HomeMy WebLinkAboutPlumbing Permit 16-1038 DATE TUE
CITY OF PRIOR LAKE SCHEDULED ---i-1----� I
INSPECTION NOTICE —
ADDRESS
OWNER CONTR. //
PHONE NO.
PERMIT NO. I zQ 1 0 3
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
0
❑ FOUNDATIONMECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL O GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS: cit " G.A.(t
Sa •
WORK SATISFACTORY,PROCEED
❑`CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: X `-' Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
O p�0� Date Rec'd
a CITY OF PRIOR LAKE PLUMBING PERMIT . /6p
v
.:',: File PERMIT NO. /6, /03X
.Gold App /
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS (7 e I shot.b•.4 A. 13 foe( ZONING(office use)
Sha rxr e... . mit) .$-537`
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
.Tame) , P o.n (Phone) 6/2-336'2//6.—
(Address)
/S(Address) 17 5 h o Inc iv.,d
APPLICANT
(Namme): -Task IZ iLbwri3 (phone) 9 z-356.-74/3 z
Address)' 1771 Sha.. /i l i 8/..Q sk A.Kdpcc S-S 379
(Address) (City) (Zip Code)
(Contact Person) micas k 9 5 2 - 3 S L-7'/3 - (Phone)
APPLICANT SIGNATURE . - ,..,.DATE - G t 2.0/ 4
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 S pnkl
ner
Water Closet(Toilet) '✓ Other ? C(
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 $ 5Z7
STATE SURCHARGE $ fC1
TOTAL PERMIT FEE $ 4?,..
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid u ,.-0 Receipt No. 6
Date (,i (� � (ly By
Buntline Official Date "`
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372