HomeMy WebLinkAboutPlg Permit 01-1033
CITY OF PRIOR LAKE PLUMBING PERMIT
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(Please tvDe or Drint and sie;n at bottom)
ADDRESS
"33~J G,/"nLAhf~' (~I N W
.
I
LEGAL DESCRIPTION (office use only)
LOT I BLOCK J../ ADDITION
OWNER
(Name)
(Address)
7J-~ '-'.
,
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APPLICANT
(Name)
(Address)
(Address)
/033
~. ~~ ~!~ I PERMIT NO.O,J_ I()3:_
J. Yellow Applicant "_
( 312\
(Phone)
ZONING (office use)
1 ;;)-SD
PIDd 5- 3Sd. 7J1t,-()
9S'.J /,2e:J f., - '77' /Jtf
(Zip Code)
(Contact Person)
APPLICANT SIGNATURE ((~k ~4AJ [1d
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
q4rn~ ~
V V
lER CONDITIONING
GUL.L\GAN WA.uLLlGAN WAY (Phone)
~OJ~T'ONKA, MN 55345
MJ (952) '93S-720C (City)
Quantity
(Phone)
DATE qAh/
-,-.-: ',;
Type of Fixture
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 $ (J. Do !!-
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
Building Permit #
$---.2ct.SLJ
$ .50
$ ---!iLJ m.Q
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Date9~_;~_{)J
ReceiPjf!J5 q 3
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SCHEDULED
..JllRESS
3'j? I
~y~.
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WA T HOOKUP
o S HOOKUP
o BING FINAL
CH FINAL
COMMENTS: j_\-'. ()
DATE TIME
I~O!oL '1:3'0
. I
t)t-/dj'3
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
!6 WORK SATISFACTORY, PROCEED
o CORRECT AC~N AND PROCEED
o CORRECT ~ K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: I , Owner/Contr:
'<-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI