Loading...
HomeMy WebLinkAboutBuilding Permit 11.1041 N- 4 n ` f A NA, A ?u Uf AA 7 , ANA A A U u u A U ,_a i__ i.i ,_i c. __i ii,_. i_.ii.. ,.r..n_.i:a ., o.i,.i i,_i ,:n i,_u Y it.i nc_r i,.r..n..i.. _.rr..�_.u. c,_n:.i,.n i,.i,� .� i__�ii. i,. ,�._. ,. ,, i2 C neiftftxafr of (fit patty r CITY OF PRIOR LAKE girparfturtif of 0 uiIMMI cinsprtfi.xn I�Fina1 Permitted ❑ Conditional C.O. Expires This Certificate issued pursuant to the requirements of Section 110 of the ❑ Resi f ❑ International K Building Code certifying that at the time of issuance this structure was in compliance with the various ,. j ordinances of the City of Prior Lake regulating building construction or use For the following: Use Classification ; c \ - r, , ( •r r i i c r ( - , ( Bldg. Permit No 1 1 1 6 (I 1 ,I�); Occupancy Type (IL. . Type Construction Zoning District _ r r Legal Description L Y i '- ' (ice I .1.� 1 er _ U 1 c 1. 'I 1 c ? „.4 ,t-.),- , Owner of Building Site Address I 1 1 r, (/ ' / 1 " 1 r, "`'" '' vS ' Contrator's Name & Address �� a T ` - 1 � . ( _ I ` C i ty Planner r Building O Date: �/Z / '( t z Date: POST IN CONSPICUOUS PLACE V_ fi'/ ` V V %S} Y ,' 1 ti V -- 0 T. a J re W � > q ,o a. (`) N. (pawing) ; 0 < 41 o W Lersa Z \ O W O Q 0 r E. 000000 M I 0 'o �. W = rL tOi a O W 6 » 2 Z a O W G re C 2 0 Q LL J 0 U V • _ — Z it z —zzzZ 0 c N O N r 0 d m W W m a z jUI" W W Z X 1:14 JW Q J W tL A a W 11.1 W W % \\ %. a a u. I W W • 0 0 O W Q LN a O .I c JF' _ ta O 0 e J U O h O z F O a 1- < Q ro 1 rt O O O ozy h Z N W w W a. r.. y = IMZE ..J W X a W c < 0 0 W W W W OD h2F O O O • V d 0 0 t �? N1 '= 0 0 V? < 0 a 0000 0 \ ISKO 0 c CO 0 J W H E r e W ti VI tl g g55 0 W 0�W Wu 0 d `M 4 C =_, w VLLLL0 Z } 0 ❑❑❑❑❑ct > co re —b ` V O ore = N G J W Z C D Z YY Z U 0 ka 2, 4 Q LL J 0 o 0 r 4. V 0 W r O __ _ 2 3 0 c N o n o <3 _I C C Z x O �8 a �3 ft N l a � w w re w �' � -- 0000❑❑ o o cc Z a a LL = J ~ O 0 5 o Qo re co us OC O O O N Z co w w - W ill U. co re W 0n p ix y .2 V V O W re W Z OO12 N C 0 LLLL LLZ rt. in" O � 0 0 1. 5z < 0 a 0 0 0 0 ❑❑ C., 0 0 c 0 Jg W = ZI t- .JJ IZ Y.Z_ ui o=VV� z 0 4 8 555= > 0zWWy 0 < `ti W Z ce _ o uw 0 u. 0 a z I 0000❑❑ o j 0 0 ce _ u• N O o a. o _ m w z LI J Z Y Y ? Z 0 4 G ! F 0 000< v d a oC La _ Z Ce Z —= =Z D 0 Z u � W g co m z � z �,,11 m 0. z iii H V d �U '3 n o 0 0 Z F - O d 3 W J UJ W W W w k ' a re 1W__`' 00000 i 0 0 a 4C 1 a a LL = o _ re z a o w I � ` 0 0 u. a 0 oC 5r 0 I a 0 m ea 0 z z w CO ~ CO a 0 0 I- r 4 m0 O 0<Z N Z N W W ....1 ty to u. co ce W 0M M j W 0. Q O _ _ 0 GW re W Z OO�NZF- '� 3 0 0 �. 5z O Po o g 0 u, u. u. ? T. u) 0 � ,� / h 4 = a 0 00000 0 a — 4 PR /04.p CITY OF PRIOR LAKE BUILDING PERMIT, 1 H M II t ` d ti TEMPORARY CERTIFICATE OF ZONING COMPLIAN 11 r AND UTILITY ECTION PERMIT S E P 2 2011 r NN E $ °� See Main rue 1. White File PE `�' _ o , — �f 2. Pink City ► .n � . �• . 3. Yellow Applicant ' ti mi 4 (Please type or print and sign at bottom) ADDRESS f 43 Li r1 S PA t S l DE= CO u P21 ZONING (office use) OP LEGAL DESCRIPTION (office use only) LOTS 3 BLOCK ( ADDITION i .