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Home My WebLink AboutBuilding Permit #00-0013 r ':;"~' ,,~ '~'i" - ;~~-,,,!,,;>,~,;.,~,~U J O() - (.>0/3 The- Ctntrr of the Like Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED j v'6-N5 /l)r}NN 1/7/ZQOO I I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 3'-199 I31-1'v/ /~tJOL-~ De. I Accepted ../ Accepted With Corrections Denied Reviewed By: LJAL.~..Il ~~IlE:~MA^,^, Date: 1/1'11,100 Comments: ~E. ac.>I~INtA ?E/tl"l/T" #- tJo- 010 (3t./g, BI4Y IGkJI..L-S .Dftlu~ ) "" ~(t IJJFotlMJ4.TIOIV. ATTJ'blJ'lofENr,s AIJD~.... (J.,j, s" "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." DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 1~-fJ L .K "'D 1 h J)f: ADDRESS ~4Bq ~'1 CONTR. OWNER 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 o EXIGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: ~l L~St.le-- CeO. . Co.O s; e- -C';l e- PWORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ "'U~ Owner/Contr: CALL 447-9850 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! IliSNOTI DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED /2-7-01 , PHONE NO. 3'-191 &t/klJtJ//~ Dr. ( CONTR. Wl/J.SttI~IJ() PERMIT NO. -.f1!:J -0 ('~ ADDRESS OWNER o FOOTING o FOUNDATION o FRAMING o INSULATION ~INAL ....- 0 SfrE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL 'X:' EXIGRAD/FILLlNG .., 0 COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: CU/~ 130;1( - OK.. 6,..(-< - 0 t:'- P(,WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING In5pector:~ _ \JWner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS 34 ~q Oc'1 ~u...S CONTR. OWNER PHONE NO. PERMIT NO. o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI ~F: MING 0 WATER HOOKUP o SULATIO~ ~EWERHOOKUP INAL LUMBING FINAL SITE INSPE ION ECH FINAL COMMENTS: p~ - m ~x ~rl- ~;;~ TIME to ":CJ) 0-/3 o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o ~~I U If ~- q-L tS!A-If);z~~~ ~ ~ (I?')~ i ~ ~ ~_~, I I ' . , ~.__._. _..~~'w_~"'-~......... 7, C.[), -tfM' ~ II / (JrJ " - I . ~~-~~. ~p. ~-u..r?, -~ ~ ~ ?'1J.&-. W / FrJ. ~. to /;; ft; / Bf) . . I o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED 'jI. CORRECT WOR~ CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ { Owner/Contr: . I CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTI CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ~/Of).3..lAJD.. ADDRESS 3 t./.89 1311.'1 KN Ol,-G-..s OWNER CONTR. PHONE NO. PERMIT NO. tJo -()CJ /3 o FOOTIN= ~ , ~P-uA..'~OIl' o FRAMING o INSULATION o FINAL o SITE INSPECTION A o PLUMBING RI ~ECH RI WATER HOOKUP SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: Srr-kJ 0~ L/ Inspector: Owner/Contr: EXT INSPECTION 24 HOURS IN ADVANCE. RE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI hfr CITY OF PRIOR LAKE / 00 BUILDING PERMIT, / / Z qEMPORARV CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT File City Applicant ~Bt! IIfAIIfI Flu:, OO.{)O/l) Permit No. () () - 01Y-3 DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 2. SITE ADDRESS ~~ 7 15 t:i. Y k ./vo /1 s- J) r ,. u ,. , 3. LEGAL DESCRIPTION LOT C I;~ JIJ7 J BLOCK J PID ;)5- 3.5-0 ~ o03-t) 13. TYPE OF CONSTRUCTION (Address) /i9~ 1/42.~ br,'vf Ca"ulV /7l/V 55/~J- 9hptic 0 Deck 0 Re-roofing 0 Porch 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 ADDITION 4. OWNER (Name) (Address) 5_ ARCHITECT (Name) (Address) 6. BUILDER (Name) W"/VfI'n6.IVN I..J fJ I'Yl t' f 7_ TYPE OF WORK Fireplace 0 New Construction ci---' Alterations 0 Chimney 0 Misc. 8. PROPERTY AREA OR ACRES Sq.Ft. 