HomeMy WebLinkAboutPLUMBING PERMIT 16-923 DATE
TIME
CITY OF PRIOR LAKE SCHEDULED
141.4-“a
INSPECTION NOTICE
ADDRESS OX
CLL
CONTR. 2
OWNER _"
PERMIT NO.
PHONE NO. 0 EXIG" DIFILLING
0 PLUMBING RI 0 COMPLAINT
0 MECH RI 0 FIREPLACE RI
❑ FOOTING
❑ FOUNDATIONA0 WATER HOOKUP 0 FIREPLACE
❑ FRAMING 0 SEWER HOOKUP 0 REPAIR FINALTAL
❑ INSULATION 0 PLUMBING FINAL 0
❑ SITE
INSPECTION 0 MECH FINAL
❑ SITE
COMMENTS: l,J(X'3" I
` OSZ
WORK SATISFACTORY,PROCEED
0 CORRE ACTION AND PROCEED
❑ COR'
ORK,CALL FOR REINSPECTION BEFORE COVERING
ir
pwnerlContr:Inspecto '
7 9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.SAFETY!
CA
HEALTH
REQUIREMENTS ARE FOR YOUR PERSONAL
INSNOTI
-co' c° Z o9 -02,42-P P l/l Date Recd
� PRip�
e CITY OF PRIOR LAKE PLUMBING PERMIT
U
Q'
�rj�'NESo� 1. Blue File &
PERMIT NO. //-
2. Gold City / , q 23
3.Yellow Applicant
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS
31.3 ? lox-/ ii I ► o. i`I
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION
OWNER f2 (Phone) /.2L2_=___- 29A1--- 3-7-3—_
(Name) 8r�-X YL'
(Address) 3y-3--7 FOX- -t I l t'C �-�,/
1 �" 'py I_a_k e i i i„} 5 .5 3 7R
(Name)IG - YY-- — R , , (Phone) `15 2—70 7--106 0
'`�`�
ad-00 Vv A-k w t 3 61-1-11MS �� / ' Ai A) &S 3 3 7
(Address)
(Address) (City) (Zip Code)
I s (Phone) 7 1�U 7
(Contact Person) 4;_e 't'" Ja
Ili / ----
APPLICANT SIGNAT 'fYI `_. .� /
— DATE
APPLICANT PLEASE COMPLETE BELOW T��e of Fixture
T •e of Fixture Quanti
Quanti Rough-ins
Bath Tub with or without shower Water Heater
Dishwasher Water Softener
Floor Drain Stand Pipe(Washing Machine)
Lavatory(Bathroom Sink) Sewage Ejector
Laundry Tray(1 or 2 compartment sink Backflow Assembly
Shower Stall Backflow Assembly Test
Sinks Lawn S.rinkler
Bar Sink Other
Water Closet(Toilet)
FEE SCHEDULE
Residential,New One&Two-Family $149.50
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit#
PLUMBING PERMIT FEE $ it `19 -S6
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 5 5 U
(Office Use Only) eipt No.
This Application Becomes Your Building Permit When Approved Paid 1-7—D • '� (F ,3
Date ��. / 6 tRetrAc.
Building Official Date 0
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372