HomeMy WebLinkAboutPlg Permit 01-1165
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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ADDRESS . ~
5\9Jll7 \mt\\rI~ U 00
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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(Address)
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APPLICANT SIGNATURE J1-\I,l6LL
OWNER
(Name)
(Address)
UAktv
1. Blue File
2. Gold City
3. Yellow Applicant
PID 7.5-33~. om-O
(Phone)
QS9)-440- 4({D~
(Phone) qc.,{})--L1?Jc; /'1110,
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(City) (Zip Code)
(Phone) q~ (f. --'~?h/ /J;11(]
DATE tOil-tol
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I 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 Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
Quantity
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
(Office Use Only)
This Application Bec mes Your Building Permit When Approved
10 -"(lJ-d I
Buifding Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
-
Building Permit # 0/-6/ / ~
$ --3 t1.. CV
$ - .50
$ ~ .. (/f-/
Paid 41J . (f7)
Date
IO.../(P-O!
Receipt N4-t;7 / t.?
By fi1'
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
5/;)&
SCHEDULED, S/!1/ 0 z., 9,' 1 t)
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJ( -(I (i;~
o FOOTING
o FOUNDATION
o FRAMINGo@
o INSULA TI
h1fFINAL
6 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
o GAS LINE AIR TST
o
COMMENTS:
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AlWORK SATISFACTORY, PROCEED
10' CORRECT ACTION AND PROCEED
o CORRECT WOr;r,LL F:R REINSPECTION BEFORE COVERlNG
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI