HomeMy WebLinkAboutPlg Permit 02-1174
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
I. Blue File PERMIT NO
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LEGAL DESCRIPTION (office use only)
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APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
Quantity
(Phone)
~ _TE
APpgCA~LEASE C~MPLE;E B-EL'OW
Type of Fixture I Quantity I
Bath Tub with or without shower I I Rough-ins
I Dishwasher I I Water Heater
I Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink I X I Lawn Sprinkler
I Water Closet (Toilet) I I Other
~URE
9 -/'7 -01-
A
_ _ 'tJ.' "'. "
Type of Fixture
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
7> 9. S-O
.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
. Paid J I ____
'IiJ,
Date a . ~
-, r / -, - d....
ReceiPt~a~J ~
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHED~LED
6-;C;-3 TIME
ADDRESS
ItJ7~~ " (;d~ OU:A)
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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COMMENTS:
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~- 1171
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: -J. W Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/NSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl