HomeMy WebLinkAboutPLUMBING PERMIT 16-0962 CITY PR LAoar
INSPECTIONOF RIO
NOTICEKE TIME
SCHEDULED 9.
ADDRESS —.
! 4°. 1
OWNER
CONTR.
PHONE NO.
PERMIT NO. Rd , G1(, L
❑ FOOTING 0 PLUMBING RI
❑ FOUNDATION 0 EX/GRAD/FILLING
0 MECH RI 0CMPLAINT
❑ FRAMING
❑ INSULATION 0 WATER HOOKUP
0 SEWER HOOKUP 0 FIREPLACE I
F
❑ FINAL PLUMBIN FINAL ❑ FIREPLACE FNAL
❑ SITE INSPECTION 0 GASLINE AIR TST
❑ CH FINAL 0
COMMENTS: TI— e , % . „
I
411.
ilya , i
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:
O
il
wner/Contra
CALL 447_9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENT S ARE FOR YOUR PERSONAL HEALTH&SAFETY.
/NSNOT!
,o"-;,R, lo� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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rNNESoy
I. Blue Filo PERMIT NO. /6, 96,�
z. cola City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5350 S�ore`T—r& l 1 .E .
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) r ce, ' ,t ?rctcw (Phone) t IL 508 (2.55
(Address) 5350 5horG l a.i1 1 • . , }Pr'tos Let Le
APPLICANT
(Name) t P l H Pro—P1 ocu 6-I k t I[ . (Phone) 615 2. 4'C R Io et¶9
Address S5I 5 20 -b4 5-E LalcemI le 5504- ti-
(Address)
R
(Address) (City) (Zip Code)
(Contact Person) D elo (Phone) q92- 4G9 �o R a R
APPLICANT SIGNATUR. _ DATE 8 ' 8
APPLICA T P EASE 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 I Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
1 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 $ 4q.50
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 50.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 1--D ,7'1 6,6 Receipt No.
,DV12
Date D I W By
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372