HomeMy WebLinkAboutPlumbing Permit 04-0297
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
Z,OCI
(~IL flrJ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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-.....
.
DATE TIME
(y(3 ~~
~- 4,-1-11
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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9?NORK SATISFACTORY, PROCEED
, [] CORRECT ACTION AND PROCEED
o CORRECT WO K, CA)c9 FOR REINSPECTION BEFORE COVERING
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Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~: ~~: ~i~ I PERMIT NO. ,1L/_ ~ ~.n
3. Yellow Applicant . (/ c::7'-l J I
30& I
ZONING (office use)
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ADDRESS
LEGAL DESCRIPTION (office use only)
LOT
ADDITION 0- ()/3
OWNER"""'')
(Name) ~
(Phone) %).-LjLJ7.-e;J/L/6
(Address)
APPLICANT
(N ame)
(Address)
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
..PPLICANT SIGNATURE
(Phone)
DATE
1-: "... 30-c-' ~
APPLICANT LEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower 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 y 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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
3q~
.50
?ftJ----
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid t( 0 /~
Date y _ 30-0 L{
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714