HomeMy WebLinkAboutPLUMBING PERMIT 16-0895 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED I 1 �l7 lc
ADDRESS 4 I qb p (zot Ca id 5,-,1
OWNER CONTR. /
PHONE NO. PERMIT NO. /6 - S'CI 5
❑ 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 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 91
COMMENTS:
4VORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: �g.).— Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
4' 1) 50.,_S-D 2-016
'oJJV 3 Date Rec'd
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;_N-,1 ,1°* YL-cCITY
ING PERMIT OF PRIOR LAKE PLUMBING
1.417VE OS.
2.1.Blued FCity ile PERMIT NO. /G , g 95'
Gol
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
`/i q �j4d A St
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) h gyros (Phone) / $ —O VO/h
(Address) L/i 9 r .e�_44,,. - se 61.i t LL2 k 1 41
APPLICANT
(Name) he(-� /{'12—I ( ( (Phone) 95a 67-100 0
(Address) 2200 \N i-twq 13 '-X f6V41- 1 )(YIN 55331
I ,� ` ,(Addres ) (City) (Zip Code)
(Contact Person) 1 CUA. LQ ba A S . (Phone) q 5,Z--- 6a 7 /10 7
APPLICANT SIGNATURE AIM . A. 0 AL .= DATE -7/29/k7
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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
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 $ 4-/(3,5-0
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 5 t7 . S'0
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid .5.--b /6---0 Receipt No. G 573/
Date c/i 1�„ By
Building Official Date 0
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372