HomeMy WebLinkAboutPlumbing Permit 04-0502
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
I PERMIT No.tk/-c 5"~
q'1ease ~ or orint and sim at bottom)
ADDRE~
0914 Cv~ ST.
, ZONING (olliceuse) ,
LEGAL DESCRIPTION (ollice use only) /.J <
LOTa--BLOCK6 ADDITION ( I /~
OWNER r_ J ...._
(Name). h) i \ \ i'eur... ~
~
~;~:~ANT ~uu.u:J\ lA.Jed~ (Phone) !.PI d-~'()/- fP'oO
(Address) u,' L4 0 gQ A V '5LU H Lt tr I.u}\ N'JV\. 66?6D
(Address) (City) (Zip Code)
(Contact Person) t-J I!( Ie::' l wed:1" (Phone) liJ' d -8/0 <jS- 4 if ole
~\PPLlCANTSIGNATURE ~l _':5\____. DATE 5- ri-O '()l..j
APPLICANT PLE~E COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Address)
Quantity
~2~
V'
PID .JC;-~/6-cJ3C;-()
(Phone) Q6Y-447-/3D8'
Type of Fixture
V'
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial. Commercial & Multi.family 1% of job cost witb a 539.50 minimum Residential. New One & Two-Family 599,50
Residential. Additions & Alterations 539.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'2,q .31
.50
4fMD
(Omee Use Only)
r This Application Becomes Your Building Permit When Approved
- r
Building Official
Paid LfOr
Da3-dS-~
Rece'ti~'r3 /}
By ~ _
U
Date
14 bour notlee for all Inspections (951) 447-9850, fax (951) 447-4145
16100 Eagle Creek Ave., S.E., PrIor Lake, MN 55371-1714
DATE TIllE
//-!/~-
S?/</ c;,,<<;.,.~~ :Sf
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CDNTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
, ,. ~w"'BING FINAL
[J MECH FINAL
~~S~_7-
[J EXIGRADlFILLING
o COMPLAINT
[J FIREPLACE RI
o FIREPLACE FINAL
[J GASLlNE AIR TST
o
COMMENTS:
A /' /}/ /1 I /l
~ t-/d4/ H~l/ennF -f..s."-
...."&,..,,, ~ ~~~ nor-o.-
-
ht?e>q,...s
/.. . " / . "
/ ,,-.-;,5 -r- /2
~r;';1~/""'V
.~ be
4 6~ v ,.
.h ~..:? ,./
b/{
c/ /
,-r- f
h;;/...dr-
,/ ,
~WORKSATlSFACTORy.PROCEED
[J CORRECT ACTION AND PROCEED
o CORRECT WORK, ~AI;L F~INSPECTION BEFORE COVERING
Inspecter. ~ Owner/Centr.
CALL "7-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
INSI<<m
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY/