HomeMy WebLinkAboutPlg Permit 02-0824
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and si2I1 at bottom)
ADDRESS ZONING (office use)
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L Blue File PERMIT NO~~_~d4\
2, Gold City
3. Vellow Applicant
LEGAL DESCRIPTION (office use only)
LOT cr BLOCK ~ ADDITION
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OWNER
(Name)
(Phone)
(Address)
APPLICAl'ff
(Name) \~lCl.m.rrLJnftrunko. \ ('fJ.f\\-fQC~) ~r.. (Phone) _(g~) Ji91)-l../~lox
(Address) J2!J!JCf rDV(')-t-lj ~. H. ~lrCffi'l \' \\.-e". 523~ '/
(Address) (City) (Zip Code)
(Contact Person) 'Jo'h" ~r.f (Phone) f/!1'J..."pa. -0001.../
APPLICANT SIGNATURE DATE ~! U!tJ-z.
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Type of Fixture
,
V
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I 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 $ ~. 50
Building Permit #
PLUMBING PERMIT FEE $ 3Cf ~SD
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 4/).00
(Office lIse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
P~L/D crO
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Rujy~N~~
BY~
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF P~ LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED / -31-QJ
d9{)z) ?o,(f?~
CONTR.
PERMIT NO.
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o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL r- 0
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I
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~SATlSFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