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE Yes No 1. White 2_ Pink 3. Yellow 1. DATE j- J- .:z.OO 0 JeZSO BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) 12. NO. OF STORIES (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE (Tel. No.) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS ~Sl- ~O{r <;<100 SEATS 16. PROJECT COSTNALUE 17. COMPLETION DATE I hereby certify that I have furnished infonnatlon 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building offici can revoke this per' for jus~use. Furthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections. X ~"")- / Y...$- tJ" / - 7-:2.. 0 I) 0 d /~ignature License No. Date It' FOR ADMINISTRATIVE USE SETBACKS: Required Actual Front Back Side BUILDING DEPARTMENT VALUATION OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION USE OF BUILDING .sPl'1 8\ , (1(')(':). aD o Water Tap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ Total Due .............................. $ Paid ~;.rLl. 01 Date II (...s-h, () By This is to certify that the request in the above application and accompanying documents is in accordance with the City zoninJOrdinanle and may proceed- s requested. This document when sig~City a ner constitutes a temporary Ce,cate of Zoning compliance and allows constructio}l..to commence. Before occupancy, a Certifi of Occupancy must be issued. A-. - ',-!.~ Se~ 'By.:tt:- f)() - on I 0 "City nner Date Special Conditions ff any TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R Division 1 2 3 4 Pennit Fee ................................... $ S U City: ~oSO Li q 'i . ~3 4.0, S-D Plan Check Fee ............................. $ State Surcharge ............................. $ Penalty ....................................... $ Plumbing Pennit Fee .(JJ)~..m.!.~.. $ / C> C> . C9 C;J Mechanical Pennit Fee @. ~.61..~... $ /0 0 . 0 C) Sewer & Water Pennit 0l.:D.U.1.3... $ '3S; , 50 penn~'t ~~.ro. .... $ 4() . 00 e Your" ennit When Approved. ~ Date -.I - I ~ - ~VDC.J ~-/ . pancy ~ I ~ I Issued Side MATERIAL FILED WITH APPLICATION SOIL TESTS 0 ENERGY DATA 0 PILING LOGS 0 PERCOLATION TESTS 0 PLANS & SPECS 0 SETS COPIES SURVEY 0 PLOT PLAN Amount Brought FOlWard .................. $ Park Support Fee ........................... $ A c..n. 06 SAC ......................................... $-LJ Ob .00 Collective Street Fee ....................... $ Sewer Tap ................................... $ I' $ Pressure Reducer ......J................... $ 70.00 Meter Horn ................................... $ 00 Water Meter ........1........................ $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ ::25().ob 1,2.00.00 . ?Qo. a"l -0 - 5.' 75'f.O~ .J (., 1 7 1..- 24 hour notice for all inspections 447-9850 j',,, .;' (. /7 I ,f, . \J \ '.' :.....,/ The Center of the Lake Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED " , '. " I ,. ., . J "'J" I I \ ~ I': /'-'//\ 1\...../ '( --...... ' , I -, ,.,.. .r' i./_'_) (.. / (, ) /17/,.2 - v i I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ,. .........." '-I,' (,... c--{ ,/ - I r l i~, ," , ,--. "1 --'- . / /-,.. ; .. t..,.... ~/ -___.I I . I :...,) f.:..__ . Accepted Accepted With Corrections Denied Reviewed By: Date: Comments: "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 violatiol'l 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." 