HomeMy WebLinkAboutPlumbing Permit 16-0925 CITY OF PRIOR LAKE 4 TE/ TIME
INSPECTION NOTICE SCHEDULED ) /l�
ADDRESS [ 5 31 LD `cc `
V e_rS
OWNER CONTR.
PHONE NO. PERMIT NO. /6- Z S
❑ FOOTING 0 PLUMBING RI 0 EXJGRAD/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 GASUNE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: W 0. "e1 kr,
( 4) Le,
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORR�)O- ,CALL FOR REINSPECTION BEFORE COVERING
Inspecto ��� Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
Tumor,
O�VRIO� Date Rec'd
�„ CITY OF PRIOR LAKE PLUMBING PERMIT
a
��'iivlvssot� .Blue File PERMIT NO.
.cow city ( itt _
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS • ZONING(office use)
/ 531 (.2 JeCCeis 0Q S Ai G° 553=-7P,
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(NameOWNER 3 a Y l i 3 (Phone) 95): 55- / / Z/
(Address) J Q 14&51- -- -
APPLICANT _ — Appliance Connections one
(Name) 12i5bO Cl iestnut Blvd: )
(Address) Shakopee, MN 55379
(Address) 952-445-4803 (City) (Zip Code) •
(Contact Person)c\amlP ((? 4)ps - '� . (Phone)
APPLICANT SIGNATURE9.0c-
f PS DATE _____4400 .
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 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 SCHEDPLE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residenjial,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
i
The Minnesota Statutes§326B.148 $ Building Iernnit# .
"SURCHARGE"has been extended �Gj,
The minimum surcharge for a`, PLUMBING PERMIT FEE $ `
STATE SURCHAR0E $ r / �0
�
"fixed fee"permit iso TOTAL PERMIT FEE $ .-11 SC'"
This Application Becomes Your Building Permit When Approved Paid 3 0 SO Receipt No. 6.4 0
Date d` /7 /6,
I.
Building Official Date c�
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 \
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372