HomeMy WebLinkAboutPLUMBING PERMIT 16-0867 DATE TIME
CITY OF PRIOR LAKE ,� �I
INSPECTION NOTICE SCHEDULED `
ADDRESS '-� c g S `__2 F'/Ci D
OWNER CONTR.
PHONE NO. PERMIT NO. \(p.. F3(t'7
❑ 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 ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL `
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COMMENTS:
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WORK SATISFACTORY,PROCEED
❑ CORRECT 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
`)/71, `f' Date Rec'd
; / \ `, CITY OF PRIOR LAKE PLUMBING PERMIT
UI/ i, \its
I. Blue
God City 2. Gold CitPERMIT NO. /6, _ 6) 7
3. Ycllow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name)
(Phone)
(Address)
APPLICANT 1^ `�
(Name) a �ve, 10lb(9 u 1�1.�'/� (Phone) -1y 16115 ' ZZGei
(Address) le---3535 M1 Q.l itk, , 101 r i'l', t / r)A G-)5 4471
(Address) (City) (Zip Code)
(Contact Person) S (Phone) 11/0j - 2-63-1418V
APPLICANT SIGNATURE _ � A L 4. �r DATE 1- 2$• zuGo
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rou.h-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 VVD
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 $ IPS—0
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ `5 0.50
(Office Use Only) •
This Application Becomes Your Building Permit When Approved Paid ?) Receipt No 42 —7
Date�� Z / B (0 r !�
Buildinrt Official Date .
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.R.,Prior Lake,Minnesota 55372