HomeMy WebLinkAboutPlg Permit 02-0378
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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4-/7-02-
I. Blue File I PERMIT NO I
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ADDRESS ~ 1111..3
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ZONING (office use)
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LEGAL DESCRL.t' nON (office use only)
LOT 9 BLOCK Z- ADDITION /1// IV 05~
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OWNER
(Name)
(Address)
(Phone)
APPLICANT J - - ~ (,1 '. .JI );
(Name) IA-fl!l ~T' (phone)
(Address) r:2t1 ?.. ~7 /A :uc..,~)J() ... ~ itA it'i:-'
(Address) (City) r --
(Contact Person) -I.... ':" I~<' ~ /-1 (P.hone)
APPLICANT SIGNATURE ~L /' ~ DATE
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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)
pr021jj~6".36
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(Zip Code)
~ ~//7 /<12-
,
Quantity
Type of Fixture
fi-
,
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE Sl.:I1EDULE
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
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # () Z -637f;
..39. 5V
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4<J_OCJ
$
$
$
Estimated Cost $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
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Building Official
4-- -/7 -02-
Date
Paid 46. 0 ()
Da!g j ,...., I
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Receipt ~.( 0,
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By !JJt<-,
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
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SCHEDULED
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.12J FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~.Jt- ~r' )
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........
A"T".
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o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK 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!
INSNOTl