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Home My WebLink AboutPlumbing Permit #08-0090 , DATE TIME CITY OF PRIOR LAKE � � )� � INSPECTION NOTICE SCHEDULED __� !__�__� . �— r ADDRESS � t �� r`'Iy K/ / h T /Z � OWNER CONTR. PHONE NO. PERMIT NO. ��" '�'' �'� V ❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING ❑ FOUNDATION ❑ MECH RI � COMPLAINT ❑ FRAMING �C,1.-''1AIATER HOOKUP ❑ FIREPLACE RI ❑ INSULATION � P��B�NG NAL ❑ GASLINE TST O FINAL O SITE INSPECTION � MECH FINAL � COMMENTS: �'.` r �' �z -�-�..`--�--- - c-•:�:a., ❑ WORK SATISFACTORY, PROCEED ❑ CORRECT ACTION AND PROCEED ❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: � ' '� `- '' " Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTSARE FOR YOUR PERSONAL KEALTH &��r cTYr INSNOTI � ,�Rjo,p � Date Rec'd ti/ �� CITY UF PRIOR LAI� PLUMBING PERMIT �� ,�� i � r� � �� E S�� ' B ''g �''` PERMIT NO. a g qv Z. Gdd �iry 3. Yellow Applicavt i � t88t O[ ?� � �Y �lOixOID ADDRESS ZONIlVG �o�« »�� Le �D � r� n r�c �� LEGAL DESCRIPTION (oE�ce use onty) LOT BLOCK ADDITION PID OWNER !,' � / � /� . (�� / V (� (Phone) (Address) ` APPLICANT � � � �� hone �� aL �J (Name) / (�' ) � �A�S, I�1 ro ��I-e �5 rs til 53 �� (Address) � tY (ZiP Code) (Contact Peison) GL �vl h'L (Phone) APPLICANT SIGNA �� DATE `� �� APPLICANT PLEASE COMPLETE BELOW aanti of Fiztare anti of Fiatare Bath Tub with or without shower Rou -ins Dishwasher Water Heater Floor Drain Water Softener Lavato Bathroom Sink Stand Fi Washin Machine Laund Tra 1 or 2 com ent sink Sewa e E'ector Shower Stall Backflow Assembl Sinks Backflow Assembl Test � � . Bat Sink Lawn S rinkler Water Closet Toilet Other FEE SCHEDULE Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & TwaFamily $149.50 Residentiat, Additions & Alterations $49.50 Estimated Cost $ � ! Building Permit # PLUMBING PERMIT FEE $ `T • � STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ � • �?z� �ot�� us� oo� > -.. This Ap ' tion Yoar Boilding Pe it ee Approved Paid �^ `� U R i o. �a �.� 3�O D g Date �� v BaildiAg Of6cud Dah � ' 24 hour notice for all inspections (952) 447-9850, faa (952) 44'7-4245 4646 Dekota Street 5.�., Prior I,ake, Minnesota 35372 • , , � � �G [ G R Mecha.nical, Iac. A,nnual RPZJBackflow 12401 Ironwood Circle #500 T -� Rogers, MN 55374 763-428-2663 F� 763-428-7656 Date: y � Customer: f11� 1� ' L�r,c,�� Site Address: �� i 6/' 1-K. - Contcactor: G R Mechaaical Inc Mastet License #:� � Address: 124QI Ironwood Circle #SOQ Phone: 763-428-2663 Ro MN 55374 Fax: 763-428-7656 Location of Device: /Y1� ° Device Serves: . . Make: J' `� � Model: � Size: � Se.rial #: y�37�� Check Check Pres Dif Pres. Dif Valve #1 Valve #2 Across #1 When Relief Strainer Test before Leaked {} leaked {} None {} RePairs Closed {} Closed {} PSI PSI Clnd {} Fina1 Test Closerl {�- Closed Q�- PSI �7, � PSI 3,� Cieaned orily: Ciesued On1y: �ePlaced: Replaced: Rubber ldt Rubber kit CV Assembly CV Assembly a� a� s� s� : s� s� St�em/guide St+rem/Guide Retainer Retainer Lock nut,s Lock nuts Uther Other Remarks: . J .�, �b��l �- �l ��-�� I herbY certify tbat t�us date �s accurate and reAects the P�P�' oP��on and maintenance of the assembly. Testers Name (Print) hOrl cert. #: 0�-3 7' Testers Signature: Date: �- !�.