HomeMy WebLinkAboutPlumbing Permit 15-0169 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED 40145.—
,
ADDRESS 3 L(i 2 .--- GL.,, o
OWNER CONTR.
PHONE NO. PERMIT NO. /S— /[of
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 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 A.GIA:
COMMENTS: "�`�
0(.6.,-e. -...-tc, ! f
WORK SATISFACTORY,PROCEED
❑ CORRE •..TION AND PROCEED
❑ COR' •RK,CALL FOR REINSPECTION BEFORE COVERING tl
ir
Inspect. It Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
/NSNOTI
O� Rip�� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
jN1VEsdo"
1.Blue File PERMIT NO. /5 6
2.Yel
3.Yellow
Applicant
Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
3�S shore Crfl)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER i7vrin �Scoif (� p /� 31-1(Name) J� I�I,C� (Phone) tO �� � lY y' J I JG
(Address) 1 i-ryco S ho re, C r V1 :
(NameCANT�d 1 1 4 5 (i'C{flC.& (Phone) QC7L(3S - qa
(Address) &oqo Wit Ea 44 a • bUc[(15J1UCi
(Address) ( ty) (Zip Code)
(Contact Person) (''1.QQ e./ ( (Phone) ( 0,1/12,
APPLICANT SIGNATURE (41DATE
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
'- ler^ , t,. .. • . -ra ions ..e.
Estimated Cost $ Building Permit#
PLUMBING PERMIT FEE $ 4
STATE SURCHARGE $ .ria
TOTAL PERMIT FEE $ , 0
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ,J•� eipt No.
•
Building Official Date Date,
i
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24 hour notice for all inspections(952)447-9850,fax(952)447-4245 ,
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372