HomeMy WebLinkAboutPlumbing Permit 15-0154 CITY OF PRIOR LAKE.
INSPECTION NOTICE DATE
SCHEDULED j TUNE
ADDRESS 1+ (t
OWNER
CONTR.
PHONE NO.
PERMIT NO. l
❑ FOOTING `"
❑ FOUNDATION 0 PLUMBING RI .______'—
❑ FRAMING
0 MECH RI
0 COMPLAINT
❑ INSULATION 0 WATER HOOKUP
❑ FINAL ❑ SEWER HOOKUP 0 FIREPLACE RI
❑ SITE INSPECTION ❑ PLUMBING FINAL ❑ FIREPLACE FINAL
COMMENT ' ,"MECH FINAL
0 GASLINE AIR TST
S 0
,❑ WORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
0 CORREC
REQUIREMENT
CALL FOR REINSPECTION BEFORE COVERING7S
Inspector. ir
. Owner/Contra
CALL 7- 50 FOR THE NEXT INSPECTION 24 HOURS
CODERS UI IN ADVANCE.
FOR YOUR PERSONA HEALTH&SAFETY/
IMSA'Or,
CITY OF PRIOR LAKE f,
INSPECTION NOTICE DATE
�,{� TIME
SCHEDULED 3– T"—
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO. _IS--6�j
O FOOTING
O FOUNDATION 0 PLUMBING RI r
O FRAMING ° MECH RI ❑ GRAD/FILLING
❑ INSULATION ❑ WATER HOOKUP 0 COMPLAINT
O FINAL ❑ SEWER HOOKUP ° FIREPLACE RI
❑ SITE INSPECTION ❑ PLUMBING FINAL ❑ FIREPLACE FINAL
0 MECH FINAL
0 GASLINE AIR TST
COMMENTS: °
i
,
IAS
4.t".
❑ WORK SATISFACTORY,PROCEED11
0 CORRECT ACTION AND PROCEED
ED
CORRECT T
ORK,K,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 KEALTNdc SAFETY!
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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3.Yellow Applicant ` 4,
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
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LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
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(NaWNER 1) c s l e (Phone) -"('Lf-0;0?
(Address) K 3 3(QLt ViO m 6(ucl
APPLICANTC �.p, r
(Name) rr�� ��v � I r 1t�CJ (Phone) `tel n q
(Address) a 0 c 0 Cc W U(� IZO{ "f W 14 (T l ('lam y 1�J3 7
(Address) (City) (Zip Code)
(Contact Person) ,� P ' (Phone) 1,5s- `1"d
APPLICANT SIGNATURE 41411 . /i�[1�, DATE a/1
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 job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit#
PLUMBING PERMIT FEE $ L{C
STATE SURCHARGE $ S•00
TOTAL PERMIT FEE $ .50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid h/L t P e eipt No.(0°1
✓'T
Buildine Official Date Datfyj �/ �1
24 hour notice for all inspections(952)447-9850,fax 447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372