HomeMy WebLinkAboutPLUMBING PERMIT 17-49 CITY OF PRIOR LAKE DATE
INSPECTION NOTICE
ADDRESS 3 -�-�- TIME
SCHEDULED 2 �, �7
1 �
4�.o
OWNER
CONTR.
PHONE NO.
PERMIT NO. `7 � C,
❑ FOOTING 0 PLUMBING RI
❑ FOUNDATION ❑ EX/GRAD/FILLING
❑ MECH RI 0CMPLAINT
O FRAMING
❑ INSULATION 0 WATER HOOKUP
0 SEWER HOOKUP 0 FIREPLACE I
F❑ FIREPLACE FNAL
❑ FINAL 0 PLUMBING FINAL
❑ SITE INSPECTION 0 MECH FINAL ASLINE AIR TST
COMMENTS: w WU-,
4
4 WORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
0 CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspecto ,
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOT)
04 pOH Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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4 ►Es°o Yel
Blue Fiilrye PERMIT NO. /7. 41
3.. Yellow
low Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
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LEGAL DESCRIPTION(office se only) it w
LOT BLOCK ADDITION PID
OWNEIt 1 / In
(Name) V �^� i 1�1,1. �{ C -�' Vv—t (Phone) lL( 370 d& ( I
(Address) < % .a-di
APPLICANT Np ce (. 1nections Inc.
(Name) 12&50 Chestnut Blvd. (Phone)
(Address) Shakopee, MN 55379
(Address) 95Z-44548U3 (City) (Zip Code)
(Contact Person) C,"j4A/11 6.- i-f (Phone)
APPLICANT SIGNATURE C----Ir - Y"- --le-' i 'i) A. f DATE //1213
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins •
Dishwasher _ i 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
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The Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended PLUMBING PERMIT FEE $ �g'
The minimum surcharge for a STATE SURCHARGE $ L W
"fixed fee"permit is
TOTAL PERMIT FEE $ 5-0 SD
This Application Becomes Your Building Permit When Approved Paid , S Receipt No. 7 .¢i
Date,
�Sy �-7 By
Bulidins Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372