HomeMy WebLinkAboutPLUMBING PERMIT 16-827 DAT TIME
CITY OF PRIOR LAKE )/
INSPECTION NOTICE SCHEDULED 7 ZC, ! Se
ADDRESS 15
.3 Ca fad ® )L
OWNER CONTR.
PHONE NO. PERMIT NO. )67 ' ��
❑ 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
COMMENTS: z'o 1-1"4-K--,
kg-
›....W.211K SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: LQ
)......a Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
WSNOT!
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
rNH$S°'�
1. Bhm File
t,a any PERMIT NO. /4,_ 9 Z
(Please type or print and sign at bottom) 3. Yellow Applicant
ADDRESS ZONING(office use)
I�2AA0 e k OGS kaot PM LG,lkc i M,N 553 2
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION pID
OWN
(Name)ER M Uv� 'Gt (Phone) V 7- 1-1140-0--1(41(D
(Address) IC U(P t2-"wl, Oala boa 4 , pipule, tcat, 5312
APPLICANT
(Name) (t -frrLh i AV (MOW)uh(1/1 (Phone) 6/ --g35-
(Address)
-g3S'Address 11-41G
(Address)
(City) (Zip
Code)
(Contact Person) KCAAp/ (Phone) "f2��)Sl-1-1
APPLICANT SIGNATURE PUN L// 111'A //L
DATE i'1.27-1 W
APPLICANT PLEASE 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 Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
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 $ I1,60 Building Permit#
PLUMBING PERMIT FEE $ 41-S0
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 5 f7,rj(7
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid a r0 Receipt Nob 3 s a�/
4✓
DateDate 1 ' ( 1. /& By
sh
Building Official
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372