HomeMy WebLinkAboutPlumbing Permit 03-1597
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CITY OF PRIOR LAKE PLUMBING PERMIT
1Z-./~.03
" REQUEST FOR FINAL
, . INSPECTION SENT TO
.~.~v~t~-and-It--L. '. .0. W..N. E.R. 01-05
AD~ HOME. _._ ...
190 . . ..--.::..rDiHr ~0~
LEGAL !DESCRIPTION (oftIce use.,.,ty)
LOT BLOCK
Au1J1UV1~
Date Rec'd
5.. !'_I PERMIT NO. Cf./597 I
ZQN!NG(_....)
J Je~O
PID zS: 03". 001.0
tSR.u.CLUl ~ (phone) M.z- 'b7- <{q~
(A~ 1521:11 ~ltbw\'~ 11LL W. _~.l.uJc,. ~ SS3n
J .-
~~~.\\ .Q'-. ~i~lN.~ . (phone) J."C;;/- 2..loS- B{(Q
(Addres~) ~() ~ '""Kc\ . 7.1l6.- ~ tl\L-\ SS1~J,.
(Address) . U' (City) (Zip cooer'
(Contact Person) ~ ..-+-..\ 1. - (phone) ~
APPLICANT SIGNATURE ~--h~. DATE . 1:>r-1/( I n~
r. APPLICANT PLEASE COMPLETE BELOW ,. ~
. Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher f Water Heater
Floor Drain Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
OWNER
(Name) ·
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
~~
Estimated Cost $ 0100
,/
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
BuildingPennit# 03./597
.:;5.50
. 50
Ut) .<8-
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(omce u.. Only)
.+. This Application Becomes Your Building Permit When Approved
, .\ I Building omctl. Dlte
paid40. (J 0
Date
I'Z-. If;. 43
Receipt ~~ CJ 8 z..
BYp-
14 hour Dotice for allln ,', .. f . ,., (951) 447-9850, fas (951) 447-4145
16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
IS" )..() 't
Fu,:.-kt",k ...
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MI'CH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MI'CH FINAL
It)-o It-tl\ k,-
COMMENTS:
-
.---
( /'
/ In~
L--IV
----
)
DATE TIllE
r-(]-rC
-r,.-I. ,q,
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASUNE AIR TST
o
~
1 I \
t (I...D. )
./
--
----.
~ATlSFACTORy.PROCl'ED
o CORRECT ACTION AND PROCEED
o CORRI'CT ~~~FOR RI'INSPI'CTION BI'FORE COVI'RING
Inspector. f/I/T OwnerlContr:
CALL "7-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
-,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI