HomeMy WebLinkAboutPLUMBING 07-1012
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
II-Jj~
ADDRESS
/ 701 L fl~f<-:")VL+ 111/A L~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7-/()/2..
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
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
flJA) I-k~ 4-
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./WORK SATISFACTORY. PROCEED
o CORRECT ArTION AND OCEED
o CORRECT WO K OR REINSPECTION BEFORE COVERING
Inspector: 1 Owner/Contr:
- y
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and siJtll at bottom)
~. ~~~ ~:;y PERMIT NO. 67- 10 ( -,
3 Yellow Applicant . ~
ADDRESS
~ Phea--5CUlt Jv1~C(d6~V Ll1 \ SW
17 cJ I~
LEGAL DESCRIPTION (office use only)
ZONING (office use)
LOT
BLOCK
ADDITION
PID
g,':e~R \. k;j(J' .'-.Ar(tVrc,~ . (Phone) qS~ .441-/009
,(Address) ~ Q -/ 1t'iD(" la,ke. M N . ~) 53r7"d-
APPLICANT
(Name)
Champion
:51-386 1340
3670 [)odd Rd. #100
t:CI~~~s~r123 1338 (City)
k(\~len ~ .(phone)
v._"_~-.f) I J ~ DATE
APPLICANT SIGNATURE 11 .t1 ~ .v'.J\1f ~
. ~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
(Phone)
(Address)
(Zip Code)
(Contact Person)
q- ~C).-o'l
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
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 $
TOTAL PERMIT FEE $
31 C50
.50
Ul\ . U)
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
pai1ro .Vu
Datelu .1 tf, lJ7
;) lo€)'j5
Dp
ipt No. S4f.1/f" (
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714