HomeMy WebLinkAboutPLUMBING 16-0162 . DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3 `7
ADDRESS S 3 Z
OWNER CONTR.
PHONE NO. PERMIT NO. ) i -2--
❑ 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 XCQ
COMMENTS: ,t- O
'7CORK SATISFACTORY,PROCEED
1:17177ORRECT ACTION AND PROCEED
❑ CORRECT WORK,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!
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4PRION - Date Rec'd
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CITOF PRIOR LAKE PLUMBING PERMIT.
444,000 ' •
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z.cola city PERMIT NO./6,, /G Z..
3.Yellow Applicant
(Please type or print and sign at bottom) -- -
ADDRESS ZONING(office use)
34 3 )Qu I,f Id (i - .5. 35 -7
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER �} - hone) /c5?-447- 3 4 d
(Name) �e 1Ct/G� '"��C' (P
(Address) - 30(VI.Q- _
APPLICANT
(Name) ApplianceConnections Infphone) ..
12850 Chestnut Blvd. -
(Address) Shakopee, MN 55379
(Address) 952-445-4803 (City) (Zip Code)
(Contact Person) Q l�l,t`e /: I j • (Phone) -
APPLICANT SIGNATURE ` . gt. U iDATE __.343/&"
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity - Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher 410Water Heater
_ Floor Drain , 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
i .
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
The Minnesota Statutes§326B.148 $ Building Permit# .
"SURCHARGE"has been extended PLUMBING PERMIT FEE $ �g
The minimum surcharge for a STATE SURCHARGE $ I A
"fixed fee"permit is o TOTAL PERMIT FEE $ 5.70*
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50
This Application Becomes Your Building Permit When Approved Paid 5� Receipt No.4433_
4 Date3. -7. !G By ade 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