HomeMy WebLinkAboutPlg Permit 04-0796
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
7 z..- ft ()~
<'lease
~. ~~~ ~!~ I PERMIT NO. 0'1-. 07t!J (p I
3. Yellow Applicant , 7
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
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I OWNER
(Name)
(Address)
(Phone)
APPLICANT " jJ f) ~ / 1 j~
(Name) S..J.C"f!< (L-lfrlt), ~~. .~ /7.) ~
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(Address) ~ ~lf/ /7c.z: .:; - lvi,
(Address)
(Contact Person) :} () /'1.)"'\
APPLICANT SIGNATURE
(Phone) ?--) 2 ;2 ...19 Cf /:J :2
le;/PJt(/~<S's-O{/r
(City) (Zip Code)
(Phone) CJS-.2.2 :3 '7 9/ ~ ')
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks I 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 $39.50
Estimated Cost $ Building P~rmit # 01-. 0 7'1 b
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:J ~.!fl.)
.50
;.O()O
(Office Use Only)
Building Official
Date
pai~, C/O
Date J...-
.'V,dT
Receipt NOf"7$
By
This Application Becomes Your Building Permit When Approved
24 hour notice (or all inspections (952) 447-9850, (ax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
ADDRESS
/S60?
DATE TIME
SCHEDULED ((~-
C~o/ de
.' \IF PRIOR LAKE
.t4SPECTION NOTICE
OWNER
CONTR.
&y'-7516
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 SEWER HOOKUP
~MBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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/WORK SATISFACTORY, PROCEED
A ~~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL F REINSPECTION BEFORE COVERING
Inspector.
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl