HomeMy WebLinkAboutPlg Permit 05-0678
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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ADDRESS '3:J t 9' W/l j tJ f) pJ
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LEGAL DESCRu' nON (office use only)
LOT I?aLOCK / ADDITION
OWNER
(Name)
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'77t1
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(Address)
APPLICANT
(Name)
L Blue File
2. Gold City
3. Ye\low Applicant
I PERMITNO(:jS- -0 7~
ZONING (office use)
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,;ro D- 1 :r t1l tNL- N . J.J (J/lI4/ J
~Afdress) ...... / (cIty)
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
(Address)
(Contact Person)
~PLICANT SIGNATURE
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $ 9&J
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
)hiS Application Becomes Your Building Permit When Approved
Building Official
Date
CfJ) ~7 )67'
,S ;]i.(j
(Zip Code)
/p/.J- .).)/ '1rVC/
7hr~)-
DATE
Type of Fixture
,
I
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow ~ssembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
.50
Paid c; cj. 00
Date ,.-/
7-/5: '7
Receipt qq'/ 7 h
By ~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372.1714
DATE TIME
CITY OF PRIOR LAKE 7~
INSPECTION NOTICE SCHEDULED
ADDRESS 3.~ /01 W';~ ~ ~
(1\
OWNER CONTR.
PHONE NO. PERMIT NO. 5'''~I9..
o FOOTING o PLUMBING RI o EXIGRADIFILLING
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 GASLlNE AI~
o SITE INSPECTION o MECH FINAL )4. ~... It., · "'-
COMMENTS:
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRtlEK' CALL FOR REINSPECTION BEFORE COVERING
Inspector' . /) Owner/Contr:
CAe p.. FOR THE NEXT INSPEcnON 2A HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIIOT!