HomeMy WebLinkAboutPLUMBING PERMIT 17-160 DATE TIME
TPROR LA
INSPECTION
INOTICE SCHEDULED 2123 /7
ADDRESS Li a r L , 1`Ok 4(.5\".,k--- 0.71r r
OWNER CONTR. ,1
PHONE NO. PERMIT NO. 17_ )(p V
❑ 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 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: WeittA /4A--
C[os..e ik .t- (.,
`Kl WORK SATISFACTORY,PROCEED
!�❑ CORRECT ACTION AND PROCEED
❑ CORRERK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr.
CALL 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
JNSNOTI
p4 13111% CITY
Rec'd
�� CITY OF PRIOR LAKE PLUMBING PERMIT
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1. Blue FliPERMIT NO. /6, d
2.Gold City '�
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESSZONING(office use)
!4 (a Fox Hunt CB-wrt
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER In �J �n /y Q �
(Name) V r b I f p bord S t�r v / �' l (Phone)C 15?') U Ej - tet"
V
(Address) 'tet 3CI ie MX 'HIM+ O,O1 1 C st
,PNIa3tInieANTC '1 V um I ' , 'n n ae`2 8si - t(-03) �V I ���1' ►' ` �WvY Y 1��)� (Phone) 1, J � �[f
(Address) 1 14-1,5 ,Sw Alto c_gj . NAL 5510 tje
Addr Ci
( � (City) (Zip P Cod )
(Contact Person) AtiVtAj (Phone)CLE17/)a-7--q0-33
APPLICANT SIGNATURE DATE _
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher V 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 $ VP 0,e- Building Permit#
PLUMBING PERMIT FEE $ 4-61 ,S_
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 50, 5.0
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ci) Re eipt No.(moi
Date By
Building Official Date Z, i ..iI
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372