HomeMy WebLinkAboutPlg Permit 05-0743
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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I. Blue File
2 Gold City
3. Y eUow Applicant
PERMIT NO. tJ5: 0143
. lease type or print and sign at b.u.,u...)
ADD~SS _
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ZONING (office use)
LEGAL DESCRt.t' nON (office use only)
LOT
BLOCK
ADDITION
PID z..r: 0/7, ()72~O
OWNER
(Name)
(Phone)
(Address)
APPLIC~, ' _I _ '- fL 1._
(Name) Lf!aLl ~ tJ.Ld\l.te... I::::!DDYll <;
(Address) bV if 1Iil! (!15t_.:itSb
(Address)
(Phone)
Pn{;Y~
(City)
95"J. -If'lO-/30~
5537'J-
(Zip Code)
(Contact Person)
l/Y);flM ~
(Phone)
DATE ~
APPLICANT SIGNA TU~
Quantity
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)
Type of Fixture
/1
/l
yO
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # () s: 67-1:J
39.50
.50
&to ,<LJ
$
$
$
Estimated Cost $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 40- vO
Date r/ ? i". ..-
I . ~" V ..i
Receipt NO~ 8tPJ
BY/D
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
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
.-I!'15lUMBING FINAL
o MECH FINAL
COMMENTS: J
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S-7'Y?
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~WORKs~~n
/ a--cORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR INSPECTION BEFORE COVERING
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Inspector:
~ .vner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
,
,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!