\ _F .12- S VIA-1M r 20 tv `t PID 2 1 '-1 7 BO S 3 b OWNER (Name) ;''t A T 1 ••1't' - N - U t' - S (Phone) b) c;R' — 8 9$ - 2 t o 0 ( Address) 12.c> t 1/./ A S 14 t r b u 1 4 A v E S . $ T a 2.o i O t r - . l -R M t -1 S S LI. 3 9 BUILDER (Company Name) 1 -'r T A-r- -t s i - 14 - C) t-I E. S (Phone) 9 S2 ' 8'5 S — to ULE3 (Contact Name) S U e— " (Phone) (Address) 1'2 1 t....4 1 (T1 J A vl_ S S'l_ 7 r) t t -O 1 N At H tit s - 2D9 TYPE OF WORK 0 New Construction EI.Deck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ❑Addition DAlteration ❑Utility Connection CODE: KjI.R.C. ❑I.B.C. ❑ Misc: Type of Construction: I II 111 IV V A B Occupancy Group: A B E F III M R S U PROJECT COST /VALUE $ ( 6 b, OCX) Division: 1 2 3 4 5 (excluding land) 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 - mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X .- ..__—e r22 E3G.- - 2.-4::› 2 1 532).1:::) Signature Contractor's License No. Date Permit Valuation t O © ®_ Park Support Fee # $ Permit Fee $ 1443, 3, 5-4) SAC # $ Z7_3 Plan Check Fee $ 1 1.6./S Water Meter Size 50)'; 1 "; $ G t et. -- State Surcharge $ m e Pressure Reducer $ p_ Penalty $ Sewer /Water Connection Fee # $ (5- - ' Plumbing Permit Fee $ i 5-4 CO Water Tower Fee # $ ( p00. - Mechanical Permit Fee $ 1 51-• s® Builder's Deposit $ (500.. Sewer & Water Permit Fee $ SG Co Other ,S 12.e - , Gv 6 $ IS 14'..C4 Gas Fireplace Permit Fee $ 5 -Co TOTAL DUE $ f9/4 7$ This plicati ■ . : o ., . , our Building Permit When p ved Paid 9 / � .. 7, Receip O. Z 1.7 (/ ` Date /b , 5 // By Buildi _ 0 cial te This is to , wi that the - . est • e above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signer thj . /' • .er .nstitutes a temporary Certificate of Zoning co lian and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. 4 i®iritL 6 3 ( i ' Planning 1 re c �� te Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 ez ' , • k NitN444 ?Ri CITY OF PRIOR LAKE to c � y _ � ; •A • HEATING /AIR CONDITIONING/FIREPLACE PERMIT OCT 1 7 2011 ,737'' 'z A)s'ESo�w i. Pink "c P ERMIT N i ii 1 = • • . a. Own CO) , Iri &. . Yaws. Apdxoa L (Please type or print and sign at bottom) ADDRESS ZONING ((Aye use) J \IA3.. ` .. 1 1G C, 0( . k' 1 \1 kA3 ' LEGAI, DESCRIPTION (otfice use only) I LOT BLOCK ADDITION PID OWNER ' h (Name) ..._ — _ _.�" i ' . 0 . A iii (Phone) AI (Address) . • APPLICANT - - �i - , r (Phone) q St, "I r t OM {Name) ......_.__._. / ' �,T k � (Address) D H Vi/ t 2 �m ∎-,, va e . �i> s. .3� _ ( 4 . , : 'i) (City) (Zip Code) I /-, y (ma (Contact Person) j- i L _ _ [L e (1 /� %L'L ' (Phone) IS „D "1", l 'E, q . [ APPLICANT SIGNATURE .. ._Mt: 1 'i /' : - .' r. t, - _ r di ..:. . .............. DATE _ APPLICANT PLEASE COMPLETE BE LOW a EW CO STRUCTION ❑ REPLACEMENT (3 ALTERATIONS FURNACE MAKE AND MODEL }-k VW ∎3i''l th - 1 _ Or — FUEL )(t - 4 6,6....'3 FLUE SIZE RETURN OPENINGS INPUT UNIX) IX) OUTPUT t )'00 TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner warm Air Plants D Steam Units and Fireplaces Cannot Encroach Gravity ❑Hot water into Required Side Yard Setbacks. Mechanical ❑ Radiation Fireplaces with Box Additions or V ic/ Air Conditioning ❑ Special Devices p cots System ❑Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi-Family 1% ofjnb cost Residential, Gas Fireplace 349.50 $49.50 minimum Residential, Heating & A/C (New Construction) $i49.50 Residential, Additions & Alterations 549.