HomeMy WebLinkAboutPLUMBING PERMIT 16-1133 DATE TIME
CITY OF PRIOR LAKE l /b
INSPECTION NOTICE SCHEDULED ((I (1 1
ADDRESS 4.56 C I /9/1,4-04(t8 /,,,,,„:„
OWNER CONTR.
PHONE NO. PERMIT NO. 1 4 r /(`
3 3
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
* 0 INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0r`
COMMENTS: f'1 2 0 "
c `{
rORK SATISFACTORY,PROCEED
ORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: � �"" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
�� Yltlo Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
U trl
NN E S L Blue File I PERMIT NO. ,`('- //33 I
2. Gold City
3.Yellow Applicant
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS -
Ci 1 i p,.r-i .e Lc i LK SE
I
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION
OWNER (Phone) a �O'tr,
lir(Name) JA tea. & 1 C_f1�
(Address) 5 (1 1 kiM ado lei-e.Li L cSZ D anitfse
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APPLIC• t l `t '
(Name) \ A_ V AI \ _ c1111".1. L. (Phone)M� �"1`�� ,l`l
(Address)t�� `�v= , 1 I` _ ` ). Ci b r (Zip Code) 9
(Address) (
City)
(Contact Person) \VlS.K(.... (Phone) J C \
`3.I_�►�e k,. II •TE o?-1 k
APPLICANT SIGNATU -- ,
APPLICANXPLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I 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 i
FEE SCHEDULE
Industrial,Commercial&Multi family 1%of job cost with a$49.50 minimum Residential,New Residential,Addittiions&Alterationne& s $49.50
Estimated Cost $ #`a g .a) Building Permit#//
PLUMBING PERMIT FEE $ 7n' So
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 50.5-0
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ,s-Il v Receipt No. -7 0 +3
DateC9 Rta By) 1
Building Official Date t .�� '.
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372