HomeMy WebLinkAboutPlumbing Permit 16-1213 DATE TIME
CITY OF PRIOR LAKE _
INSPECTION NOTICE SCHEDULED O \?-s(1J
ADDRESS 71 '-j ( , 412 •
OWNER CONTR.
PHONE NO. PERMIT NO. ) (o• I 3
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL iliASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS: �Z C
'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 REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
PR/04) Date Rec'd
ti - CITY OF PRIOR LAKE PLUMBING PERMIT
tri
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l*NESO�
File
z. Gold c PERMIT NO.1 , /Z
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ,. ZONING(office use)
/ 7 711/ c-0 4_of/V V) -am('21XE, WA/ :5§?A) s
LEGAL DESCRIPTION(office use only)
7
LOT LOCK ADDITION /746/612-(i ,(�� �j( PID Zr--5-0,S
OWNER L15 4 4601'1//2.90ame (Phone)
(Address) i7111`1 6O1 i)1A/ VIL((1 /1f lifl DA .2/4i Er MN JJr57.
(NameCANT CoU/1 1y turfl 6111P/1/0/11/44;
(Phone) / ,5)0- 5 - /50
(Address) Trc ib J J Jr
(Address) "(City) (Zip Code)
(Contact Person) f0 i /7 /1
' (Phone)
APPLICANT SIGNATURE ( DATE
19 l6
APPLIANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water 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
7
Estimated Cost $ 3i 1) / 7 '� Building Permit#
PLUMBING PERMIT FEE $ 1/9.
9.
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ "5-0.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid —. Receipt No. .-7/e/�
Building Official Date Da`v f i /� Byc-zr,
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372