HomeMy WebLinkAboutPlumbing Permit 16-1219 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED \,Ai' 1\O
ADDRESS .13c"o Q ,
OWNER CONTR.
PHONE NO. PERMIT NO.
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
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COMMENTS:
t�1
KIDc
ORK 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 REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
0 pRip� Date Recd
,� CITY OF PRIOR LAKE PLUMBING PERMIT •
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I.Blue
w c� PERMIT NO. /9
3.Yellow Applicant /(O
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
4067 Yet/T.1-V_ La , S 5.53 -7?
LEGAL DESCRIPTION(office use only) :
LOT BLOCK ADDITION PID
)RJA I ed�w+ctrY QVV J . .i�- Q5c 446 c 8/(Phone)
(Address) SQ 11/1-e__
APPLICANT Appliance Connections Inc
(Name) 12850 Chestnut Blvd. (Phone)
Shakopee, MN 55379 -
(Address) 952-445-4803
(Address) (City) .(Zip Code)
(Contact Person) _ 1141.1. •r - (Phone)
APPLICANT SIGNATURE IIW MI DATE /6/4/
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher COWater Heater
Floor Drain Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
The Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended /�q
The minimum surcharge for a PLUMBING PERMIT FEE $ '� r
"fixed fee permit is STATE SURCHARGE $ LLOO
lv 0TOTAL PERMIT FEE $ o. %5°
This Application Becomes Your Building Permit When Approved Paid eceipt No.- ci
Bundine Official Date Date`(' 9 0
24 hoar notice for all mons(952)4479550,fax(952)447-4245 ('
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372