HomeMy WebLinkAboutPLUMBING PERMIT 16-0961 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED C1 J 12 Jc
ADDRESS (72'-') LI ill e),14-4-4'
OWNER CONTR.
PHONE NO. PERMIT NO. 11- -6
❑ 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 t�, GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL �j
COMMENTS:
C `.-
0-0 WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:C(�.(d., , ' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY.
INSNOTI
(01„1171k-
Date Recd
CITY OF PRIOR LAKE PLUMBING PERMIT
F
V
sa't° 1.caBlue Fite NO. G�
3PERMIT.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS • ZONING(office use)
09,84 tlicwStiheld La 553'7 a
LEGAL DESCRIPTION(office use only) •
LOT BLOCK ADDITION PID
•
1 OWNER `, '^
-(11/4I--e) _ _ Ul Aav vC'/ (Phone) 95?-,(Yo--7-58 14
(Address) — c( V- J _
APPLICANT _Appliance Connections Inc -
e) 12359 Cl,t-%tnut Blvd (Phone)
(Address) Shakopee, MN 55379 -
t (Address) 952-44 J-4803 - (City) (Zip Code)
(Contact Person) v U� l�� - �`)'�1�, - _ (Phone)
APPLICANT SIGNATURE - ,A(„ l.(. DATE e 1 ).•
APPLICANT PLEASE COMPLETE BELOW `
Quantity - Type of Fixture Quantity Type of Fixture
Bath Tub with or without showerRough-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 SCHED!3LE
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
The Minnesota Statutes§326B.148 $ Building pernut# .
"SURCHARGE"has been extended PLUMBING PERMIT FEE $ 4141
The minimum surcharge for a
6919
"fixed fee"permit is STATE SURCHARGE t� I
t o o TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid R-r)
Receipt No. bq3
Date ` 24
A vii By ,
Building Official Date �-`i'
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 .