HomeMy WebLinkAboutPlmg Permit 01-1424
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
.
i 2-- 2 (,-0/
~. ~~~ ~I~ PERMIT NO.OI/_IJ 'ZJ J
3. Yellow Applicant I '-r "'r
(Please type or print and sign at bottom)
ADDRESS
,
IJ;L 10
Roc 1rcU \ i1'
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~~e~R ~11l WY1 1ffin f 0;
(Address) ~4( 0 ~ ~ -1 VT1( 1'v:
~~;~~ANT ~A t)y) ffiLWJr
(Address) J1JrlL(O 1iRdr1rJd 11101
(Address)
{Contact Person) ~.~ rMtfY
APPLICANT SIGNATURE
(Phone) qt1l\- 9J~{f-~ro
(PhOne)~~L[W-" ~77D
, {It(JV\\l p_ -' . ~V
(City) (Zip Code)
(Phone) .t1 Vf))- If/J0.. /lf77D
DATE
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Residential, New One & Two-Family
Residential, Additions & AIt~a/ns
Building Permit # 0 1- 1 tf z... 't
3 q. )"0
.50
4-0 - LV
$99.50
$39.50
Estimated Cost $
$
$
$
(Office Use Only)
This APp~n' Bnildmg tl:~tiZ':J'i...ved
Building Official Date
paid1<J; UV
I Date[2,__~' 0/
fi I~ /
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULE~ 2.2/-02- /:3LJ
ADDRESS :3 4/ () Fox miL 77~
OWNER CONTR.
PHONE NO. PERMIT NO. o ( ~ / 1-"24-
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
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
M. GASLlNE AIR TST
'1 t- () So ,.-,-
I I r .
COMMENTS:
6lK
/
rORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~K, ~ ALL FOR REINSPECTION BEFORE COVERING
Inspector: p... Ja.A.N Owner/Contr:
CALL ~7-9850 FOR Tk NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl