HomeMy WebLinkAboutPlumbing Permit 04-0285
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Date Re~'d
Cll i OF PRIOR LAKE PLUMBING PERMll.
I. Blue File
2. Gold City
3 . Yellow Applicant
PED... NO~'I""'Ol<fS
(Please type or print and sip at bottom)
ADDRESS
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LEGAL DESCR.1.t' lION (office use only)
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APPLICANT . J ' d (J \ -
(Name) IJr c..("~ j te y\ \..UJV\ YJ,l!\U
(Address) 7. 7 700 ~ ~V\ e tr'ttc.i J
(~dklress)\
(Contact Person) Th vvt ~JO t... '"
,r-l'PLICANTSIGN~~ ~ ~
OWNER
(Name)
(Address)
Quantity
ZONING (office use)
paS[)
~iVV\
Lf14~
(phone)
4liO-'-;"26,7
(phone) (9)Z) '-/JfI-l/[)DO
L~ ~f lJillQ S-S-OC/4
(City) (Zip Code)
(phone) Kofi') 25'/- '59'7'1
DATE "'4 h1/o $I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compa.lment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
y
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn -Sprinkler
Other
~ ~
FEESCn!JDULE
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 PERl\t.l.l. FEE $
~9-S-0
.50
qO,- -
(Office Use Only)
/~' '"his Application Becomes Your Building Permit When Approved
Building Official
Paid / fA
-W,.~
Da~J
Date l,{r/.9-04
24 hour notice for all inspections (952) 447-9850, f~X (952) 447+5
16200 Eagle Creek Ave., S.E.!, Prior Lake, MN 55372-1714
Receipt No. tI foil 7'/
By j "
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS LlI "t ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
t.f -'-0- otf
(l~tr
1/:.rLl
w&'~~
~
CONTR.
PERMIT NO.
'-I-?:6'
o PLUMBING RI 0 EXIGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING ANAL V A GASUN~IR TST
o MECH FINAL D \" .. Leu.J1Il. _I'I"'~~"--
~ORK SATISFACTORY, PROCEED
~CORRECT ACTION AND PROCEED
o CORREC10. RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector. , "j Owner/Contr.
CALL .lSJFOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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