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only 549.50 Estimated Cost $ 55 4 Building Permit # The Minnesota Statutes * 326l3.l4g "'1 RCIIARCit:" has hcen changed for one HEATING PERMIT FEE $ ItAci. yearcffcctive STATE SURCHARGE $ 5 'v - - 10" *fitly I. inio. until June 30. 2011. TOTAL PERMIT FEE S t - ' v The minimum surcharge fora "fixed rte" permit ��a (Office Use Only) is;,:, heitlnn {ne.hdr 1.2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date 13y PAID WITH Bolldtne Official Date , BUILDING PERK' 24 hour notice for all inspections (952) 447 -9850, fox (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 / 1 3' 1.4 c r RiQ ,J Ll)t e� t e� CITY OF PRIOR LAKE PLUMBING PERMI O 2 011 4rrNNEsdo- t. atm Ede r i,i, i ; a. .' :� ! : . 2 cord CO ri - • n 3. Yellow ApphK ._ _ 1�_ (Please type or print and sign at bottom) ' ADDRESS ZONING cornet use) IL4; ' I = PCA_P(- ...__ - :l..J LEGAL DESCRIPTION (otTice use only) LOT BLOCK ADDITION PID OWNER 0 (Name) ' ] - �r t f. (Phone) (Address) APPLICANT �7 J �� U (blame)_ u, 1 V V U ._.._ r ' _ (Phone} C � __ t ` it \ ' U " � (Address) _ -_ . vU_........ � �!� ���},� �i� 4 v�� � ?�3� (Address) (City) (Zip Code) ,n y y� `. , (Phone) (Contact Person) . , L i , 1 i V.J� ) j� � - , %-..t..) %-..t..) „- APPLICANT SIGNATURE .. Ala l ) 4 .. ::. ..__ ' ati,' 1- DATE .. _ .......__ i A APPLICANT PLEASE COMPLETE BELOW _ Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower 3 Rough - ins Dishwasher Water Heater j Floor Drain _ _ Water Softener Lavatory (Bathroom Sink) Stand Pipe. (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly 1 Sinks _ Backflow Assemb Test Bar Sink Lawn Sprinkler Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi - family 1% of job cost with a $49.50 minimum Residential, New One & Two- Family $149.50 l (� (� Residential, Additions & Alterations $49.50 The Minnesota Statutes $ J26f3.14R ^ gat $ = 1 Pntldtng Permit # S1 has been changed for one year effective PLUMBING PERMIT FEE $ 1 `SI) .July 1. 2010. until J une 30, 2011. STATE SURCHARGE $ g 7-:58 e minimum turcbarge fora "fired fee" permit TOTAL PERMIT FEE S 1 S is u, beginning July 1, 2070 This Application Becomes Your Building Permit When Approved Paid Receipt No. . _..� Date 13y l H- Building Officlat Dale - _ PU LD !G PEEWIT 24 boor notice for all inspections (952) 447 -9950, fax (952) 447 -4245 4646 Dakota Street B.E., Prior Lake, Minnesota 55372 1+31. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec''d TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / . / 2. . / L .. v i t..... ez, AND UTILITY CONNECTION PERMIT 4,1 8 'NES. ° PERMIT NO. //, /041 (Please Type or print Ira sign at bottom) - . ADDRESS 1 i ZONING iarfwt ., /4 1 7 4 1 - 7 1 *--) A tZi I 10' CT: Al i(- lki/ Lc oc,,,34:44e; 1 i LEGAL DESCRIPTION office use only) LOT BLOCK ADDITION P10 OWNER — ) , i 1 , , (Name) Pi 4 T14 1 ti 4.. me ., (Phone) . (Address) - 72.L.:' i kilAct-1 its i &T Me: 'S. BEER ,s,C (Corripany Name) t4r1 riff' Ph* 1,..tatES 101'J (Phone) (1151-794 —044 7 • (Contact Name) -400601 i2100,d.T.Cg- (Phone) (Address) b >, _„ __., p. 1,-.0a L Aie-cs t-404 i4vrt>i TYPE OF WORK '.New Coristructou ,,r 0Proch °Re-Roofing 0Re.S 0Lower Level Finish 0 FurpLice 0Additaina 0Aiterarton 0 Utility Connection COPE: 14I.R.C. DLB.C. 0 NI:se . Type of Construction: 1 II III IV 65 A & ' Ck-cupartcy Group A B E F H I 14 .