HomeMy WebLinkAboutPlumbing Permit 03-1383
DATE nME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /(>-/ v' 0)
ADDRESS ;32~(P ~~ ~ (JA:;Z)J J u--d.~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7- I ""{ f/') 7
- ..;
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 EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o Gt;.~E AIR TST, J IJ
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COMMENTS:
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~O~K' CALL FOR REINSPECTION BEFORE COVERING
Inspector;..l---) Owner/Contr:
CAL _ 44 -9850,.6R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQU~MENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
.j .... I~.....
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
It; ., ?
j 5. G....J
I. Blue File PERMIT NO
2, Gold City . /l...? -1' "> Q ?
3. Yellow Applicant U. :..J tl->
(Please type or print and siltl1 at bottom)
ADDRESS ZONING (ofliceuse)
32-&(P woof) O{)(J.,K- DL. fUj)
LEGAL DESCRIt'uON (office use only)
LOT J -, BLOCK I ADDITION
WlvDS :flu:>
OWNER
(Name)
. (Address)
APPLICANT r ^ I
(Name) - J~V"1-S (:2v(."1;1/!./V{ ~-
(Address) 141ft,.. ~~) ~ j"/d-.
(Address)
(Contact Person) ...., d
\PPLICANT SIGNATURE Z~itL/(Z U~
PID ZS-,337. () /7.0
(Phone)
(Phone) X,;-7J.r=W tf.
#'~~ /J'J14/- f?-:J~c(
(City) (Zip Code)
(Phone) 74.? --I ?~t?-~
DATE _/q//$2
. ,
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks \i.J 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 $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
31.SV
.50
40. 61J
Paid .f~. t/lJ
Date/ lj. I r. V'"
Rooeipt N';J9J
By CO
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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