HomeMy WebLinkAboutPlumbing Permit 04-0858
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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ADDRESS ZONING (ollie< use)
I 509~ AppA-\oo5Q\Va.J.
LEGAL DESCRIPTION (office use only)
LOT / BLOCK ;::;) ADDITION
. OWNER
(Name)
(Address)
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(Phone) ~6d' 3% -lod/oO
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~~~~~ANT D~ lVe.da.l (Phone) ~.00B,.QLJ:a.l9J'.
(Address) In \ 4 ~eQ. ~\ ~ 81. ~n. \-l uk.ftA....Uo\J)"M
(Address) (City) - (Zip Code)
(Contact Person) ~~. W~ (Phone) LPI~ '6Lo~~44"b (.,
APPLICANT SIGNATURE t ~ - DATE
r-' APPLICANT PL~SE COMPLETE BELOW
Quantity 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)
Type of Fixture
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 with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
bq,tij
.50
40 . 110
(Office Use Only)
). This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid ?fO. ...--
I Dat"R_ d3..(j-(
ReceiP~-?l/'q'9
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS J~4r~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
/J ~ I Oi'\~O
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
I~
lr-
Ll- 08~
o EXIGRADlFILlING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
.9 'SLlNEAI~
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/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREtfj, CALL FOR REINSPECTION BEFORE COVERING
Inspector I Owner/Contr.
..L/ -
CALL "7-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE_
CODE REQUIREMENTS ARE Fall YOUll PElISONAL HEALTH & SAFETYI
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