HomeMy WebLinkAboutPlg Permit 01-0140
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and si~ at bottom) /I
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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(Address)
~~;;~~AN~;7" ~~ t~
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!))- If 1- (J ~L !J-l~ ;f; \
(Address)
(Contact Person) ,Ktfh \.r wI~ ,
APPLICANT SIGNATURE f!d~/aPA
(Address)
I. Blue File
2, Gold City
3. Yellow Applicant
I PERMIT NO.OI-Ot40
ZONING (office use)
PID
(Phone)
tt/2 :5!1C) 7~/.J- I
(Phone) LI / )
IIiw Jwu
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(City)
s~ 1/ rP .JJ-~
,G--VJP
(Zip Code)
(Phone) /1 J)SJ t/ ~~;JI/
DATE '3 - --5-=cJ /
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (l or 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
--,
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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 se nip)
hb p t jlec~ Yon. Bnild;ng P"m;' When App,"ved
/ 'S,~-~
u i fficial Date"
Building Permit #
$ "3q. s7J
--'-
$ .50
$ U Ii _ ir;
I
Paid
Receipt NO~t)Uc.-
BY(//7
Date ? I~J
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
'DAT~l.
S~HEQUL-tD ~i t{;; J!2 r
J55S-~ ~{'oc> L,C.rLe.-
TIME
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(')/-440
-- .
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HO IL
~WERH PIT
PLUMBI INAL
MECH L
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: .J
U)o:r-er-
,
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: (t; _V fJ.).).[J Owner/Contr:
CALL 447.9850 FOR. 'HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI