HomeMy WebLinkAboutPlg Permit 01-0618
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
ZONING (office use)
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
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D~
LOT
BLOCK
ADDITION
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PIDZO ..-350,.003 - I
OWNER
(Name)
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~~;;~~ANT I~~ c:: ~~ __ . (Phone) ~!;z..r- ~:.;>s--; ~':)-:;cL
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a:ddreSS)/1 11/1, ~
(Contact Person) ~ I A, -r- ~ --{Phone) ~,o'2.... ~ r'~ oS --5 ? ') d
APPLICANT SIGN~~RE . 0 - - DATE
(Phone)
95;).. - 'YS/- .y-,i/')
, -
(Address)
(Address)
(City)
(Zip Code)
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
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
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
(Office Use Only)
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 39.50
$ ~50
$ ~_ Ii () -
,
Date
paid40 .I Q()
Date
&. r,O -01
Recei~91 34=-
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE
TIME
!O)~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED 7-~ - CJ /
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CO~.
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
l~ to I Y
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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{j . t:Y
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/I--JJ
.....
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK,'CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ \ ,j).A1!.) Owner/Contr:
CALL 447-9850 FOR TJE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS~RE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI