HomeMy WebLinkAboutBuilding 02-0685
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APPLlANC ;.I;
PERFORMANCe. TEST
Attach to gas line adjacllflt to regulator
Heating Contractor ~ L7- 40)"1.
Name of Tester IJ.J1;. ~~
Date ~13 -03
Job Address
/5.JIL,' ~~S
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Atbbt;V~
c;J. Ig - 03
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laO
Heating Contractor
Name of Tester
Date
Percent ~
Percent CO
Percent C02
Stack Temp.
Combustion air is adequately supplied per
UMC Sec. 606
---
Input
---
IO"d
tl ~f;eO 00/90
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VOS:90 EO-EI-5nV
CITY OF PRIOR LAKE BUILDING .~~ft/ 1/1 F I ~a~eC'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 5" - ~ 4 - 0 :J-.
\ c:;:o \ 4-
LEGAL DESCRIPTION (office use only)
LOT Cl BLOCK t4- ADDITION
1. White File I PERMIT NO I
2. Pink City . 0 Z. - O'-'J. r:::-'
3. Yellow Applicant . (J)QJ .
c'
PID
(Phone)
ZONING (office use)
~ 3't~-O bJ-O
~~~~)ER (',( , lip '1 ~ . 0. i ~ DY"YI..... <;.
(Contact Name) -cdd I E
(Address) , "2L.J _\.,~ \ , u
(Phone) C6L. ({6 q. ItJq()()
(Phone) tJ 12 - h y~c;. -3:2LJ<9
. /
h/-./) ? r J
.....IJ... . t. C
ODeck
TYPE OF WORK
OPorch
ORe-Roofing
o Fireplace OAddition OAlteration / OUtility Connection
, 17.'7 /\f\7':,
PROJECTCOST/VALUE (exdudingland) $ ,::r:) L/V<"')
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-me . ned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I are the uilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city offici or a designee may
enter u r erty t per rm nee ed inspections.
.)
o Misc.
x
t, "--.-J
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
$
$
$
$
$
$
$
$
100.00
00 .Ot:>
35\ SO
401
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
U"''''lBooom'' Yom BWlolin. ."",it Whrn Appro""
U!j . ~ 5-'3/-(27
Building OffiCI Date
/2t)q
Contractor's License No.
Park Support Fee
SAC
Water Meter Siz 5/ ",1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
$---
$
$
$
$
$
$
$
$
#
#
o .00
.00
500.00
\ Paid ~ /5:5 ' (" I
Date {, -'/7- ,(/z"
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
~:~ed ~bY the City Planner constitutes a temporary Certificate of Zoning compliance and allows constructio~~nce'OBefore Kcu~, a Certtcate of Occupancy must be
cr;( ./C---Z~--:r--" L-I L./ E?_ ~~'(~ V(.X L-r":l''-d.,~Yt{ <
C Panning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
..--''''
White - Building
Canary - Engineering
Pink - Planning
Thf' ("f'nlf'r or Ihf' l..kr Councry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (~4J (.h Jl ~-f-
APPLICATION RECEIVED {i"";:j II-tp....::..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whiis proposed at:
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/J1fB
Date:
h-L/~d--
Comments: See Reverse Side for Additional Information!
Driveway Must Have Concrete Apron
Damaged Concrete Walk Panels
will be replaced hy thp Builder
prior to issuance of Final C. of 0.
I(l ",'i'\. Fa e..
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control PI~n
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~
Tht' Cfnfef of lhe Lake ('ounll1
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (!~ ~
APPLICATION RECEIVED 5: ---- a If-~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whi is proposed at:
(J I/~~'
Accepted With Corrections
x
Accepted
Denied &
Reviewed B~ -_
Comments:
~
Date:
s - S 1-0-:1...
S,p all a.~ ~CUAcJ2~uk
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary - Engineering
Pink - Planning
The Ctnter of lht Lake Countr)"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
t/
,
Accepted With Corrections
Denied
Reviewed By: ~~~~
Date:
c/r;, Jb2-
~
~: J<vft-i~-1l::i~~~ ~
l <, . G JJf'~.tQ ~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
05/14/2002 15:18 5077445555
Of\,':ll'OZ flU 1~;05 FAX tnZUHHS
BADGER EXC
CIt\' Of PIUOR l.AKE
PAGE 03
~ool
Dlft Rec'd
CITY OF PRIOR L.AKE
SEWER AND WATER PERMIT
CPI!;..- ryplI Of Jlri!!t mS IiaD u1;lxn:las)
\ ADOaESS
163l'i
~. E" ~~_ \ PERMIT NO. d. - bP~
11 WND<~
~~ I\JW
Pr;"l'"' L~
LEOAl DESClUPTION (otft~ \I. anly)
l.__LOT q BLOCK 'f ADDITION ~9 c..l Cr~
I OWNER f" J L ~. . I L..... _... ~
! (Name) ~~ ~ lJII""T-'~
I (Ac1d.lc:ss) (9.;1.0 b.~(3 \\Jd..
~". ~d~)
I APPLlC~
i (Name) t:>Q.d.~ tF~ c..~ .., ~
(ArldJas) 9 31 S" L...s I o~ .&1r.AUct-
(AcSdlotll)
P10
J
(Phanc) .1$2.- ~, 9-I.fiOO
'-~m "l (e: tf"_~-o '-('-{
C\ (CadI
(Contact Peuon) 5
lMPLlCANT SIGNATURE
(Phone) SOi-"( '( Y - s ~ ..1-
L~ck)., 5~Y~
(Ozy) (ZIp Code)
(phone) Sa'/.- -? I./. 't - ~ r
DAtS - 0
APPLICANT PLEASE COMPLETE BELOW
Si~ of Wtier 30m" ...L...- inches.
Locadon of any cO\lplinp ftcrn strUcture - feet.
Type of sewer pipe. 0 ABC [3?VC 0 Cut Iron
Estimated lenith of ICwer line ~ feet.
Clean out (ifrequirr:d) loc:;a~d at - feet from SUllctu:e.
\
\
I
,
"EE SCHEDULE
RCIlidential51wlf Ind water IIJ\I CDMlIt.tion S3~.SO Industrial. Com'l. Multi-family 1% ofjob colt with a S39,SO I'ftinimwu
SewlIr c:onnll~tion onlY S 17 .50 WaleI' GOnlltClllcn only S 17.'0
Estimated Cost $
Bui14illl Permit #I.,.:.:" .. "
SEWEll AND WATER PERMIT PEE
STATE SURCHARGE
TOTAL PEllMn FEI
S
$
S
:s~
- r~~(.~ 1,
Ir!>,.! "--
gUs' D~ll\''-
... ..., ~~'''I ~~. ~
(omtt tit 0"11)
TIlII Applic;ation a.tOm.. Your BullcU1l1 parmlt When Approv1_ [Pald :;~.
._.. -' ... I Da~)IIN I ; 281ft- . Cf'
Z6 lu"ar notice 'or tlllnlpRltiOl\1 (t5%) .''1''''.. .. C9S1) 6""'~45 .
J
Jun.24. 2002 8:02AM
GENZ RVAN PLUMBING AND HEATING
No.8559 P,4/7
Date R<<' d
CITY OF PRIOR LAKE PLUMBING PERMIT
c:h c;.~ f'Jl0
~: ~ ~~ I PERMIT NO. 1_ /;-, ,>.d~
3. Vdl_ AwIi_1 . d ~o J J
I ZONlNG(...._> I
':.'DPMSS-"':;'
116~1 W Jj .liS
LEGAL PESClUPT10N (office use only)
LOT
BLOCK
ADDmON
PID
(Address)
(.b) WeeP. OJ fl/
1.-
~J)~
\JD
UJJa..vt( Ie
(phone) q 5 Z - l.{ b 9 - (p 9()()
'fv\ N SS- 4
OWNER
(Name)
(Contact Person)
(Phone) LoS" I ~ 1.4 Z'3 ... II LI L{
~{JU...Y)r SC-y)fo'6
(City) (Zip Code)
(phone)
APPLICANT
(Name) (ri?Xl'l - ~
(Address) l4'1Wc; ~ ~~.,- ~t-
(Address)
APPLICANT SIGNATURE
DATE
l1;{ Zy ({J2-
Quantity Type of Fi~re Quantity Typ2 of Fixture
\ Bath Tub with or without shower ~ r TRough-ins
, Dishwasher I Warer Heater
I Floor Drain . t./J Water Softner
}S Lavatory (Bathrooro Sink.) I Stand Pipe (Washing Machine)
1 Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall ' Backflow Assembly
I Sinks BackfJ.ow Assembly Test
Bar Sink Lawn s~er
1- Water Closet (Toilet) Other
PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi~famlly 1% of job CCJ.c With a $39.50 minimum Residential, New One &. 1\vo-Family $9~.50
Residential, Additions &. .Alterarlons $39.S0
Estimated Cost $
Building pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
!".-.... .
-------,~ --"--
(
~"';'\. -
Buildiug om~lal
Date
Paid Receipt No.
Date 'I By
(Ollie" Use Only)
. This Appli~tioo Becomes Y Ollr Building per'JIlit When ,Appro-ved
Z4.hour DDti~ for alllnspl1:etions (952) 447-9850, fa:$: (952) 447-4245
GENZ RVAN PLUMBING AND HEATING No.8649 P,8/8
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
~~~~:~~~~~~.~.~
1. 1'lNi:
2.~
3, YelJaw-
~.;. t PERMIT NO. - / c' '-I
A.ppIi...... ,~ ~ s
I ZONING ,...."'" j
I ~7t::-~Ul-S
PASS
tJuJ
LEGAL DESClUPll0N (office use ouly)
LOT BLOCK
ADDmON
r
PID
(Address)
~
V ;1 Ie..-
APPLICANT (L
~ame) ~~19r: ~~
(Address) \ l..\ . ty2...L-
(Address)
'I
VtO
(,phone)
~ll(L
OWNER
(Name)
(phone) /.pSt -LlL:~ -114U
, (lD~ I 5fI:Ja~
(city) (Zip Code)
APPLI
NEW CONSnc..UCnON
FlJR,.'lACE MAKE AND MODEL LU\J'\.D't...
FLUE SIZE RETURN OPENINGS
TYPE OF SYSTEM
gwann AU' Plant!
OGravity
o Mechanical
jgAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
(phone)
PATE
L-
(Contact Penion)
APPLICANt SIGNATURE
ASE COMPLETE BELOW
o REPLACEMENT 0 AL T.ERA nONS
G2loQ3-1S- FUEL~. (11-~
5 INPUT r r"]ce;1 f\D1) OUTPUT 1 C1 oW
HEATING OR POWER pLANT
o Steam
o Hot Water
o ~diation
o Special Devices
o Other pevic:es
:PLEASE N01'E:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial &. M1,1ltl.Family
FEE SCHEDULE
j ').. or job cost Residential. (!as Fireplace
$39.50 tni.nimum
$99.50 Residential, Additions & Altera1ions
$64,50 Residential, AC Only
$39.50
ResIdential, Beating & Ale (New ConSlNction)
Residential, Heating Only (New Construction)
$3950
$39.50
Estimated Cost $ Building permit #
flEA TINO PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.so
\= /', ...... ~~tNO. J
/" -'~
In~lh:l! Un f)ulY)
jis Appl1catioD Becomes Your Building Permit When Approved
Date
B..ildiJJg OfficiaJ
24 honr notice for all inspections (952) 447-9850, fax (9Sl) 447-4145
Ma~ 30 03 02:33p
Todd
612-633-6432
p.2
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGlFlREPLACE PERMIT
Date Rec'd
b~~~\'~;~ \)rl~
V --p
LEGAL DESCRIPTION (office use only)
~_ ~~~~w ~l~itanl I PERMIT NO. ;< /0f ~1
ZONING (office use)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
Q.~
(phone)
tOfd - -La ~S -~c<1
(Address)
APPUCANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone) 651-633-2561
(Address) 2700 N. FAIRVIEW AVENUE
(Address)
BRENDA H ON
(Contact Person)
APPLICANT SIGNATURE
ROSEVILT.E MN
(City)
651-633-2561
"i c; 1 11
(Zip Code)
APPLICANT PLEAS MPLETE BELOW
NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Phone)
CY0:: DATE
s- 3D <)'""6
DWarm Air Plants
DGravity
o McchilIlical
OAir Conditioning
OVent System
HEATINGORPO~RPLANT
o Steam PLEASE NOTE;
o Hot Water Air Conditioner Units
o Radiation Cannot Encroach into
o Special Devices Required Side Yard
o Other Devices Setbacks
~c.0- f1 \do ~~~~~
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit #
8lJILbA1D ""'17-1
1NGp
'ERMr,.
