HomeMy WebLinkAboutPlg Permit 02-0539
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
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ZONING (office use)
LEGAL DESCRIPTION (office use only) In ....
LOT If BLOCK I ADDffiON IY~P,PA7~~---'
OWNER 0 ,r rt ""' f2:; n' ",..J "
(Name) () \A)lAA' ~ r ~
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(Address) \ lt140 1r'ed.a.tt 'VlL1lf1,
(Address)
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APPLICANT SIGNATURE
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370 .
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(Phone) C{5~-L\l\l9-,5l5
(Contact Person)
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(Phone) ~- L06/01J 0
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(City) - (Zip Code)
(Phone) t{ ~, 4f1J'i/IJ;71 (J
DATE
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 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 PERMUT FEE $
~ ~. S-D
.50
HO- 00
(Office Use Only)
Building Official
Date
Paid J J ex)
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This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE ..~
SCHEDULED
DATE TIME ob
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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
FINAL
~ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~$~
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1i WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
- "1
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI