HomeMy WebLinkAboutPlumbing Permit 14-1177 DATE
TIME
CITY OF PRIOR LAKE SCHEDULED
INSPECTION NOTICE
ADDRESS 2+2^
CONTR.
ONTR.
PERMIT NO. 22
PHONE NO. GRgp�iLLING
EXI
PLUMBING RI INT
0PLA
❑ FOOTING 0 COM
0 MECH RI 0 FIREPLACE RI
❑ FOUNDATION 0 WATER HOOKUP
❑ FRAMINGA0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ INNALATION 0 GASLINE AIR TST
-FINAL ❑ PLUMBING FINAL MECH FINAL 0
❑ SITE INSPECTION 0 �� 50S‘-t. -
COMMENTS: a
v
yl WORK SATISFACTORY,PROCEED
❑ CORRECT A ION AND PROCEED
❑ COR-iir RK,CALL FOR REINSPECTION BEFORE COVERING
rOwner/Contr.
Inspect" ASCE.
IN ADV
CA _ minim
FOR THE NEXT INSPECTION 24 HOURS
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
WSNOTI
N
ih
Date.Rec'd
4011%1 CITY OF PRIOR LAKE PLUMBING PERMIT
►l�gOS ,. Blne File PERMIT NO. / ir"
YelApp /
3.Yellow Applicant �
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
�-�tea ) C)e e,�kQ.\). ZY SE 1
LEGAL DESCRIPTION(office use only) ,y
LOT 1 BLOCK Z ADDITION �6- -.ee C&- PIDO - 370- 1) / - 0
OWNERNo�r\ i 4\e,\c,,vN c.`\o,,C� (Phone) q 5�- A Q �D 15t
(Address) \-7)73 rte('C:'‘,\ ) J� ?r`vc \,G�� M N 5 G 37 a
APPLICANT 11 1►
(Name) Cr G� 'Mlpih (Phone) �O "f
(Address)
`Z,tD'i c� �o�� E2.�c er ‘i\I\1 SCI Z3
(Address) (City) (Zip Code)
(Contact Person) U C-cA d - (Phone)
APPLICANT SIGNATURE DATE , O /15 20 (4
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
St $ Building Permit#
The Minnesota Statutes§326B.148
"SURCHARGE"has been extended PLUMBING PERMIT FEE $ •So
The minimum surcharge for a STATE SURCHARGE $ G
"fixed fee"permit is$5.00 TOTAL PERMIT FEE $ 5 Li,50
This Application Becomes Your Building Permit When Approved `ai; Ct\ e57) Receipt No. ,p ,53
•.to h i By P>
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