Building Permit# The Minnesota Statutes §326B.148
PLUMBING PERMIT FEE $ "SURCHARGE"has been extended
The minimum surcharge for a
STATE SURCHARGE $
TOTAL PERMIT FEE "fixed fee"permit is $5.00
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid C4/S ft No.
J I l
Building Official Date Date- /41
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372