HomeMy WebLinkAboutPlg Permit 05-0867
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.CII iOF PRIOR LAKE PLUMBING PERMIT,
...,. .
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
IIUll FII,
lold City
. .llow AppliClllI
l~o ~ ::S\ru_--t.
i~GNiQBSCRIPTION (oftice use only)
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LOT BLOCK ADDITION
APPLICANT LAL ~Iu-h..."
(Name) ~,~
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(Address) l..1i.j(...GI 2;", te.- ~
(Address)
. OWNER
(Name);' "
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(AddreSS)
PID 25. / ~s: O~9. (j
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(Phone)
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. (phone)
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(City) -
$s:n?
(Zip Code)
(Contact Person) ~"
~- 'PLICANTSIGNATURE t_ .(!.
Quantity
,
,
(Phone) ct(.,.'\"\~
DATE - 9 - (~- o{""
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
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEESL;nJ!..DULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ Building Permit # OS 0 at, 1
PLUMBING PERMIT FEE $ .3 9'. 6b
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ ~. (/V
~oiJ)
(Omec'UleqDly)
'lis Application Becomes Your Building Permit When Approved
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,
. QuUdlDIOmelal
Date
Paid 10. FV
Date 9. ~ tJS'
Receipt NO'4-993&
BY~
I
~, 1 ", l
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Easle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
S66-s- /50~'
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
[]~EWER HOOKUP
L~LUMBING FINAL
o MECH FINAL
DATE TIME
-P9A'
/ /
O~
S"[>{7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMME~TS: / / I "
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~ORKSATI~~A-y.PRQI''9t~ ~
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpector:~ .,....-- Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/NSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!