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HomeMy WebLinkAboutPlg Permit 05-0504 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd 5. 3t. oS (Please type or print and sign at bottom) ADDRESS l. Blue File I PERMIT NO 4-1 2 Gold ('it, . OS- 050 3 Yello\\ Applicant 3J3d :::Th.~ 0. ~ r~ ZONING (o!fi,'" use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID 25. 3 96. 0 (p z. 0 OWNER (Name) _ _fk. Q_~e... (Phone) (Address) S1 ~ ~~llI'~ c.! APPLICANT j" . (Name) ~c. (Address) lo"l~q 2:^r-.. (Address) (Contact Person) ~~ ?III~~" / A.J",- (Phone) 9sa..... $lCf~tJ ~AA. (City) " ~ _ (Phone) ~g (Zip Code) APPLICANT SIGNATURE _~ f......."'J..... _ DATE S'rl~ APPLICANT PLEASE COMPLETE 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) Quantity Type of Fixture Rough-ins Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Eiector Backflow Assembly Backflow Assembly Test Lawn Sprinkler . Other 'I. FEE SCHEDULE Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family Residential. Additions & Alterations Estimated Cost $ Building Permit # O~. 0504- PLUMBING PERMIT FEE $ .,31. s-o STATE SURCHARGE $ TOTAL PERMIT FEE $ .50 J../D.oo (Office lJse Only) This Application Becomes Your Building Permit When Approved Buildinl! Official Date Paid 4--0 I 00 Dates: 31.05 Receipt No. 41/332- By fdL 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 ADDRESS ~~~ OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: DATE SCHEDULED ~ J~r~ r~+- TIME CONTR. PERMIT NO. .5 - 56'-1 o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADlFllllNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL J'1:::.~ (\1 , () ()) l_A~~ rtt.~{ JL / ~ORK SATISFACTORY, PROCEED o CORRE CTION AND PROCEED o COR CT ~, CAll FOR REINSPECTION BEFORE COVERING Owner/Contr: C 44 - 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. V CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! IItSIIOTl DATE TIME CITY OF PRIOR LAKE 1/J%:- INSPECTION NOTICE SCHEDULED ADDRESS 3OI;t ~ea! OWNER CONTR. PHONE NO. PERMIT NO. O~-SJ~ o FOOTING o PLUMBING RI o EXIGRADIFILLlNG o FOUNDATION o MECH RI o COMPLAINT o FRAMING o WATER HOOKUP o FIREPLACE RI o INSULATION o SEWER HOOKUP o FIREPLACE FINAL o FINAL o PLUMBING FINAL o GASLINE AIR TST o SITE INSPECTION o MECH FINAL .)(:rrr~{C"M. COMMENTS: ~RK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o C~Od12RE RK, CALL FOR REINSPECTION BEFORE COVERING Inspecto: Owner/Contr: 7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/ INS1IOTJ CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd (g./~.()~ I. Blue File PERMIT NO 2. Gold City . ()C". 05-7/- J. Yellow Applicant .:...J . {CO (Please tvDe or orint and sil!)l at bottom) ADDRESS ZONING (office use) 301a &~brl1.+ ~I o.Lu) . LEGAL DESCRIPTION (office USe only) LOT BLOCK ADDITION PID OWNER (Name) (Address) p~ ~1J. 1 o (Phone) q.S'..J -d~O -13'1Q ~.\- -ri \ APPLICANT (Name) M~ $1~f (Address) \ a~ <O~ ~IUM~ .z lllr_ t.)Jt.. (Address) (Phone) -3.P- tttif."!-., (.,00 Sa~, (City) S'.f'3 7~ (Zip Code) (Contact Person) ~.u APPLICANT SIGNATURE ~ ~(~J '- - (Phone) ~c.-L DATE c, - 1'1-0 r APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins I Dishwasher Water Heater I 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 ~ I Lawn Sprinkler Water Closet (Toilet) I 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 Pennit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ .3 GJ. SD .50 (Office Use Only) L./P Building Official Paid f(). tJ 0 Date /. 0' ~ Date (11. 2CJ,,> ..,; 24 ho.. oo'ke fo, all in."",no.. (9<2) 447-98"'. fox C9Sr74245 ~e~eiptN~Ja7 BY.~ This Application Becomes Your Building Permit When Approved