HomeMy WebLinkAboutPLUMBING PERMIT 16-1295 DATE TIME
CITY
INSPECTION OF PRIORNOTICE LAKE
SCHEDULED (Z ( —
I
ADDRESS C- . r _ (` I `�5
OWNERCONTR.
PHONE NO. PERMIT NO. /12_—__A21. ----_
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOOTING 0
❑ FOUNDATIONMECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION
0 SEWER HOOKUP 0 FIREPLACE FINAL,E)- ❑ GASLINE AIR TST-FINAL 0 PLUMBING FINAL 0
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS: (A)akk- - 'lees—
___----_
eer
WORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
0 CORRE ORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
O�PRI) CITY
Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
V
Bcis Blue
PERMIT NO.
/6
type or 3.Yellow Applicant /' ' I ��'
print and sign at bottom)
ADDRESS ZONING(office use)
i4ri 'l\i i iN1 141,1k C+- ))L 653-)a
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)) 4
OWNER I 1 t coif)._ LX't 1 a- (Phone)() 1 a 0-g-6 14,k4
(Address) — 5Cili i lki2
APPLICANT Appliance Cum i ctlons Inc
(Name) 12850 Ct-lestnut Blvd (Phone)
(Address) Shakopee, MN 55379
gat ^45 4803
(Address) (City) (Zip Code)
(Contact Person) JO AA 1-e_ a. (Phone)
APPLICANT SIGNATURE -(, V.' DATE `C) ) •
APPLICANT PLEASE_COMPLETE BELOW
Quantity Type of Fixture Quantity _ Type of Fixture
Bath Tub with or without showerRough-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
The Minnesota Statutes§326B.148 \ $ Building Permit#
"SURCHARGE"has been extended �!� c-1�
The minimum surcharge for a` PLUMBING PERMIT FEE $ lit J C)
"fixed fee"permit is 3— STATE SURCHARGE $ LLOD
l,Do TOTAL PERMIT FEE $ , 'O
1
This Application Becomes Your Building Permit When Approved Paid �` � 60 Re
ceipt No. 2 O y
illumineine Official Date Date f I `, 4, i (a Bi
24 hour notice for all inspections(952)447-9850,fax(952)447245
C .
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372