HomeMy WebLinkAboutPlumbing Permit 04-0529
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
r., . 2- ,04-
'- Blue File I PERMIT NO I
2. Go~ Ci~ 'AA..052-0
3. Yellow Applicant u--r I
q'lease ~ or mint and sim at bottom) I
I ADDRESfD63 ?av0..D ~ LoJv I ZONING(o/liceuse)'
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDmON
\J~ roVMO~
~
~;;~~ANT tJ~ Wec!ql
(Address) lD 14 ~gj) I\\L 8.D
(Address)
(Contact Person) t() LKJ(.... .
~<\PPLICANT SIGNATU~)
OWNER
(Name)
(Address)
Quantity
PID ZS, :jq,t:j"tJO-ln(J
(Phone) q'6d- d;;l(o- ddtt8
(Phone) ~ (PI;:)' 801-od(o()
~~
(City) (Zip Code)
(0 I d - RUg. 4lJ 6/.0
t5-;jl '04
(phone)
DATE
Type of Fixture
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 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
.~ This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit # ()4- .0 5 ~9
'6Q .3)
,50
~O fYJ
Paid1t/. (/t/
Date (, . z.. 0 'I-'
Receipt Nit~y 10
By /flI
I
14 bour notice for all In". ".:. . (951) 447-9850, eax (951) 447-4145
16100 Eagle Creek Ave., S,E., Prior Lake, MN 55371.1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
5'()5J
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE nUE
SCHEDULED ~~~jI'
Ahr1~i€ ~
<../
CONTR.
PERMIT NO.
tJ~ -S..2 9
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
o MECH FINAL
o EXlGRADlFILLlNG
a COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
a GASLlNE AIR TST
D
COMMENTS: , ("7 . ) /
-4~~ ~//,--",-/cler'~
A-"cL#~ "hevl",,-7?"-
I"
~/C
-
,)( WORK SATISFACTORY, PROCEED
a CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~..OwnerlContr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY!
IN$NOT,