HomeMy WebLinkAboutPlg Permit 02-0888
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
7-/f.07-
1. Blue File PERMIT NO
2. Gold City .~l-09~
3. Yellow Applicant U
(Please type or print and si~ at lv~;"'_)
ADDRESS
6w.33 ea;;newClOo
~ I :
-
Nb
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT 4-BLOCK 3 ADDITION $/tND ~ 57H
PID 2,5- 2...3'9- ()3'-O
OWNER
(Name)
(Phone)
(Address)
~~~ANT ~ ~~ .I _j _ (P~ne) 7i;~ ,7;o/b-.1S77
(Address) ~33 a/~uJtJotr >"..j(}j_ ff1ldr# ~1-3-?l
(Address) (City) (Zip Code)
(Contact Person) .M /1/t1J ~< (phone)
APPLICANT SIGNATURE ~ .'H"'~L/ DATE ~
APPLICANT ~ASE 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 V 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 $ Building Permit # 02,. () e f fJ
PLUMBING PERMIT FEE $ ..J q. 50
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 40. 0 ()
(Office Use Only)
This Application Becomes Your Building Permit When Approved
~
Building Official
,.../ q...07-,
Date
Paid J~
~tJ , 0 0
Date
7,."...01-
Receipt No. A-A
~ 2.-5-rv
~~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
. LAKE
I~ NOTICE
DATE TIME
SCHEDULED 35d IJ .~
_~~5~ (ld~
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)Il FINAL
/0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Srtfv
II
~__ ~)J2 ~
COMMENTS:
I
N -PR-Y
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
fJwORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ _ Owner/Contr:
CALL 447-98~-~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/NSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl