HomeMy WebLinkAboutPlg Permit 02-1235
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
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I. Blue File PERMIT NO
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LEGAL DESCRIPTION (office use only)
LOT (7BLOCK '/ ADDITION /2;c;/td ~T
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OWNER
(Name)
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(Phone)
(Address)
APPLICANT IV1 f}"- . AA 11t: ; 'A-;-:c-IJ
(Name) / , IOtJIl.t ctf /vIODltC w.. I c:AL
(Address) /037b Ol-- qq a. A- Vt- . JO.
(Address) . .
(Contact Person) --1)ily'f ~ /) /L
APPLICANT SIGNATURE /h' 7/ (JJ
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
Dishwasher I 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
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PUi "C(}-a.) ~S-J71
(City) (Zip Code)
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DATE /d'-:<~a ~
(Phone)
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Quantity
Type of Fixture
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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'1 q~su
.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
40
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. Rectl~ toe
BY~
Date
Building Official
Date
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
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
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SCHEDULED
CONTR.
PERMIT NO.
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o PLUMBING RI 0 EXIGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
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d WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~T WORK CALL FOR REINSPECTION BEFORE COVERING
. 0 ;-02--
Inspector: /.- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI