HomeMy WebLinkAboutPlg Permit 06-0978
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
'ADDRESS b I..LL^
I '000 I' nr1Ct 'T( I S E
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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I. Blue File
2. Gold City
3 Yellow Applicant
I PERMITNO.0~- 978f
ZONING (office use)
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(Phone) gl)~ -441- 301 ~
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(Address)
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APPLICANT
(Name) \-+f p', PQ.Al )Q(~ <)
(Address) Jo 1 () 1'YY:i ~ Ro\
(Address)
(Contact Person) ~ Y I 5 0 I e- h
\PPLICANTSIGNA~URE ~/J IJLth
(Phone) (,fJ\ - ~lc.f)- \ ~ \)
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(CiJ) (Zip Code)
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(0- ;10 - 0 lo
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
I 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 $ ;J 00. W
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
,~q. '50
.50
4D (j 0
Paid. .
VO.-
Dati ~;J7-- b
ReceiP~/g-50
I By c1'
CT
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
c1
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS ( (,iJlDh
~""c.... 1',)"
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:
G\r)~. ~,~iL_
DATE TIME
I~~
~\ Cf7B
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
yc~~
~~~ ~e.~ -
'-ti'woRK SATISFACTORY, PROCEED
~~~RRECjTTION AND PROCEED
o CORRer! K, CALL FOR REINSPECTION BEFORE COVERING
InSpector:\ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!