HomeMy WebLinkAboutPlumbing Permit 04-0656
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Ree'd
fL. 7.-1.04--'
q'lease .!'d>':. or orint and si... at bottom)
I ADDRESS 50ol\ ~h~e.Q~
lcDu
LEGAL DESCRIPTION (office use only)
LOT 4- BLOCK z... ADDITION .Pt~~ [31'k
tOOb :, J~\'te.v Rucl.t.
5OJ'\I\.J...
~~;~~ANT lXY~.v'-'6 We.dqf ,S - ft,\i3 -'a)~~
(Address) le\l-\ 3~ A.\Jt &8 6535')
(Address) (Zip Code)
(Contact Person) ~\ \ IZKl W~ (phone) La I (t - '8"1.0 8 -4460
,..-- \PPLICANT SIGNATURE ~ ' ~.._~J... DATE l.o - 0.5 '04
APPLICANT PLM COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compamnent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
OWNER
(Name)
(Address)
Quantity
\
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
18DOO
Building Pennit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Omee Use Only)
~ This Application Becomes Your Building Permit When Approved
r
Paid -fO, tAJ
Date {g. Z/l,dtf- .,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 U
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372.1714
Building Official
Date
L Blue File I PERMIT NO I
'.Gold C;ty .04-.0r.,s;?,
3. Yellow Applicant
ZONING (0_ use)
PID ZS"3QQ _ CIS". 0
(Phone) q 6a - 4 LlO - to 18"3
(Phone) ~-
~~
(City)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
BacktIow Assembly
BacktIow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additinns & Alterations $39.50
(j~,() 'r-b
o'f .5D
,50
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Re;:;iPt N04-7;LSd-
CITY OF PRIOR LAKE
INSPECTION NOTICE
~4r nME
~912q A,.ds~cIy~ ~
CONTR.
PERMIT NO. ~~ --(;56
SCHEDULED
ADDRESS
OWNER
PHONE NO.
D FOOTING
D FOUNDATION
D FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
~MBING FINAL
D MECH FINAL
D EXlGRADlFILLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASUNE AIR TST
D
COMMENTS: ...-- / /
~~4:t-, .J pJr/ ~,tf.1 ~ r;
A"4.~f-'/~' #~t'".A ~c__
- I
V/L
,XWORK SATISFACTORY, PROCEED
D CORRECT ACTION AND PROCEED
D CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~ Owner/Contr:
Inspector.
CALL "7.9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY/
ININOn