HomeMy WebLinkAboutPLUMBING PERMIT 17-109 CITY OF PRIOR LAKE
INSPECTION NOTICE DATE TIME
SCHEDULED ..27.2.Ver/—
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ADDRESS < l d /
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OWNER
CONTR.
PHONE NO.
PERMIT NO. /21_7-
❑ FOOTING ��
❑ FOUNDATION 0 PLUMBING RI
0 FRAMING 0 MECH RI ❑ EX/GRAD/FILLING❑ INSULATION 0 WATER HOOKUP 0 COMPLAINT
❑ 0 SEWER HOOKUP 0 FIREPLACE RI
❑ FINALIE INSPECTION 0 PLUMBING FINAL 0 FIREPLACE FINAL
0 MECH FINAL �GASLINE AIR TST
COMMENTS:
4OVORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
0 CORREC K ALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTl
�'PRI0 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
sos�
. g`°` p''e PERMIT NO
3,Geld Ap
3.Yellow Applicant /7"'
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(Please type or print and sign at bottom)
ADDRESS' ZONING(office use)
111 1613 tiu 4 5 (-P n�ti) 1�,3
LEGAL DESCRIPTION(office use only) J„
LOT BLOCK ADDITION GVp,c1g 2() L _.:, x) PID Z 5-- it-o,) /— v
(Name)R l� 'V�___gl ) \)•C/1 \Oair Pi1� (Phone) (e/075-['?- .2-sdr--/
(Address)
APPLICANT
(Name) appliance COnnectiuns Inc. (Phone)
12850 Chestnut Blvd.
(Address) Shaknpee MN 55379
�,(Addre9$2-%45-480 (City) (Zip Code)
(Contact Person) i Aka.♦' �►a :1.... (Phone)
APPLICANT SIGNATURE 4f4.4lI4&. ! L / AI DATE o'�
APPLICANT PLEA E 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
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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
The Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended
The minimum surcharge for PLUMBING PERMIT FEE $ 447 sz?
"fixed fee"permit isr.$(�' STATE SURCHARGE $
040 TOTAL PERMIT FEE $ 5Q, J
This Application Becomes Your Building Permit When Approved PaidReceipt'No. Qa /7
Date z`. .` .....T By S
Buildins Official Date ZS
24 hour notice for„all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.P.,Prior Lake,Minnesota 55372