HomeMy WebLinkAboutPlumbing Permit 16-1424 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED (1,i'L1,'(6
ADDRESS / 0 11gi
OWNER CONTR.
PHONE NO. PERMIT NO. f( , . 14 2`1
❑ 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 ❑ PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS: Z'�
cp WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: l � Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
p4 P
U Date Rec'd
NR-1°*
CITYOF PRIOR LAKE PLUMBING PERMIT
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1. Blue File PERMIT NO.
2. Gold City /6 „/ 4-24--
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
eLEGA\ io se-
LEGAL
L DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) G X\U�CC)C9, 95\1.1)5(-- (Phone)
(Address) J
APPLICANT � �
(Name)w� `ihT kW D\ f'Pe(07\1\011-}— (Phone) "469b— +`c
(Address) ;123 • • �►i c ►j 1(r. tcQ -{� 41\3 ` 1 2
(Address) Cj (City) (Zip Code)
(Contact Person)SC601Za9'1\ (Phone)
i •. A*__ j_io
APPLICANT SIGNATUR O.A LI_ 0� �is• iP
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APPLICANT PLEASE COMPLETE BELOWDATE
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 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 $
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ - ---CD
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid S -,5,-- . R 'eipt No. r I
Date B `P
Building Official Date (7j„ 4I 'l
24 hour notice for all inspections(952)447-9850 k_
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372