HomeMy WebLinkAboutPLUMBING PERMIT 16-1054 DATE TIME
CITY OF PRIOR LAKE SCHEDULED \114
INSPECTION NO
ADDRESS
CONTR.
OWNER G..
PERMIT NO.
PHONE NO.
0 PLUMBING RI ❑ EXIGRADIFILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FRAMING ❑ WATER HOOKUP
❑ FOUNDATION 0 FIREPLACE RI
L
❑ FIREPLACE FINA
❑ INSULATION 0 SEWER HOOKUP ❑ RPLA AIR NA
p FINAL 0 PLUMBING FINAL
TST
MECH FINAL
❑ SITE INSPECTION 0 S° --
COMMENTS: �l
11
WORK SATISFACTORY,PROCEED
O COR CT ACTION AND PROCEED
O CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
Inspector:
CALL 447-8850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
u SNOTI
111$31 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
�r�so�e
File PERMIT NO.
2.Geld App // V
- //���
(Please type or print and sign at bottom) a. Yellow Applicant �•r l
ADDRESS
ZONING(office use)
1' L 0 Pa,r - w L- N _5537
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 1; r,IllSc,, Vu -
(Phone) (,I a , a OS54
(Address)
APPLICANT
(Name)
4ULLIGAN WATER CONDITIONING (Phone)
(Address) 6030 CULLIGAN WAY
ivtlartliON tf A, MN 55345 (City) (Zip Code)
2) 933-7200
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE g- 9- 113
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Roth-ins
Dishwasher Water Heater
Floor Drain y 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 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 $ 00. 00 Building Permit#
PLUMBING PERMIT FEE $ `7`qc �Q
STATE SURCHARGE $ I 4
TOTAL PERMIT FEE $ C7_57)
(office Use Only)
This Application Becomes Your Building Permit When Approved Paid �, , rlteceipt No. /t v,/
Buntline Official Date Date / CI'
By
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372