HomeMy WebLinkAboutPlumbing Permit 16-1209 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED / /l,
ADDRESS ? CI 1 (._(, b 6d 4nv/1A-1
OWNER CONTR.
PHONE NO. PERMIT NO. (Co ( 2-On
❑ 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 '' ii
COMMENTS: Hy° `�i -_
ki‘ 13
❑ WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector.d2Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
JNSNOTI
01 PR/0* Date Rec'd
,,,,ANe.e. CITY OF PRIOR LAKE PLUMBING PERMIT
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I. Blue i
2.Gold City
PERMIT NO. /(.0 /it)/
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
-13 w) ) I0w :fci/ '�12in ) l s---t_
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNE
)R / " -410-ft--1•\ Le U C 1L (Phone)
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(Address) I Segd i .
APPLICANT Q r(Y� 1 i q �7 Q
(Name) lx 1 L(�i t�N(C 1 co (')C (Phone) ! �- /�� U��
(Address) lD 2_0 64-_S----P- A) L(,1 Ale 0' e-- u 5 7 /
(Address) (City) C (Zip Code)
(Contact Person) JMj1 ._1 . J S- T k-1"""- (Phone) 'J 2 "1S 8 --S /�d S
APPLICANT SIGNATURE ideciJA,a,,,,.., DATE 4/4_11‘.
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher i Water 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
I I 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 $ 4-'7, 50
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 50, 5 )
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 0 Receipt No.ii
7
1+-6
U
Date
Buildine Official Date t 0 A 61 1(9 )131
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372