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HomeMy WebLinkAboutPLUMBING PERMIT 16-1426 r`�_`.�/ DATE TIME INSPECTION OF PRIOR LAKE SCHEDULED 122 �4_-- NOTICE ADDRESSG CONTR. - — pWNER PERMIT NO. / ❑ EwGRADIFILLING PHONE IN 0 COMPLAINT 00 MECHRI PLUMBING RI 0 FIREPLACE RI ❑ FOOTING 0 WATER HOOKUP 0 FIREPLACE INAL ❑ FOUNDATION ❑ SEWER HOOKUP ❑ FRAMING 0 GASLINE AIR 7S7 ❑ INSULATION ❑ PLUMBING FINAL ❑ FINAL 0 MECH FINAL ❑ SITE INSPECTION COMMENTS: III © r WM'S y(WORK SATISFACTORY,PROCEED 0 CORRECT ACTION AND PROCEEDREINSPECTION BEFORE COVERING 0 CORRECT W•"" ' CALL FOR pwnerlContr: Inspector: .. CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE E. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HATH INSNOTI • Cl PR10� Date Rec'd 4I\I\ CITY OF PRIOR LAKE PLUMBING PERMIT pc t, . BGollaed FCity ile PERMIT NO. /6, _ def b 2. 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS 99 {LaZONING(office use) 36)6i Cr?sU Body ne LEGAL DESCRIPTION(office use only) f LOT BLOCK ADDITION PID ONE (Nam)R l70-ri Ka,mro• L (Phone)(61a) q63-4''197 (Address) 363. Cr -or r . L. ,, ID :, N 5 AP(NPLIC)ame) U ;,�j j_�rANT3 „,__ , �O fl Pl bi qi. (Phone) 151—3425 -1L-11) !�g 2 (Address) i • V i I, i. °O . 4'100 _f LSA" ma 123 (Address) C'( • ) (Zip jC�ode) (Contact Person) _Lid1 i C,ole1 (Phone) 105 t 21a S- 1'34�/ APPLICANT SIGNATURE ..'"..:ift DATE 6 a2-7'iit APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower RRou�gh-int Dishwasher i <�Water Heat Floor Drain Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compai talent 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 $ 5 00.00 Building Permit# PLUMBING PERMIT FEE $ 119/5° STATE SURCHARGE $ $1.00 TOTAL PERMIT FEE $ 54.50 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid SD.50 Receipt No. 7 4063 / Date i2 ((0`I( try Building Official Date 00 ( - 24 fll inspections 44 - (/ 4646 Dakotahournotice Street or.S.E.,aPrior Lake,(952)Minneso7ta 559850372