HomeMy WebLinkAboutPlg Permit 01-0581
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ADDRESS
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I. Blue File
2. Gold City
J. YeHow Applicant
Date Rec'd
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PERMIT NO. 0/-$8/ j
CITY OF PRIOR LAKE PLUMBING PERMIT
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT I BLOCK l..-ADDITION
tc:N ()~ III ~L- 2- NO
PID 25"-:33'1 . (X) 7_.-0
OWNER
(Name)
(Phone)
(Address)
APPLICANT 11 cc r€7 d ~ fed ~I \AWl \?,lyt Ii
(Name) /I T-J
(Address) 22700 \)Me trc<; (
(Address)
(Contact Person) T 0 IV1 JJ.o c""
APPLICANT SIGNATURE ~~
(Phone) C9~2) Ljt, 9- VoOG
Ll(kev; [f e SSO'/V
(City) (Zip Code)
3(,3~ (,~O?
~(2.
(Phone)
DATE
APPLICANT 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 Softner
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I I Lawn Sprinkler
I 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 $ 350. 00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
31. fl)
.50
-47J . (/7)
(Office Use Only)
This fro J~DP.~ . t;.. o~..' Becomes Your Building Per. mit When Approved
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: ~. '1__--- (p . 12.-. 0 I
, Building Official Date
Paid 4 I)' --\
-. Ol/
Date
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Receipt No.
, 3?9~Z--
By A1dtf.
/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INs,rECTlON NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED I -g.... 7-(13
Cf/o c;tJl4~~
(/
CONTR.
PERMIT NO. (- ..s?/
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
OMECH~1~
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.0 Wj>RK SATISFACTORY. PROCEED
\!;rCORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Lj<f'VvQ
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI