HomeMy WebLinkAboutPlumbing Permit 04-0407
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
q'lease tvl:!e or mint and si2Il at bottom)
ADDRESS'()d50 Wood- ~LLCJ( LY. I ZONING(offioeu,,)
i~L ~~~H~", I PERMIT NOOt(/ t!o1
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
, OWNER
(Name)
(Address)
CV\J...l ( j(
50-..v\V
()e..bb~
Lu; ISCM.
(Phone)
Qad-l./QD-7;;)n
(Contact Person)
',PPLICANT SIGNATURE ~
t\~ We.cl~
Lv I Y ()Q.Q Av Sw
(Address)
~~
(Phone) LP/;i' 8D1- 5dloD
1"lLd-c~ 55350
(City)
(Zip Code)
APPLICANT
(Name)
(Address)
Quantity
l~
\J
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
(Phone)
~
5'd-OY
-..
DATE
Type of Fixture
I
-------------1
I
I
I
I
I
I
I
I
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backtlow Assembly
I Backtlow Assembly Test
I Lawn Sprinkler
Other
FEE SCHEDULE
Industrial. Commercial & Multi-family I % 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 $
?FI. CD
.50
'-ID,(X)
(Office Use Only)
This Application Becomes Your Buildiog Permit Wheo Approved
Building Official
Date
I Paid Llb---
I Dat~.,_ 7 -0 'I
Receipt Ufo f, / ~
By y.-.
U
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E,. Prior Lake, MN 55372.1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULED
DATE TIME
f<- ;), 0 -() 1./
ADDRESS
3250 WOOf) f)(/U-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4.4-07
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
I<l'FINAL
ItJ SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
COMMENTS:
icaU71 S /J'/I..~Q..A.....-
\ / ~ \/ /
/'1 lY ( c.
(/' y\
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~, CALL FOR REINSPECTlON BEFORE COVERING
Inspector. (TJ if).--- Owner/Contr:
CALL It.::so FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" IUFETYI
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