HomeMy WebLinkAboutPlg Permit 04-0900
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMI..
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ADDRESS
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REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
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City
" Appl.,.,.
PERMIT NO.!) t.j -91XJ
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ZONING (olliceuae)
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LEGAL DBSCRu HON (office use ODly) bl _ --J ~ -" J /_
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(Address) J 4; a1 ~ ( ~ du.L. <13, I A..l J ~ ~ I mVl. S~ 3 ') J-:..
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AP(NaPmLIeC) ANT 0 J JJ ,~ ~JI n , _ . l^ .....
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(Address) XL/,?tJ ~ CR& ~"IhA'~, milt 55/0103
(Address) ---,.---' -. (City) (Zip Code)
(Contact Person) In IJ I'l1/ (phone) /,../.J.. - ~ c; - / r-~ L/ tJ
APPLICANTSIGNATURE YJ1tJ. .l!~ ~ DATE g'IJ..:t../oq
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r APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
Floor Drain I 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
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ d CJc.. ,."
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
..39. ..5D
.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
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By
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Date
Building Official
Date
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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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
~LUMBING FINAL
o MECH FINAL
DATE nME
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o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~/,-? REINSPECTION BEFORE COVERING
Inspector: /' ~.t-- Owner/Contr.
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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