HomeMy WebLinkAboutPLUMBING PERMIT 16-1423 DATE TIME
CITY OF PRIOR LAKE SCHEDULED /42111/:7
INSPECTION NOTICE
ADDRESS 11138 ' • ul
CONTR.
Ter-
OWNER L-�
PERMIT NO. go
PHONE NO.
0 PLUMBING RI ❑ EXIGRADIFILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FOUNDATION 0 FIREPLACE RI
❑ FRAMING ❑ WATER HOOKUPPLACE FINAL
❑ INSULATION 0 SEWER HOOKUP 0❑ FIREFIREPLACE
AIR NST
❑ FINAL 0 PLUMBING FINAL I`GAS I
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
1111111
-"I WORK SATISFACTORY,PROCEED
/ ❑ CORRECT ACTION AND PROCEED
0 CORR ORK,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contra
Inspecto :
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
4 VRI)
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
44,INNVES°fir
F
2. (111:
led Blued CCiity j tit PERMIT NO. /
J /�2,3�'
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1'438 / (731v L )voJ 1 r 1 66S7�
31
LEGAL DESCRIPTION(office use nly)
LOT BLOCK ADDITION PID
(Name) (l OT rho 5 kid (Phone) 21.) '-79/- 7d5
(Address) '`,S Q lilAj2,
APPLICANT
(Name) Appliance Connections Ine(phone)
12850 Chestnut Blvd
(Address) Shakopee. MN 55379
(Address) 952-445-4803 (City) (Zip Code)
(Contact Person) I_ ( ' 0 ,I /r , (Phone)
APPLICANT SIGNATURE P 11111111111111
AW / I .11 DATE 1 (Sid-0(6
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher
_Water Heater
Floor DraiWater Softener
Lavatory(Bathroom SiStand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartmentSewage Ejector
ShowerBackflow Assembly
Sinks , Backflow Assembly Test
Bar Sink Lawn Sprinkler
ClosetWater . 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
The Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended PLUMBING PERMIT FEE $ 1747.
The minimum surcharge for a
"fixed fee"permit is "' STATE SURCHARGE $ L
l/v 0 TOTAL PERMIT FEE $ 5D 57
This Application Becomes Your Building Permit When Approved Paid Y t-t,--7 Receipt No..7l�(0o
Dater 2 By�
Building Official Date ((t9 `
/—**
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 V
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372