HomeMy WebLinkAboutPLUMBING PERMIT 16-1404 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED I218 C(P
ADDRESS 3a.((-1 i Ls' ut.)0
OWNER CONTR.
PHONE NO. PERMIT NO. 7 ./ 74-64--
❑ 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 0 PLUMBING FINAL ❑ G�Aqq S INE All?TST
.�UJ� t
❑ SITE INSPECTION 0 MECH FINAL +t`J
COMMENTS:
4
010‘742, 1. (--/-,
WORK SATISFACTORY,PROCEED
O CORRECT ACTION AND PROCEED
❑ CORR ORK,CALL FOR REINSPECTION BEFORE COVERING
Inspecto : Owner/Contr:
CAL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
PRIp,f, Date Rec'd
r~ (� CITY OF PRIOR LAKE PLUMBING PERMIT
U to
kNE50
I. lue File PERMIT NO
2.GoldlCity .p /
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
37- 1q `T w.b-ertduv
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER(Name
o r S (Phone) (L 2 - 3 7- 2393
(Address) • 2 � w—�-t�W o�� C �v t t r v✓ Lc-14-
APPLICANT c-14-APPLICANT _ \ O
(Name) /U U c``o 0 v"._ �,c w. 1 (Phone) ,) 2 - Z-� 3 3
(Address) I S 5'e- , W` S( o
(Address) (City) (Zip Code)
(Contact Person) S —e U (Phone) 6 Jam/ / t 5
APPLICANT SIGNATURE - DATE / 2-/2// 6
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 Assembly Test
Bar Sink Lawn Sprinkler
i 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 $ , SU
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ SO . TO
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid &j \5�\U ✓ Recei No. el r7 Cf
Date( ")lJ t By J
Building Official Date ` ''°I(0
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372