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HomeMy WebLinkAboutPlumbing Permit 16-120 • DATE TIME OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 3C‘ `I(O ADDRESS / .13'2 5 - S„,,,_ e OWNER CONTR. PHONE NO. PERMIT NO. \b , ‘'Z„7 ❑ FOOTING 0 PLUMBING RI ❑ FOUNDATION ❑ CAD/FILLING 0MECH RI 0COMPMPLAINT ❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI ❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL ❑ FINAL 0 PLUMBING FINAL �SLINE AIR TST ❑ SITE INSPECTION 0 MECH FINAL COMMENTS: N ek,' - ELC- — , ©QC- - ORK SATISFACTORY,PROCEED ❑ CORRECT ACTION AND PROCEED 0 CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING 4.1222 .___ Inspect() _ Owner/Contra CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY! ❑ISNOT, 04 PRI() Date Rec'd c) CITY OF PRIOR LAKE PLUMBING PERMIT U I ArzvESo 1. Blue File �f 2. cow city I PERMIT NO. /6 / a_0 I 3. Yellow Applicant (Please type or print and sign at bottom) ZONING(office use) ADDRESS 113 CC(An (o (/ Ci (. ski , l LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER IZA'N t l 1/L✓s res V(,y (Phone) (P I " o J n-7(o 6(, (Address) I-73 C7 Sui 1 A,,( C{ , S w . APPLICANg -T (Name) hone c �1C( (re. ) `"f `- (c-r-)-- ) l r (Address) / �./ _ '_ A I/ CD d /_ AA(i ° I `C.pp . (Address) (City) (Zip Code) (Contact Person) 1YiQ 119e ( (Phone) q0 - -('3 ' 5443-- APPLICANT SIGNATURE . ,g / DATE -�/? II APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher 1 Water Heater Floor Drain Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower StallBackflow 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# PLUMBING PERMIT FEE $ Cf"f/; C?D STATE SURCHARGE $ $1.00 TOTAL PERMIT FEE $ O, "7O (Office Use Only) This Application Becomes Your Building Permit When Approved Paid • eceipt No.4,2,...t, V ,.3‘./(V, (r; Building Official Date Date '� ((b ` `" 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372