HomeMy WebLinkAboutPlg Permit 01-1235
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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I. Blue File PERMIT NO t-'
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(Please type or print and si~ at bottom)
ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT") BLOCK,"3 ADDITION-KfJcJb
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OWNER
(Name)
(Phone)
(Address)
APPLICANT
(Name)
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(Address)
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(City) (Zip Code)
(Address)
(Contact Person)
APPLICANT SIGNATURE ~~
(Phone)
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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 Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink X. Lawn Sprinkler
I 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 $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
3Q,50
.50
40.0 ()
$
$.
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid $ LfO) [X)
Date {[-I--I
Re~6;o& d-
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE nilE
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SCHEDULED
CONTR.
PERMIT NO. 6 L - \ 2-3 S-
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL 0
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~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~A-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
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