(0 S U PROJECT COST/VALUE 5 32- 0 0 ° Division: 1 2 0 4 5 (excluding land) i t .:•mein men., that I have kattaittsi information on thasapph4hot what rs to the heut of my knowledge :Mt ON! correct !mix con& that 1 ant the owner or lutboturd agent F. the '; aboae-tneohotted property and that all tottattuctaei will conform to all existing nate and Immi laws and *IN pmeeed in acvewataner with sultrentted plans 1 atn aware that the hotthog 9 :-..a1 un , -okt this penut far at CaltatjiAlthatirtart, 1 hJerabY ogler that the CM+ Offitlai or # destgr.„0: rt thter 14'w :he propenty to prefornt nerded x IttSpeCt10113 C * C ) 7 4 . / -4 -/Z #::.• &irk CA..' I „..„, — SOature CorrtrActor's Lt' se No Date 7P Vai'—''7.----ilation Park Support Fee # S . t i-- i remit Fee 1 $ SAC # $ ..-- 1. ---, ; PUB Check Fee $ i Water Meter Size 518, 1 S State Surcharge $ Pressure Reducer S i 1 i ; Penalty $ --- Sewer /Water ConneCtton Fee rd S i nun:buts Permit Fee $ Water Tower Fee # S 1 Mechanical Permit Fee $ i L Budder's Deposit S Sr & watcr Ferran Fee $ 1 . Other PAtawmi--i ! Gas ftreplace Peinlit Fee , $ TOTAL DUE BURDING PEFimIT .--• , • , ' A . ‘ / ,'■ ; ; • ■•,, - Your Building Permit 'Mien Approved , 4 A... i Paid 1 Date 1 Receipt No. / /M : . , T h i s y a to e a r t a t t a that a f t r e v e l * to t t v e above a p p h c a n o n a n d a l a X e t A r A l l . r n g 4 1 . 1 , 3 1 ff i a l l t a A rn U . : o r - 4 m A , wah t h e C a) 7ZY11Mg Ordutesice and may proceed .a.$ reziested 'floy document 1 when wed in the Orr Planner consurutri # temporary a-rex-ate of lie* cemiphance and angers COTAtt to ,orernenor Before occupancy. * rentficste of occurrno muct ' mrue,...i elct Uty.,, P 1( ( Blatuntag Ducctut , fame Si 'ea: ■ OattiOnt, tf ze) 24 our notice for all inspections (952i 44/.9100, fat on) 44".4244 4446 Dakota Street S.1, Prior Lake, Minnesota 5$372 lir.. Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: JEFFERS POND DATE 2 2 1 2 PROPERTY ADDRESS: 14347 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS OYES ONO EQUIPMENT USED IS APPROVED YES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS OYES ONO TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: YES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS OYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS !EYES ONO 3. NFPA 25 OYES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2011 1/2 12 155 SPRINKLERS RELIABLE RES 44HSW 2011 1/2 12 155 RELIABLE F3QR 2011 1/2 1 155 PIPE AND Type of Pipe BLAZEMASTER FITTINGS Type of Fitting CPVC MAXIMUM TIME TO OPERATE ALARM DEVICE THROUGH TEST CONNECTION ALARM VALVE OR FLOW INDICATOR TYPE MAKE MODEL MIN SEC FLOW INDICATOR POTTER VSR - F 0 5S DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE TIME TO TRIP TIME WATER ALARM OPERATING TEST THROUGH TEST WATER AIR TRIP POINT REACHED OPERATED CONNNECTION' PRESSURE PRESSURE AIR PRESSURE