HomeMy WebLinkAboutPlg Permit 02-0901
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File I PERMIT NO ~
2. Gold City './} "\ _ i~ J.
3. Vellow Applicant (/~ V /
(Please type or print and silt'll at bottom)
ADDRESS 3\~:t SW:Ldi Co\:L ~ ZONING (office use)
LEGAL DESCRlt'uON (office use only)
LOT 1 q BLOCK I ADDITION c...n-rn::cIt ~ (/)/'1 k~ W ;+.//J, PIDd-5'" 311 ~ () /Cf-l. t
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~;;~~ANT 1\ -o..vOV\5
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(Address)
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(Address)
(Address)
(Contact Person)
(Phone) q6d - 410 - Oq lol
(Phone) l,l;} -RO\ ~6JtoO
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(City) (Zip Code)
(Phone)
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APPLICANT SIGNATURE
DATE
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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 $
~q~~
.50
L,f 0 0'7'
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
-
Paid Lj()/ cJU
Date~;:;:)_ ~
Receipt No. .~
U'd-50 '-'
I~~
U~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTI~ NonCE
SCHEDULED
131-C?3
S/zaclq CvuJ-f-
CJ
ADDRESS
3/3'7
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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COMMENTS:
o PLUMBING RI 0 EXIGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ( 0 GASLlNE AIR TST
o MECHF'"J-~~
l
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
'I //
GI05-
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL 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!
Il'iSNOTl