HomeMy WebLinkAboutPLUMBING PERMIT 15-1541 CITY OF PRIOR LAKE DATE
INSPECTION NOTICE TIME
SCHEDULED 3) itt
ADDRESS 1---n 2 41, ' /^
OWNER I�
CONTR.
PHONE NO.
PERMIT NO. A j 9 f
❑ FOOTING ❑ PLUMBING RI
❑ FOUNDATION 0 EX/GRAD/FILLING
O FRAMING 0 MECH RI
0 COMPLAINT
❑ INSULATION 0 WATER HOOKUP
0 SEWER HOOKUP 0 FIREPLACE I
F0 FIREPLACE NAL
0 FINAL
0 PLUMBING FINAL
❑ SITE INSPECTION 0 MECH FINAL
GASLINE AIR TST
COMMENTS: 13 +e
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
0 CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector
Owner/Contr.
CALL 447_9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Cgteeze_____
CODE REQUIREMENTS'ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNor)
O.• PRip� Date Rec'd
ACITYeN
OF PRIOR LAKE PLUMBING PERMIT
�` /a, 27 l -
tri
Iaie
i'1VEsdi� I. Blue File
2. Gold City PERMIT NO.Is/ /
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
�
� 13!u k�S St Pv-6
LEGALDESCRIPTION(office use only) ..
41
LOT ` `BLOCK /ADDITION 27/1dei/C Z—/ j PII)?. ---- /402— 0/'3_ 0
OWNERNapall,' Rd& / (Phone) q i • i i ' w do
/
(Address) cS Ca44'yei
APPLICANT Champion Plumbing
(Name) PC uu0308 (Phone)
(Address) 651-365-1340
(Address)3670 Dodd Road (City) (Zip Code)
(Contact Person) EA n t 55123 (Phone)
APPLICANT SIGNATURE — DATE /a /9 -/S
IV
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower -
Dishwasher l Water Heater
Floor Drain ater 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
'ost $C9'/ Building Permit#
The Minnesota Statutes§326B.148
"SURCHARGE"has been changed for one PLUMBING PERMIT FEE $ q ci 5b
year effective
July 1,2010,until June 30.2011. STATE SURCHARGE $ Ic e'°-743T1-
The minimum surcharge for a"fixed fee" permit TOTAL PERMIT FEE $ SO gO
is 35,beginning July 1,2010 This Application Becomes Your Building Permit When Approved Paid60 cp Receipt No. /cil
Date ��� 1 By 5
Building Official Date
24 hour notice for all inspections(952)447-9350,fax(952)447-4245 1104646 Dakota Street S.P.,Prior Lake,Minnesota 55372