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DEPARTMENT OF
P RIOR LA BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /4 pt3 /2.Kst a 6 (�`r
NATURE OF WORK LOWER LEVEL -
USE OF BUILDING € S �f2
PERMIT NO. 1 /CO DATE ISSUED 2 _ / 3. (2--
CONTRACTOR /`?g /� M y gti NOG PHONE
NOTE: THIS IS NOT A PERMIT MDR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
1 1
I 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING / a4/7
INSULATION
ELECTRICAL
PLUMBING r
HEATING (if required)
;REIM
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1 1
FINALS
BUILDING Irlz
ELECTRICAL
PLUMBING
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
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY: i Date: 2 , Z
Building Permit # , Z . /04 PID: Zoning:
Site Address / #3 a 7 p6- /cs(D �-
Legal: L B Subdivision:
Existing Structure: d IP NO
ES
CONFORMS TO ZONING NO
ORDINANCE
YES ( NO
Is this an expansion of the existing footprint or Refer to Planning
building height? ✓
Is the property located within the flood plain? Refer to Planning
Does the alteration include any additional kitchens? Refer to Planning
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors?
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
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