HomeMy WebLinkAboutPlg Permit 05-0700 & 701 Oversize Plan
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
7. Z~O._ d .1'--
1 Blue File PERMIT NO
2 Gold City . O~~ {j 7 () 0
J Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/4' 7 :?-C~ t1/ff/Dt!/?f?(. ~'/I
, ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25". 1-'/8 _ (I~9 0
OWNER
(Name)
(Phone)
(Address)
APPLICANT
(Name) ~.e-A-- Zc.- I
Plvn-tJ ,,:~
"
jZJ/~.,- ~v!
(Address)
(Phone) .iL. <;J- J..f5(2 - IS 6 ~
;3:,.:-"""_ ,C).5' d.-i
(City) (Zip Code)
(Phone) S~vrt-<-
DATE 7 -.;)..cr- c}/, c
(Address) I 71d'
(Contact Person) J:r-e-vf /It:#.~'''''''''''-
APPLICANT SIGNATURE ~ ~
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
I Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall /.-J Backflow Assembly
I Sinks ( I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) 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 #
PLUMBING PERMIT FEE
...
STATE SURCHARGE
/ TOT AL PERMIT FEE
(Office (J09;,~ /, ~ _ I l'
11j~~undingp'7(;:t~OVed :::.40..uV ~
B";Id~ ___~ I D"r 7. z.c /" (
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
$
$
$
]1jV
,50
tf-1J ,J/U
Receipt No.
4- l' r~J
By ,-1.
C/
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I While
Pin\.;
Yell()\~
File
eltv
'\l'pIIClllt
(Please type or print and si~n at bottom)
ADDRESS
---
(!.->/
/4-7 It
Iv/T12;7t..H~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
i BUILDER
(Company Name)
(Contact Namc)
(Address)
[A/ ~A,J ~
(Phone)
(Phone)
TYPE OF WORK 0 New Construction OOeck OPorch ORe-Roofing
OAdditlon OAlteration o Utility ConnectIon
Date Rec' d
1 .--
. z, () < C-(
PERMIT NO. OS--' (, 7V /
ZONING (ollin' lIse)
PID 2~-_ <fIr, 08 Z 0
&"'~/. ~rL~_~=4-_.L I
fler&L-
ORe-Siding OLower Level rll1l5h
/0
. .-
CODE: OI.R.C. Ol.B.C. ~MISC
Type of Constmction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
I hnctly certify that I have furnished lOf()rm,ltltHl un this <lpplicaoull which IS to thl' best Dr my' knnv\dcdgc true and correct I Jlsn certify' that I am the ()\\'Il1'1 Ill- ;Iutll\lrlzed ,lf~l'n! Ill! tIll'
abllv<>mcntlOl1ed property' and that all construction will confurm to all eXlstlllg state and loCJ1 "\\\'5 and \\'ill proceed in accordance with submitted plans 1 aIll ,IW<Ul' that the bUilding
nft!Clal can revllke hiS permit hH lust GlUSe Furthermore, I hereoy" agn.'C that the City: official or a dl'slgnee may enter upon the prnpclty' to perform needed IllSpcctl\\IlS
~~_ ~____________n___n n 2:_~~~~
Srgnature Contractor's License No I ),IlC
Permit Valuatton
Park Support Fee
Permit Fee
$
$
$
~.
Water Meter Size 5 8'(J'\,/
Pressure Reducer
SAC
Plan Check Fee
State Surcharge
Penalty
Plumbmg Permit Fee
Mechamcal PermIt Fcc
$
Sewer/Water Connecl1on Fee
$
$
\Vater Tower Fcc
Builder's DeposIt
Other
Sewer & Water Permit Fee
,
1 s
I
! $
<:" / /
uuumg renni~ Wht APP1v~
, /""b/o l
IDate: /
Paid :]00, ut..)
Date 7 U.,I"j--
TOTAL DUE
Gas Fireplac~ermlt Fee
11/1 d
Thi' ~l!g m" Y
#
#
! S
:\;
#
#
s
s
S
$
300 (;()
i
-------1
--~
I
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I
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---- --- - ...- P.-j
5300 UU 1
_..___._._.~_..___'~_.______._J
i S
s
Recclpt No
B~
4lQ1=
ThiS IS tll ccrt1f\' that the request III the llD\l\'e <lppl1catH)!1 and ;lccompanYlllg dllCumcnts IS 111 aCTlH-lLlncl' With tlte CIty' I.lHllng Ordltlance and 111(1)' pl()Cl'l'd ,is rl'qul'\tl'd nlls (\\)('UnWnl
'.....'hell signed hy the CIty PLuHler ((JIlstltlltes J temporary Certificate uf ZUllIng compliance and ;ll1llWS constnlctlon tll cummCIlCl' Bcfurc l)CCll~l,lllCV, ,\ ClTtdicltl' (If ()cnlp,lllc'y' must be
!.\slll'd
Planning Director
Date
2-1 hour notice for all inspections (952) -I-I7-9S5n. fax (952) -1-17--12-15
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if an)'
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
IO(~l 6"'"
l
TIME
ADDRESS
fLf3L\L
L{)~ J::." ~ L- C,
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:
. -
r' ( ~ /-1 / ) !:!"
I.-- ~ 1./ -V''---'' --r/'v.
r;\C'
H r
~ -?cO
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST I
}d L~. '9~
I
./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAll FOR REINSPECTION BEFORE COVERING
Inspecth'17 Owner/Contr:
CiAJL ~7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!