HomeMy WebLinkAboutPlg Permit 05-0997
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
(PleasetypeorprintandsipatL.",,) HOMEOWNER 01-06
ADDRESS
J4)h~ &wvieW Circ1LN(
~licant PERMIT NOtJS'- 1'97
ZONING (office use)
.
LEGAL DESCR1l" nON (office use only)
LOT 8 BLOCK I ADDmON~T ~_l~~?:
&~R t><LUJ Ro\-h en~ ... ... (Phone) Cf:)a- Yilo- M "I
(Address)~) W\nr'lov~ , .MlJ. c:3S31;)-
PID /'19- tJo3
APPLICANT lit') ,
(Name) H1' V I ~L(Jr'\iJ""~'S
(Address) 9(d] 0 1\a:klB..d,
(Address)
,...-5ContactPen;on) ~ ief\ ,
~l .PPLICANT SIGNATURE JJ.l>1tJ 0 I JLn
(Phone) -kf)' r ~\r)'5/ 13 ~ t)
~ M11J ~~~
(Phone) ffi I~ &) - '340
DATE ~J,~ Jb 5
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 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 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ d 00. 00
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~,~O
$ .50
$ '-ID. 00
..-!Office Use Only)
fhis Application Becomes Your Building Permit When Approved
Building Official
Date
Paid l./'o 1# ---
Date -? ~
/~- ,- J
Receipt ~ a6'~z,
BY~
U
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
4D.OO
C-P
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
lLI/ G L
f5cy (/~ '-' ./
CONTR.
OWNER
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
l-lk l-ful-v
COMMENTS:
~
/ /" I ....-
~ L-l un:
----
r:i
(l['c-
DATE TIME
_J iJoc,
~-'lq'7
l
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
)
~
~ORK SATISFACTORY, PROCEED
o CORRECT~CTIONANDP OCEED
o CORRECT ~O, OR 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!
INSNOTl