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
.50
Date
(Offiee Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-98
J 16 :OO~
. II n .' . _ v
1 : 08PM
GENZ RVAN PLUMBING AND HEATING
No,7910
p. 8 8
Date Rec'd
CITY'OF PRIOR LAKE PLUMBlNG PERMIT
I, Rlvl!: fIle
2. Gold City
> Ydl<l\lf APpl~11l
I PERMIT NO;;? - to 8'':, - I
I
ZONrnG (offiC!Ul:~)
~V0SS Nw
LEGAL DESCRIPTION (office: use only)
LOT q BI.OCK 4 ADDmON Y-Ztj4 C/~t
OWNER n,( 1 ~ I hA J~"" II
(Name) \.An ~~ flU! rlLS ) V'[". .
(Adc1ressL_I. . lit- jf1lyu(, LaUVl / I f, m n
I '
APPLICANT ~ () r::J , ( If' {
(Name) ~~_ - (Phone) LOv..)1 - J-f Z?-Y/Il-f '-1
(AddYess) 147' - s.\.koktetzt T ld; le.W'/'VlOkn:f~ ~p
(Address) , (City) (Zip Code)
If- f &-08
PID
(phone) Q6;}-t/id1-YJOD
6Wltf
APPLICANT SIGNATURE
(phone)
(Contact Person) ~
DATE
Quantitv -.-. Type Of Fixture Quantity Type of Fixture
f-.-. . Bath Tub with or withO\itS.hower ROugh-ins
_.:b~._-
J Dishwasher 1 Water Heater
Floor Drain - Il-T Water Softner
01!:.. tJ.., Lavatory (Bathroom Sink) J Stand Pipe (Washing Machine)
Laund:ry' Tray (~ or 2 compartment sink Sewage Ejector
Shower Stall Backflo'W Assembly
I Sinks BackfJow Assembly Test
Bar Sink - Lawn Sprinkler
~ Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
~ :.,
FEE SCIIEDl..1LE
Indusmal, CommercIal & Multi-family 1% of Job cost with a $3950 minimum
Estunared Cost $
Buildmg Permit #
RCSJdenl1al, New One & Two-Famtly $99 50
Residential, Additions & Altcr.ltions $39 50
8(J,~~ ~
PERMrr
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Ollie\: Use Only)
This Application Becomes Your Building Permit When Approved
.\~.'
'\\\/'::.",~..
Building Officisl
Dllte
24 ho", '0'''' ,,, ,II i....d.o"' (952) 447-985 ~y' (95;1) "'7~.Sm~ 0)1
~003 1:08PM GENZ RVAN PLUMBING AND HEATING No,7910 p, 78
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONINGIFlREPLACE PERMIT
~,~~ J~i__ fPERMIT NO. ~- 6 ?>Gl
(plc;lje type or print and. Sigll at bottom)
lADDi6~iLj Jeffeil~ Po.sS ,,\\~'
ZONJNG (office we)
LEGAL DESCRIPTION (office use oDly)
LOT t1 BLOCK 4 ADDITION -
PID
(phone)
(Contact Person)
(phonl!)
APPUCANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
;0NEW CONSTRUCTION 0 REPLACEMENT 0 AL TEM nONS
FURNACEMAKEANDMODEL l1J/1V10)\ bt2LPQ3-1C; FUEL VMlt t:1as -
FLUE SIZE RETURN OPENINGS ~ . INPUT 15({)Dl) OUTPUT &11115150
TYPE OF SYSTEM HEATING OR pOWER PLANT
0SVann Air Plants
DGravity
o Mechanical
t::jAir Conditiomng
OVenr. Systl:l1l
o Steam
o HotWatcr
o Radiation
o Special Devices
o Other DeVIces
PLEASE NOTE:
Air Cond1110ner UOlts
Cannot Encroach into
Required Sjde Yard
Setbacks
FIREPLACE MAKE ANP MODEL
FEE SCHEDULE
Industrial, Commen:tal & Multi.ranuly 1% of Job ccst Residential, Gas Fireplace
$3950 minimum
ReSIdential, Heating & Ale (New Construction) $99 50 Residential, Additions &:. Alterations
Residential, Heating Only (New ConstrUction) $64.50 Residential, AC Only
$39 50
Est1ll1ated Cost $ Buildmg Per:mit #
$39.50
$39.50
PAID
8UILDINWl1h
G PEFlMJr
flEA TING PERMIT FEE
STATE Sl.JRCHARGE
TOTAL PERMIT FEE
$
$
$
.50
("ffic~ Use .Only)
.Jis Application Becomes Your Building Permit When Approved
Date
Building Officilll
24 hour notice for all inspection~ (9~2) 441-9850, ~252).#.7:-4li5--..----
J II n ' i 6, ~ 0 0 3 i: 07 PM
GEN: RVAN PLUMBING AND HEATING
No.79iO p, 68
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
..~,.. -'
; ~ ~1~ I PERMIT NO. ~_ / 051
3. G<.ld A~~hQDt ~ ()
fPk'" """ ~.rln' ,..,~ " bom"n)
I ADDRESS
JtJ3r J-e fFtJf,S p{).~S
ZONING (office use)
}1J l/J '
LEGAL DEscRIPTION (office use only)
LOT BLOCK 4 ADDITION
~. uiJ C/it6
'g,=~, ~ tJpfYlfJ Inc. . (Pho~fj!7#.tflh"ft2;
(Address) 7qJ-fJ La..V1/1b J6lVd., / tJ.j<<:.YIILe, f'hn ~<j
(Address) '(Cir~) (Zip Code)
~~~~ -1ttj,1ifl (phone) !/PJ j ~ L/?fzilLftj
(Address) /LI7'-/;::; J. ~ m'l- t/}1#}?1iJ)AM }/J1n 79kP
I (Adclrcss) . (City) (7i~ Cite}
(Contact Person) ()(tJ piS. f; ~~ .[. -ff (phone) (ft}1:-.L(?6 -I! '-I'-f
'')LICANTSIGNATURE ~:3Z2,/.?<1 DATE --0
PID
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from struc.:ture ___ feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated le.ngth of sewer line _ feet.
Clean out (if required) located at _ feet from structure.
FEE SCHEDULE
ReSIdential sewer and water line connectloI) $3550 Industrial, Com'1 &. Multi-family 1 % of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50 SUll P~/D ~
DING 1'rJ..J
P~I141rr
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
\;:~'t',,--
Building Official
24 hour notice for all inspettioll.ll (95~) .W7-98S
i..
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS -1531'-1 :k{,re~ ~-3
NATURE OF WORK AJ-t-W
USE OF BUILDING .s;lj
PERMIT NO. ~O DATE ISSUED 5-"5I-oL
CONTRACTOR PHONE (P'2 -~~- 3.2ct7
NOTE: THIS IS NOT A PER IT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
l MiA.,,^- t-.. k
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING ~ 671
FOUNDATION (Prior to Backfill) {,
PLACE NO CONCRETE UNTIL ABOVE H
ROUGH - INS
INSPECTOR
DATE
6-f/-dz.
't~ "1
S BEEN SIGNED
SEWER I WATER I SEPTIC
FRAMING u./ c
INSULATION
ELECTRICAL
PLUMBING UG. . <f'-~-o~
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
J. ( oJ..-
s/s/cz.
GRADING (Prior to Sodding) ,
BUILDING L--J~ X.I/,O)
ELECTRICAL /
PLUMBING
Vf~ ;'( . I ( r>
HEATING , ,\ \ . ~ ~
/
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, car~ shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850