HomeMy WebLinkAboutPlumbing 03-0641
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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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
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COMMENTS:
0"' TE TIME
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR",ALL FOR REINSPECTION BEFORE COVERING
Inspector: X A" ~"U" (f) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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CITY OF PRIOR LA-KE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
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I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO. 0 3 - &:, q I
ZONING (office use) ), -1
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LEGAL DESCRIPTION (office use only) /), ,
LOT d-BLOCK ( ADDITION (~a.f J:<J;J,"(J ~ ~ PID ;)5- 335 ~~-o
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OWNER-tV\n ,)/ 1"\... L...._ .. a,.c;.'1 440 '411 J:..
(Name) I , w.J(" UUJJJJ'\ . (Phone) -, uo- '0 "'t--.J
(Address) ~
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(Address)
(Contact Person) D~
,-- PPLICANT SIGNATURE ~ U Y
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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)
APPLICANT t\. n.... \A. \ S
(Name) UUVI"'\
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(Address)
Quantity
(Phone) l, \ d ., &0 (- tQlDO
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(City) (Zip Code)
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(Phone)
DATE
Type of Fixture
\
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
: Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
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Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
DQ.8D
.50 7'\^
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(Office Use Only)
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. This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid j~ ___
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Date.5 - 0Lf /?
Recei~lj~
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S,E" Prior Lake, MN 55372-1714
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