HomeMy WebLinkAboutPLUMBING PERMIT 16-1460 DATE TIME
CITY OF PRIOR LAKE SCHEDULED 2�
INSPECTION NOTICE
ADDRESS LI 20 s
ack-s L-V. 0.,
OWNER
CONTR.
("J.—(---ZZ—‘9 —
PERMIT NO. L -'
PHONE NO.
0 PLUMBING RI ❑ EXIGRADIFILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FOUNDATION 0 FIREPLACE RI
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE FINAL
❑ INSULATION 0 SEWER HOOKUP 0 E NE AIR TST
❑ FINAL 0 PLUMBING FINAL 0
❑ SITE INSPECTION
0 MECH FINAL
COMMENTS: 1 le
1
kORK SATISFACTORY,PROCEED
❑ CORRECT ACTT•N AND PROCEED
❑ CORRE' WO-I; ,CALL FOR REINSPECTION BEFORE COVERING
OwnerlContr:
Inspector: . 1'
CALL 447-8850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
0 PRI0� Date Rec'd
r�,\ ; CITY OF PRIOR LAKE PLUMBING PERMIT (o
U � C:f
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I.Blue File
2.Gold City /PERMIT NO. ! ( �r
l/(7 , /7
3.Yellow Applicant !! YYY��� 444
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
IHiaO Ha-a4 l.cocc. cir {Z
LEGAL/ BLDDESCRIPTION(office use only) r-_ l
LOT sign/ ADDITION 141( L44-5 R. / 1 PID 2-e-I/®'X"`®Q i 'b
OWNER
(Name) Law a Solnricr (Phone) 45a-133-,27
qcs
(Address) H i p 1.10.0.1 fare cif'
APPLICANT G1irnpi
o 1 l Plum b I 1 l Phone( ) U51-30-11-10
(� (�y� eC
(Address) 1 R odd . 100 1 1 n l c� I2
(Address) (C' ) (Zip Code)
(Contact Person) i I Ile (Phone) COI 31o5- 1' 4t
APPLICANT SIGNATURE _ �� •
e DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Tie of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher i rater Heate>
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 $ Building Permit#
PLUMBING PERMIT FEE $ 14%.50
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 50.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 0 Receipt No. /j 15'5—
Date By
Building Official Date I Z% o. (/
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372