HomeMy WebLinkAboutPlumbing Permit 16-0102 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Z I C
ADDRESS 3 S t-z b4-2_
OWNER CONTR.
PHONE NO. PERMIT NO. `4 . I O g
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 3;3-
COMMENTS:
n IL. -1\5 b-0-2.,2_,
WORK SATISFACTORY,PROCEED
❑ ORRECT ACTION AND PROCEED
❑ CORRECT W RK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
Date Rec'd
gcoetti)I04.1
CITY OF PRIOR LAKE PLUMBING PERMIT
Lo
4l41vEs�� I. Blue File pERMIT NO. /�I
�`��Y� 2.Yell App / / ��3.Yellow Applicant (a_�,/
(Please type or print and sign at bottom)
ADDRESS / // ��'ice use)
a�
>2— �G�� /J �� Z�� "'G1
LEGAL DESCRIPTION(office use only) �!
LOT BLOCK ADDITION PID ' O5 00(.0
OWNER 1)9e) (Phone)
(Address)
(Naammee)PLICANT c Zx1N%t �i?)i (Phone) 60, 71"
(Address) 7) GHQ, c.A- ` c'l(� 41-9s(— SWt
(Address) (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE 4DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain 1 Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit# r `/;
PLUMBING PERMIT FEE $ i-t'`Z
STATE SURCHARGE $ l M
TOTAL PERMIT FEE $ 50,-C
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Receipt No.�' S5-
Dat I ` < <.O By � t/
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372