HomeMy WebLinkAboutPlumbing Permit 03-1104
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~. 2-1_03
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3_ Yellow Applicant V-J
(Please ~ or orint and sim at bottom)
ADDRESS
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()tJt,l/7H
AVe'.
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER
(Name)
(Phone)
(Address)
APPLICAN'I:I J I) /
(Name) ~r# /ck '" I'IIV'./?/? c:::: (phone) t7~2 LJ i.J,.;) //'7 <;?
(AddresS)j-C~~t?//4!Ld ~ -~b/ gq~.(-__ b~?' ~
(/ (Address) (City) (Zip Cooe)
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i-\PPLICANTSIGNATURE V _ ~ DATE Jr~..:lI.-.o.3
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
Type of Fixture
'0
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
BuildingPennit# ()3-/I04-
Building Omcial
Date
:::J'1.5D
.50
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I Dateg'd-!_tJ3
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERNUT FEE $
(Omee Use Only)
r This Application Becomes Your Building Permit When Approved
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24 bour notice for aU inspeetions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
/63//
PHONE NO,
a FOOTING
a FOUNDATION
a FRAMING
[] INSULATION
[] FINAL
a SITE INSPECTION
DATE n....
SCHEDULED ~~~
I /
Lilv# ~~
CONTR.
PERMIT NO.
L1..?-/~t7~
a PLUMBING RI
a MECH RI
a WATER HOOKUP
a SEWER HOOKUP
~UMBING FINAL
[] MECH FINAL
a EXlGRADlFILUNG
a COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASUNE AIR TST
[]
COMMEtgS: /' /7/ ~ / /)
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, Kwo~ SATISFACTORY, PROCEED
/ [J ~CT ACTION AND PROCEED
[] CORRECT WORK; ~;- -"REINSPECTION BEFORE COVERING
Inspector. /' ~ Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 2A HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY!
I1GNOT1