00 -00/3 Th. C.nl<< of Ih. L.k. Coonlry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED W6NS MI7NN / /7 /Z.OOO f I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 3Lf 69 BA\j ICNOL"L8 De.... I Accepted "Y Accepted With Corrections Denied ~ /J A-- Reviewed By: ~-? j/( & ~ L/--~ \.T)/ Comments: Date: /-/~-!il~O <3t2a. 6P-+\:-- 00 - 00(0 ~, 9lc ..) S~$. .s () r lJ-M.v ~. () "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." MAR. 14.2000 1:48PM GENZ RYAN 6513226147 NO. 766 P.2/5 .... - .... ......... . AI9LIC:Ul' aaLD - err., CITY OF PlUOR LAD: NO. (fV -tJ{) /3 SEWER AND WA-.u"A ... ~U'I' NOTE: Sewer and Water contractors must be reqistered with the city. APPLICANT: ('~ 117 - ~ ADDRESS:14\4~ ~ (i~~L. e.r:...lA., SIGNA'I'URE:. lk. ir)~n--. SITE ADDRESS:_,~~ ~ '1' Y---Yh.ll, U~_ FILL IN THE BLANKS I 1. Estimated lenqth of water service L.JO III 2. Size of water service ineb(es). PHONE:UbJ-4Z:; -11L/11 DATE: d'211~ BLDG. PERMIT # OD -()OI3 PlO# 25 - 30-0 - () 03 -0 feet. 3. Location of any couplings from st;ructure feet. ,,-, 4: . Type of sewer pipe. ABS pvcX Cast Iron , ) lin~ )...j() I 5. Estimated length of sewer feet. 6. Clean out (if required) , located at feet from strQcture. ~=_______ --==~::::!!l;===lL-.. -__ ---------~---=------~=====-~ This BY s your permit when approv~dl .~ D~TE: 3/ /4-/00 ----------------.-- "=== -~ "'~_, FEES: $ $ $ 35.00 .50 35.50 Sewer and water line connection permit. Surcharqe TOTAL * Fee for either sewer or water individually is $20.00 plus $ .50 surcharqe. * Sewer and water permits issued for nay construction must be recorded on the buildinq permit card at the time of issuance to insure that no duplicate sewer and water permits are issued. (.J DATE PAI!:? . RECEIPT # AMOUNT PAID .._ "r:;-'.\ . i\ fI~\V Gf~"'" REC' 0 BY (. ~\\n\\'~ \~v . 4629 Dakota Sl s.E.. Prior UiKe. Minnesota 55372' I Ph. (612) 4474230 I Fax (612) 4474245 AN EQUAL. OfPORTUNI'N ~LC't'ER . I MAR. 14.2000 4:32PM GENZ RYAN 6513226147 NO. 775 P .17/21 1. IhIe Ili1c 2, 0.14 CIty J. YelIwi AppIicIIIl # ()()-()())3 Phone=-.!O<: '....U2?-IIUU- e~~ .I'Y'f'i1 ~ VI' - CITY OF PRIOR LAKE ,PLUMBING PERM" AppfIC8llt(;, .Yl2 -f' ~ Address: ,lLJ1\J.~ O!J --cE,.' Signature: -f 1, > Legal Description: La Block .~~ Site Address: .~ ~ ~~II,- r,.x~ BuildingPerm~-O~ PID#Z5-.....3fiD-(JO~O NOTE: This permit ~i11 not be precessed without complete information. FIXTURE UNITS TH COIl'Ol' .r ,.. ~k. C.U'''' Quantity ? I , .3 l , I ,..- . . ',I 7- . i . .- - . TYpe of FIXture Bath Tub with or without shower Dishwasher Floor Drain Lavatory (bathroom sink) Laundry Tray (1 or 2 compartment sink) Shower Stall Sinks Bar Sink Water Closet (toilet) Quantity J 12-1 , , Type of Fixture Rough~ins Water Heater Water Softner Stand Pipe (washing machine) Sewage Ejector Baclcflow Assembly (RPZ. Double Cheek, PVB) Backftow Assembly Test Lawn Sprinkler Other $ S $ $ .50 FEE SCHEDULE Industrfal, Commercial & Multi-Family (1 % of job cost. $39.50 minimum) Residentlal, New One & Two Family Residential, Additions & Alterations State Surcharge $99.50 $39.50 $ " '\\ . ,;..."" GRAND TOTAL 'This permit ili grunted upotl the Cll.p~ condition that said ccntmctor, shall compl in all respectS wiEb the ordirumces or the State PIUIIlbin e~~epts thereof. - .. '/51'00 DATE .'1 A TI'EST Call for all . 