TEST OUTLET* PROPERLY MIN SEC PSI PSI PSI MIN SEC YES NO W/O Q.O.D. WITH Q.O.D. IF NO, EXPLAIN LOCATION MAKE & SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE & FLOOR MODEL (FLOWING) PRESSURE REDUCING INLET (PSI) OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW (GPM) VALVE TEST N/A OPERATION: ❑PNEUMATIC ❑ ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE OYES ONO CONTROL STATIONS DELUGE & IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT IF NO, EXPLAIN PREACTION FOR TESTING VALVES OYES ONO N/A DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKF MCN)FI SIIPFRVISIC)N 1 OSS Al ARM OPFRATF VAI VF RFI FASF OPFRATF Fl FASF YES NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi (13.6 bars) for two hours of 50 psi (3.4 bars) above static pressure in excess of 150 psi (10.2 bars) for two hours. Differential dry-pipe valve clappers shall be left open during test to prevent damage. All Aboveground piping leakage shall be stopped. TEST DESCRIPTION PNEUMATIC: Establish 40 psi (2.7 bars) air pressure and measure drop, which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES ONO EQUIPMENT OPERATES PROPERLY OYES ONO N/A DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? OYES NO DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION 6.42_ PSI CONNECTION OPEN WIDE Y4 PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 85B OYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING OYES ONO IF POWDER DRIVEN FASTENERS ARE USED IN OYES ONO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS 0 WELDED PIPING OYES 13 NO IF WS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS 010.9, LEVEL AR -3? OYES CI NO WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 OYES ONO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISC ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? ®YES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? YES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA OYES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: 2 -2-7-12_ NAME OF SPRINKLER CONTRACTOR: METRO FIRE PROTECTION TEST WITNESSED BY tit •WN ,i - NED) �-� TITLE D TE SIGNATURES ` �c sly l 2 2.7 �� 2 FOR SPRIN ONTRAQTOR (SIGNED) TITLE DATE a a. Z - 2- ' ADDITIONAL EXPLANATION AND NOTES P RIOR DEPAR OF LAKE BUILDING A INSP TION See Main File INSPECTION RECORD SITE ADDRESS 1A Feca.K.s Lod- CI NATURE OF WORK stN6.c.e. 11, AGE t tic No P 012- .t.L. USE OF BUILDING 5 F PERMIT NO. DATE ISSUED to la II CONTRACTOR Koer -car rt PHONE asZ -sqB- 61z NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOC ME T 1%t A/4 INSPECTOR DATE I FOOTING 1 1 I FOUNDATION (Prior to Backfill) 1 1 PLACE NO CONCRETaUUNTI ABOVE HAS BEEN SIGNED P-A-6d" 1)( c'151154'` vU/ -a0(a' ROUG G . A -IN e t3 A14tJ SEWER / WATER / SEPTIC FRAMING 1/ z INSULATION M � /� 7 / ELECTRICAL PLUMBING ro /ze, 0 ' HEATING (if required) /� FIREPLACE /� GAS LINE AIR TEST 0, ' ' p CO VER N W ORK UNTIL ABOVE HAS BEEN SIGNED S1 i∎iPC, , FINALS 2 /2 - ?// GRADING (Prior to Sdd in 9) BUILDING - ELECTRICAL PLUMBING W p j 7-7.2)/( 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, card shall be placed near main entrance. FOR ALL INSPECTIONS (952) 447 - 9850