HomeMy WebLinkAboutPLUMBING PERMIT 16-837 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED 1 3th'�
ADDRESS
OWNER
CONTR.
PHONE NO. PERMIT NO. 33
❑ FOOTING 0 PLUMBING RI
❑ FOUNDATION 0 MECH RI ❑ OMPLAI FILLING
0 COMPLAI
❑ FRAMING 0 WATER HOOKUPNT
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE
❑ FINAL 0 PLUMBING FINAL 0 FIREPLACE FINAL
❑ SITE INSPECTION 0 MECH FINAL �❑ ,GASLINE AIR TST
COMMENTS: 1 ,�I-y
C
00
ORK SATISFACTORY,PROCEED
tli❑ ORRECT ACTION AND PROCEED
0 CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:
---aa(24.I________ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH(I SAFETY!
INSNOT!
oj�RI��P Date Rec'd
/ \ CITY OF PRIOR LAKE PLUMBING PERMIT
;t_.. \
z: cola c„Y PERMIT NO. /(a 837
3. Ycllow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
35 z.l �l tionnLy n(A)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT
(Name) 3 ab t. F/ 1,0. a (Phone) 1I0
•416
. ZZ vi
(Address) I X35 Ake d i KA ted, P19 w16t,tq., 1, ►' V ►ii 55 t/—
(Address) / (City) (Zip Code)
(Contact Person) 5 0416 (Phone) 116• ZS�J'►f1t«�
APPLICANT SIGNATURE tl�lil/I� p
! LaUttviAli— DATE ��� 0'1-Uko
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 Assembl Test
Bar Sink Lawn Sprinkler )
V.
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 $ 44- 50
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 5-6.51)
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 56, 5-66 Receipt Nc6 /„
/
Building Official Date Date i. ///7 s
24 hour notice for all inspections(952)447-9850 go By
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372