16200 Eagle Creek Av. S.S., Prior Lake, MinneSOta 553721 Ph. (612) 447-4230 I FAX (612) 447-42~S An Equal Op,onunity Employer ..-l (\J "- ..-l ..-l If) SMe Addteaa l'- r-: L.oI Black Addition o . z: owner'&Name~_ .~. AddrN8J!l1_, .'ebz~~2{Y) FK~ Heating Cont,aclor _& ~ AddlBSS llh~ So ~ ~ ~e!fJ~~vcr Telephone' ---Lo~' - LI2.3 - Ill/. U. Furnaal Make & Model ---1--' -JIl Y\6J1< TYPE OF SYSTEM . ~ ~ Wa,m Air Planlnl ModelSIZI ?---~ '0 ~!~ Gravfty Cann: load Mechanical ~ <<, Air Condlllonlng ~ ~ Fuel tJt..r. ~FIU8 Slze'y ~V8n1. System ~ - ~ Supply Openings I ~ HEAliNG OR POWER PLANT ~ ':) Steen l2 Aslurn Openl~s Hot Wale' z: 1 RadJallon ~ Input r;,1ro1) Output lDD:~ SpecTatDevlces N Edr. z: w l!) Cfm. LTD~ Other Devices TYPE OF WORK E: 11. (Sj AJl.eratlone (T) "" Repair New Construction )l . Replaclltfl8n1 . Est Comp. Dale ~O-OO/3 ~ Est. Cosl $ (Sj ~ HEATING PERM" FEE' "" ..-l tY STAlE SURCHARGE . <I . E: TOTAL PERMIT FEES $ BuBdlng Permit. , .50 / ( PAlO WITH ReceIpt' \ BUlLD\N.G PE.;;;\JUT TYPE OF STRUCTLmE l. Piall - . m. 1. Ore ., :' City J. Ye~- .' OJ."... v Single Family - , lWo.FamAy rndustrlel CommelcTal. Fee Schedule Indualrial, Commercial & Mulll.Famlly Resldenlfel, Heating & AC Reslden1fat, Heatrng Only_ Residential, Gas Areplace Residential, Adcfllions & Alterations Rasldentfal, AC Only Multi- Family Public OIh8f' 1 % of Job coat ($39.60 mInimum) $99.50 '64.60 $39.50 $39.50 $39.60 Remembel 10 add the State Surcharge on the bottom of thl. apprtcaUon. The.p,lce of your heatIng permit Includes one rough-In end one finsllnspectron. Addllonallnspecllons will be billed al $35.00 each_ House Healing Test Record mua1 be submitted with biiI!IlDg RmDil numbsr before bliNd. Ing certificate of OCcuparlCV will be issued. HEAl CALCULATIONS REQUIRED with number of supply and f8twn openngs listed par room with CFM'a per opening. New .t,ucluras or addllons Hnd 1100, plan wlIh auppfy and Istuln Iooatiohl &hown. HEAT LOSS CALCULATIONS, PAYMENT AND APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR lAKE. 16200 EAGLE CREEK AVE. S.I:. PRIOR LAKE, MN 55372. Citv Hall business hours are 8 8.m. . 4:30 p.m. ALL WORK MUST BE INSPECTED (ROUGH.IN AND FINAL). CALL errv HALL 447-4230 I hereby apply for a mechanic-II systems permit and I acknowledge that Ihe Infolmallon above III complete 8Rd 8ccuref_; thallhs walk wIN be In confo.mance wllh the o,dlnances and codes of the city and with the 8tale bundIng/mach.nloaf codes; Ihat this form does not become a pelmU until Ilgned by the BUILDING OFFICIAL; Ih81 the work will be In accordance wilh Ihe approved plan In the ...../ tll work whl.n ..qui.... ..VI." .nd opptoval ., pl..... A J). ~~n"s ., oII1~~ (, 3/i5jOO BDlkIh Ig""CJffica Oale CITY OF PRIOR LAKE Me ~' 16200 Eagle CleekAv. S.E. PBfmlt NO'CJJ'-~" ~~.\\ Prior Lake, MN 55372 c: ~ . ~""\ 'J HEAllNG APPLICATION I PERMIT ~Iy 61 Commercial Dattl . Sfto/t?lJ PI) II ~ S' - 3';)/)-002 ~ Site Address S~~ JS,~ I(lJM,t.-I 7J4.;JL ~\- '/<). {f _ ,~ Block -L Addition (b I \},(\ i ^-}11 kx- l 'S+ A{)1JN () ~A ~LJ l~pi~ ~ Owner's Name Address Heating Conlraclor ALLIED FIRESIDE dba FIRESIDE CORNER Address 2700 N. FAIRVIRW. ROSEVILLE.!ill 55113 Telephone' 651-633-2561 FIREPLACE ~ Make & Model i!t.,.j /oJ ,(..: Mld91 S[Z~ Conn. load Fuel ~J Supply Openings Return Openings Input Edr. elm. Algrations Repair Esl. Co sl $ SL~ TYPE OF SYSTEM Walm Ail Plants Gravity Mochanical Air Condition~'lg Vent. System Flue Sll.e Output ~ Q.l) HEATING OR POWER PLAHT Steam HoI Water Radiation Special Oevices Other Devices TYPE OF WORK Replacemenl Est Comp. Dale New Construction v Illlllil ) Buidfng Permit . .