HomeMy WebLinkAboutPlg Permit 01-0565
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and si~ at bottom)
ADDRESS
I. Blue File
2 Gold City
3. Yellow Applicant
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LEGAL DESCRIPTION (office use only)
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LOT ~ BLOCK I
ADDITION W~~A
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OWNER
(Name)
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(Phone)
(Address)
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APPLICANT /"' A /' ~ )
(Name) (. () 6~ ~: . ~ ./
(Address) -H 7'/V .r".~ .;/
}Address) (City) (Zip Code)
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APPLICANTSIGN~TURE ~2 _#~ DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
(Phone)
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Quantity
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~q r 5"0
.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid
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Date 10 --- 1-0 I
Receipt No.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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CITY OF PRIOR LAKE
INSPECn". NOTICE
SCHEDULED
DATE TIME
Co.z.s.o I 4-: 00
.
ADDRESS
l524-; NAUT1CA CAt2-.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
COMMENTS:
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
~o FIREPLACE FINAL
GASLlNE AIR TST
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('- .ose
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(p - d-q- (!) {
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~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~l CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ \\w Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI