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HomeMy WebLinkAboutPlg Permit 02-1349 Date Rec'd CITY OF,PRIOR LAKE PLUMBING PERMIT I, Blue File 2 Gold City 3 Yellow Applicant ADDRESS ., .s E LEGAL DESCRIPTION (office use only) LOT' BLOCK ,5 ADDITION PID o OWNER (Name) (Phone) -3 hI) tft-/l 10 l.J I (Address) APPLICANT (Name) CULLIGAN WATER CONDITIONING 6030 CULLIGAN 'NAY MINNETONKA, MN 55345 (AdA~) 933- 7200 (Phone) (Address) (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE 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 I 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 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Estimated Cost $ I) 00. ~D Building Permit # PLUMBING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ ,~q. EJO $ .50 $ -'0. DO (Office Use Only) This Application Becomes Your Building Permit When Approved Building Official Date Paid ... ______ Lj{J, Date/L. 0- 0- .- .. 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS OWNER 17o/LI DATE TIME SCHEDULEP /O"'~r q .' 0 () W, tel 1',- YlCS> II- CONTR. PERMIT NO. J-- ( 14 q PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULA nON o FINAL o SITE INSPECTION COMMENTS: 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 GASLlNE AIR TST o MECH FINAL 0 We,.( 4/,gfT@ ( t6Sc hilL fWORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: r1f 10 "'t.5 -0'- Owner/Contr: , CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH de SAFETY! INSNOTI