HomeMy WebLinkAboutPlg Permit 02-1239
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
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I. Blue File I PERMIT NO 1
2. Gold City . /') _I' ""') 3.
J Yellow Applicant ( AI ~
LEGAL DESCRIPTION (office use only) //7. /1 " ' ,1
LOT 9 BLOCK ( ADDITION ~&
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OWNER
(Name)
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. (Phone) Q5d' d.dlo- 434l(
(Address)
APPLICANT
(Name)
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(Address)
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_ (Phone) LP lJ -5$0\ ... 5~loD
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- (City) (Zip Code)
(Address)
(Contact Person)
(Phone)
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APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity I Type of Fixture
Bath Tub with or without shower I I Rough-ins
I Dishwasher I I Water Heater
I Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink I ,)( I Lawn Sprinkler
I Water Closet (Toilet) I 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 $
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
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.50
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Building Official
Date
Paid L/{)--
Date
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Receipt No.. . (> '.~
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/7 ).,).-'f
Lv-f/,J",rl7<SS ~ 7'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
COMMENTS:
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DATE TIME
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;2. -11-30/
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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iFWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Cf.-f----v-> Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!