HomeMy WebLinkAboutPlg Permit 04-0464
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
REQUEST FOR FINAL
INSPECTION SENT TO
(PleasetypeorprintandsignatL","..) HOMEOWNER 01-05
ADDRESS
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(ellow Applicant
PERMIT NO. otf -"L/ h4j
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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(City) (Zip Code)
(Phone)
DATE
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APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
I Floor Drain .'f.... Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39,50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $3950
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
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This Application Becomes Your Building Permit When Approved
Building Official
Date
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.50
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Paid L( 0-
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Receipt Noc; 0 ____
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIllE
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/6 '/77
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o ~R HOOKUP
~LUMBING FINAL
o MECH FINAL
COMMENTS:/ J /
~7~/
~~~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~RK SATISFACTORY, PROCEED
A-~'ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO EINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
,
INS/tOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!