HomeMy WebLinkAboutPlg Permit 06-0910
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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)
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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(Address)
APPLICANT
(Name)?r<',- \\ t....,\
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(Address)
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(Address)
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(Contact Person)
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APPLICANT SIGNATURE
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39,50 minimum
Estimated Cost $
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J.,,/DO
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
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Building Official
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, I Date
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I. Blue File PERMIT NO ~ I
2 Gold City 06 fc, ~ {ltZl '.
3 Yellow Applicant -I ~ 1'1
ZONING (office use)
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PID
(Phone)
(Phone)
(City)
(Zip Code)
(Phone) q)" J - ''1'1") - I ~(" 11.
DATE i D - q - <.)~
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99,50
Residential, Additions & Alterations $39.50
3'9. c- 0
.50
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Paid /J
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Date /0/1/0 y
Receipt No. 31*170
By q-.
24 hour notice for all inspeetions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
.'1:
.1.
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
0-C/O? - C/lrj
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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
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COMMENTS:
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FWORK SATISFACTORY, PROCEED
U CORRECT A~TION AND PEED
o CORRECT WOR . CA R 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