HomeMy WebLinkAboutPlumbing Permit 04-0142
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO I
2. Gold City · ADU -I Lfv
3. Yellow Applicant . V -, .
I. ZONING (ofticeuse) I
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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(Phone)
(Address)
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APPLICANT
(Name)
(Address)
(Contact Person)
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(Address)
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(Phone)
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(City)
\PPLICANT SIGNATURE
(Phone)
7673-SS5-3Sd 2-
SS-y~
(Zip Code)
7b3'~79- S9dR
DATE 3-IS-o'/
ICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower U.4, Rough- ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
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 $ 3~ o~ ~ o~
I
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
85. SD
.50
qO,DO
(Omce Use Only)
This Application Becomes Your Building Permit When Approved
~~
Building Omcial
Paid
Receipt No.
3fr;-/o'f
Date
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
4 -/1.,12
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
)8 PLUMBING RI I J /
o MECH RI Vi (f",
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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----
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-
, WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
[] CORRECT W7 FOR REINSPECTION BEFORE COVERING
Inspector: t Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