~~ (n, -Qln rl. ~~ -~... HEATING PERMIT FEE $ ST A IE SURCHARGE $ TOTAL PERMIT FEES $ .50 Receipt , en lD :J r+ rVPE OF STRUCTURE J. ftllk - 1'"* t (ftn - CIty lJ:l 1. l"1!.... . c-...." '< Two-Family . Industrial Fee Schedule InduShla!, Convnercial & Multi.Family Residenlia~ Healing & AC Residt!ntial, Healing Only Residential, Gas Fireplace Residential, Adcfltions & AJleralions Residential, AC 0411y Pwijc MtIIi-F8II1itf O1tter .,., .... , lD (II .... a. lD o o , :J lD , 1 % or Job cosl ($39.50 minimum. 199.50 164.50 S39.5O $39.50 $39.50 MAY \ 0 2000 Remember to add lhe Slala Su~llarge on Ihe botIomof lhis appication. t1l U1 ..... The price of your healing pennil includes one rough-in and one Iif* :....,.. ....Jloo. t1l Co) Co) Additional j"",,t"':'..Jons wiA be billed al $35.00 each. CD CD CD House Healing TKt R.....w. J must be submitted wi\l1 buHdinc;J JWIDi DWIIlmr before build- y~ ing certificate of occupancy wi' be issued. . tlW.c&.WlATIONS aEaulREO with mrnber of supply end return II' '.1 listed pe roorn with CFM's per opening. New slrudures or additions send floor plan wiSh supply a.-.d relurn locations shown. HEAT lOSS CALCULATIONS. PAYMENT AND APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 162.00 EAGLE CREEK AVE. S.E. PRIOR lAKE. MN 55372. City Hall business hours are 8 a.m. . C:3() p.m. I ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL 441-4:l30 I hereby apply for a mechanical systems permit and I .cknowledge that the inlorn,alion abo,,'e is complete and accurate; Ihal the work will be In conlormrmce wilh Ihe ordinances and cDdes 01 the city and wilh the stale buildingfmecoanlcal cndes: that this fOfm does not become a permit until signed by the BUllDlNG OFFIC IAL: that Ihe work will be in accordance with the approved plan in the case of all work wrnch requir9s review and approval of plans. 3: III '< , ..... o . o o ~ .,:>. o J> 3: ~~ t::""~iJ/ fJ~ ~' - Oate S/; 0(::; "'tl III co lD .... Co) ., . " Job Address 3.~ <67- c~iulJl ~ Heating Contractor C(Az:.~ tv~/I . Name of Tester I t C~ . ~~(r_~ . Date . u-~ ~ 7 Percent 02 Percent CO 0 Stack Temp. e5'; Percent CO2 t6 '\ P.RIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS ~ B ~ &.~ k WJll,. D" . NATURE OF WORK ~ ~lt-uc:..t..I~CD'\. USE OF BUILDING SFA PERMIT NO. 00 .. 00 , -:J' DATE ISSUED CONTRACTOR ~\A.~ ~..~_ u'''_6~~ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT , FOOTING I 0 '~i:;: I , FOUNDATION (Prior to Backfill) (:D197( I . PLACE NO CONCRETE(vNTIL ABOVE HAS BEEN SIGNED ROUGH~NS. . SEWER I WATER I SEPTIC . K: Z/3(()() - . FRAMING (/fW7Ico /J INSULATION d'~<{;/tff(L~ ~ L. ~t%.~ ELECTRICAL , j/ ;;. .L. L. .~ /~ Jot-, PLUMBING tJ;}, . ^ '( I / ~/) r HEATING (If required) , U ,,-j 7/f/{J J.,. I FIREPLACE . V ("\ . a gh>/C/) GAS LINE AIR TEST M!fK lU~;) ?/vp '~~ff'v. COVER NO WORK UNTIL A E.. VE ~AS BEe:iiSIGNED aD I I FINALS /Jib GRADING (Prior to Sodding) BUILDING i c.o-tW. ~/I f ~ fb:n t,J~/," ELECTRICAL PLUMBING HEATING DO NOT OCCUpy UNTIL ABOVE HAS NOTICE '1'..--- '-l~-qe, - --&- . DATE /~-/-o/ . {p. ~ ~/;).-~/~ ~(~~ 1,/;)-0/ 01J I BEEN SIGNED . 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. Call between 8:00 and 9:00 A.M. for all inspections FOR All INSPECTIONS (612) 447-9850