HomeMy WebLinkAboutPlumbing Permit 04-0586
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please tv]>e or orint and si2l1 at bottom)
ADDRESS .
L151+ l4~bWd lV~
L Blue File I PERMIT NO tj ~
2 Gold C;I, . /) _ 5 (y,
) Yellow Applicant U 4'
I ZONING (office use) I
LEGAL DESCRIPTION (office use only)
LOT q BLOCK ~ ADDITION ~O h Iiit1 r;J)~
PID;;7 L) - ,qi/tj- 0/5-0
. OWNER
(Name)
(Address)
S UI\ \-\.<A-
SCJ.JNJ
(Phone)
96d-dO?s IlCfg-
:~:::::I~_~~S A~L~
(Address)
k) l KKl wedq,(
\PPLICANT SIGNATURE ~---- ~ ~l DATE
APPLICANT PLEA~OMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Contact Person)
(Phone) tol a - 8>0 1- 5dloD
I'h.dt~ovt 65300
(City) (Zip Code)
lo I rl-5?lo~-4 4 60
10' g-a<f
(Phone)
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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 $
3<1.50
.so.
LlfL[ JU
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid lJ (J , ./"
I Date /,,-/<5-4
ReCt! t'r ~q
BY~ '
v
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR V.KE
INSPECTION NOTICE
q-JO-O</
. I
SCHEDULED
ADDRESS
OWNER
4--5/7 HUI1I1/Nt/IfJbLJ TJc..-:,
CONTR.
PHONE NO.
PERMIT NO.
4-.5fj(p
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
;g:-FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXlGRADIFILUNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
LA 0 MECHFINAL ~ _ 0
(;jIW!l1 ~~
COMMENTS:
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ . Owner/Contr:
I I
lliL ~7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH ol SAFETY!
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