HomeMy WebLinkAboutPLUMBING PERMIT 16-1118 DATE TIME
CITY OF PRIOR LAKE SCHEDULED Z`Zd �(
INSPECTION NOTICE
ADDRESS 11-1 V 49 oiv`G k oo (e "
OWNER CONTR.
PHONE NO. PERMIT NO.. I V 1.
❑ FOOTING 9RIPLUMBING RI V-�'/� 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP ❑40 FIREPLACE
FINAL
AIR NA
❑ FINAL j PLUMBING FINAL'/iS�
TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS:
WORK SATISFACTORY,PROCEED
❑ CORRECT A ON AND PROCEED
❑ CORREC'WO- ••LL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contra
CAL 'T•' FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
1:11,1
i%'IUO Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT �. `�
1. Blue File
2.Gold City PERMIT NO. /6 /f/ 0
3.Yellow Applicant
int and sign at 7bottom)
(ADDRESS iii g /�// ,,,,d,..1"-c)J 4-11 ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
ler•
' a' '' "V-31443 irl Co, /, ICEglue; '5'2 s •aJ,^0a8
(Address)
APPLICANT) Jr- �� � ��
o m (Phone) ?s-a- -2, 37- MDQ 8
(Address) /'_,_'-47, i i o) AO oieco.G `A.!!� ,5c3 2
(Address) (City) (Zip Code)
(Contact Person 4 (Phone)
APPLICANT SIGNATURE - DATE
A'PLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher _ Water Heater
Floor DrainWater 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 pt,(1 $ 7A-c,
r
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 $ 50
STATE SURCHARGE $
TOTAL PERMIT FEE $ ,..cO-de) # '15'
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 50.
5b Receipt No. 700 O
Building OfficialDate 7 b Dated 08l/ By ,aei___
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372