HomeMy WebLinkAboutPlg Permit 02-0823
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMJT
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2. Gold City
J. Yenow Applicant
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I PERMIT NO. ~-~1
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ADDRESS
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ZONING (office use)
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LEGAL DESCR..il-'uON (office use only) k
LOTP;LOCKI ADDITIO~~cJ~cO~ID~5"'07J/-Ot>~-V
OWNER
(Name) C.,t:..ffi\(\ (\\~-u1\~
(Address)
(Phone) -.!:J L.{ 1 - ~ '-Ill
APPLIC1Jj,T \ '~
(Name) ~\Q.t1\\V\ 'ffiP('~~o.~ CM\fnr-W$, U\t.. (Phone) ~)~~D~ 4S.{loCb
(Address) lal-loq CDu(\\-c.A..~. \\ 'B\'(~\\ll\.LL ~,::>3~ 'r
(Address~ (City) (Zip Code)
(Contact Person) -:b\\f\ & c..:Nurdo("-G- (Phone) ~~\~ ~ fJ..."f\,^ - ~ L\
APPLICANT SIGNATURE DATE \oj p\ to l/j 2-
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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 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 $ _~ q . tOO
Building Permit #
Building Official
Date
$ sq. be
$ .50
$ 4O,~(L
Paid ~ 1ft) ten)
Date 7-f-tJo
Receipt Ua3 8 f
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PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
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Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl