HomeMy WebLinkAboutPLUMBING PERMIT 16-1312 DATE TIME
CITY OF PRIOR LAKE SCHEDULED
INSPECTION NOTICE
ADDRESS I q 23 c -F LA. 1-4- 5 (L4
OWNER CONTR.
PHONE NO. PERMIT NO. 1
❑ FOOTING 0 PLUMBING RI 0 EXIGRAD!FILLING
❑ FOUNDATION
0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 00 FIREPLACE FIREPLACE RINAL
I
❑ INSULATION 0 SEWER HOOKUP
❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: i 0
(-- (c,S-P____ 44-t-- :L---( ;)
WORK SATISFACTORY,PROCEED
❑ CORRECT ACT ON AND PROCEED
❑ CORRECTlip ,CALL FOR REINSPECTION BEFORE COVERING
Inspector: ,� Owner/Contr:
TarCALL 447 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
o� T?Rro�
Date Rec'd
ti.. . 9
CITY OF PRIOR LAKE PLUMBING PERMIT
ES° Fiey PERMIT NO. fa — (3/2_
2. Gold Cit
3.Yellow Applicant
(Please type or print and sign at bottom) Z-
ZONING(office use)
ADDRESS GG -L
�-127J f ohv►f ,(h l-f I( Go 6 N6. "�Y'iO/' S3'
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
O(NWNE) 13.7/y R (774 4011 (Phone)
(Address) 1 y Z 3S f a 44.+•.4-6,4\-- (4-11( Co+.A." 4-- N E-, 'r'o'c r- L4.1.4.. IAA 1V1 S'b37 2
APPLICANT ry i ion
P1u1r )i n (Phone) v�� '(Name) ��� � t ' �' 123
(Address) Dodd 12D1.
*ft 0 .J m.
Address
(Address) (C , ) (Zip Code)(Contact Person) Jill Ciole.� (Phone) �S' - 134D
D
APPLICANT SIGNATURE DATE fofr.04
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 compastnient sink Sewage Ejector
_Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn S rin der
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New Residential,Addittiions&Alterationne& s $49 .5$149.50
Estimated Cost $ t . 0 0 Building Permit#
PLUMBING PERMIT FEE $ Y 7' SO
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ S O . SO
(Office Use Only)
y�--3 Reckipt No. �--I rJ
This Application Becomes Your Building Permit When Approved Paid ,J`J (J`,' By)
Date( �Y l, (le
Building Official Date VV
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372