HomeMy WebLinkAboutPLUMBING PERMIT 12-0556 DATE TIME
PA
INSPECTIONCITYOFRIOR NOTICE SCHEDULED l
ADDRESS 2 U U D ( (�
OWNER CONTR. ll
PHONE NO. PERMIT NO. I Z CJ-?°
❑ 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 0
COMMENTS: W ar-
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC''ORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: / Owner/Contr:
CAL • -•:50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD EQUIREMENTSARE FOR YOUR PERSONAL HEALTH&SAFETY.
INSNOTI
lPc,
RIOT Date Rec'd 3
CITY OF PRIOR LAKE PLUMBING PERMIT
IU
/ /
�vxss�t 1 Bk* �e PERMIT NO. (�7
3 2 .D
3.Yellow Applkwa 4
(Please type or print and sign at-bottom)
ADDRESS ZONING(office use)
LEGAL DESCRIPTION(office use only) ,
LOT BLOCK ADDITION PID
OWN(Name) — \�,;C/ , j
01A ✓-1 (Phone) S' /' 1/7
(Address) Cl,rin..(4..)
APPLICANT Appliance Connections Inc
(Name) 1313 Dan;ta Cr (Phone).
(Address) Shay- " m 5537p
(Address) e�, av a a. ( ity) (Zip Code)
(ContactPerson.Z)(. (01e, Rj e,) 952-445-4803 (Phone)
APPLICANT SIGNATURE I.#A 111 AAV ��_ DATE 5 1c)"6 Q—,
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with on 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
FEE SCHEDULE
Industrial,Commercial&Multi-family I%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
1st $ Building Permit#
"SURCHARGE"has been changed for one PLUMBING PERMIT FEE $ 1� `-�
year effective
July 1,2010,until June 30,2011. STATE SURCHARGE $ Or
The minimum surcharge fora"fixed fee"permit TOTAL PERMIT FEE $ '11111P Ilb
is l3eginaiag July 1,2010 •'
This Application Becomes Your Baildiug Permit When Approved I Paid 54Recei No. L,Li�1
pate/ �>
Midis/Of idal Date tl- �( _ ,L_..
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 7
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 -
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