HomeMy WebLinkAboutPlg Permit 04-0313
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
(pleasetvPe orllrint and sign at bottom) HOMEOWNER 01-05
ADDRESS
3375 bJ~~~ ff;;j, CfW
I. Blue File PERMIT NO. () Lf- 3' (' ~
!, Gold City
I, YellDw Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only) ~
WrflBLOCK ( ADDmON ltJool~ cd- --cJu !JJ.dI~
~= f)~1-':r'&~
(Address) 3~ '25 u;.id//!/fIp} _%/1liJ
, APPLICANT
(Name}
(Address)
;;.P. PIPE"vVORKS
3670 DODD ROAD
E1fIfil1m~
rIJ p J.
DJ,
(Contact Person) ~
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I
PPLICANT SIGNATURE
PID;;?$- 3 ~3 - (Jtt.f~-()
(Phone) ~U~ J '5 5~(]
~~ :;~_)2lL4- ~L7~?~
(phone)
(City)
(Zip Code)
~
,,-
DATE 4-9-t7.~_.
(Phone)
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough.. ins
Dishwasher I Water Heater
Floor Drain Water Softner
Lavatory (Bathroom ~in1c) Stand Pipe (Washing Machine)
Laundry Tray (lor '2 ' . Sewage Ejector
Shower Stall .' REQUEST FOR FINAL Backflow Assembly
Sinks . INSPECTION SEN Backflow Assembly Test
Bar Sink . HOME T TO Lawn Sprinkler
_ Water Closet (Toile _ OWNER 01-06 Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
0/
Estimated Cost $ ~DD
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
/' ~
This Application Becomes Your Building Permit When Approved
Building Official
Date
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
~S.SO
.50
$
$
$ 4aL at>
Paid 11. , ---
..,to'
Date L/- d. ~- c/
ReceiPqt; J/ P Lf
Bt7
U-..
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 nMe
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/. 3, 0 &,
ADDRESS
3375 WlvOWcmf) 7/U-.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4'- -JIJ
COMMENTS:
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
'f.-ffvO ~
~L- oJ G L':/ t/ E 77J
/ /V/-r-t/17 V ( fl/
(
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & &4rJH 1/
INSNOTl