HomeMy WebLinkAboutPlumbing Permit 03-1336
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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l. Blue File I PERMIT NO J
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3. Yellow Applicant c.J _",_I\. ~
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ADDRESS
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 2- ADDITION I:;;II!OI5 111/..-'- 6;?1
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APPLICANT AA. _ _ / .../~~, -.----:
(Name) ./ 'vtfZ7:J:"/\/ ~7"A7/
(Address) I'IQS-tf lAJVcT c..,- ///a :rizR/Z.-~c;.r ..~ "::. ~ /..L
.. (Address) (City) (Zip Code)
(Contact Person) /P/~ TVJ ~Lh~~hOne) 9s;:) - m. - nCJ 0
/'--'PLICANTSIGNATURE ~"7J!f- ~~ DATE
/ APPLICANT PLEA" COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
I Bar Sink
I Water Closet (Toilet)
g;=~R .AIA.-rmI J.. L()/f,I: fL,-t../,eS1Af{)
(Address) / I(t! ~ Z>>Var- c- 7'
(Phone) qQ-,/'Is- ~3
(Phone)
'15"":J. - III/y- Yf)P ~
Quantity
Type of Fixture
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Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
I Lawn Sprinkler
I Other f}J..
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FEE SCHEDULE
Industrial, Commercial & Multi~family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $ .:39.50
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ -HJ.OO
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Your Building perrr/t 'then Approved
'10/?,/03
./ I tilat.
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14 hour notice for all inspections (951) 447-9850, fax (951) 447-4145
16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371-1714
Paid
Receipt No.
Date
By
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 11.1 lJ C::;..., T"")""....p (\ ~.
OWNER
PHONE NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
COMMENTS:
CONTR.
DATE
I~
nIlE
PERMIT NO. O'? - 13~(...
OwnerlContr.
INSNOTl
[J EXIGRADlFILLING
[J COMPLAINT
[J FIREPLACE RI
[J FIREPLACE FINAL
.e. ~LINE AIR TSk
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U-?J
[J PLUMBING RI
[J MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING FINAL
[J MECH FINAL
FOR THE NEXT INSPECTION U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI