HomeMy WebLinkAboutPlg Permit 04-1183
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
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i: ~': ~~ I PERMIT NO. """- ..1. .{4 ?
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ZONING (oftkle lIIe)
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APPLICANTSIGNATU~.L DATE /l//d//5l-I
r""""-', t/ APPL~CANT PLEASE COMPLETE BELOW
~ I' Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
I Dishwasher Water Heater
I Floor Drain / Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I 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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
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,50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
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Date / I. 2 2 ..{j f-
Receipt No. ~~:J~.s-
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE Tille
CITY OF PRIOR LAKE l~
INSPECTION NOTICE SCHEDULED
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ADDRESS ~m
OWNER CONTR.
PHONE NO. PERMIT NO. 4-118'?
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL vt~~~~
o SITE INSPECTION o MECH FINAL
COMMENTS:
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k1iORK SATISFACTORY. PROCEED
o CORRECT ACTI AND PROCEED
o CORRECT R ALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
1NSNOTl