HomeMy WebLinkAboutBuilding Permit #00-0223
QATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
APR _ ~ am TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
,13/7 G /VN lJa Tpr T r~ I' J
3. LEGAL DESCRIPTION /
LOT 7 BLOCK
ADDITION -G.../ V N k.. J ti 1 t'r
,
4. OWNER (Name)
5. ARCHITECT
(Name)
6. BUILDER (Name)
W 'lvJ 1111l,N1V
JJdtnt'S
7. TYPE OF WORK Fireplace 0
New Constructionp..o- Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. (JlJ - 0 Z ~ '2
1. DATE
1-..1-';100 0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
Nw
12. NO. OF STORIES
3 PID :1S-- 3bS - ()~- 0
~, AI; ~ ~ '7..'
~ If/( # , / I {).J'/
(Address)
(Address)
(Add~J)
L 8'5 /I~ ~'" /)/1
(4'0# jJ1/V
~tic 0 Deck 0
Addition 0 Finish Attic 0
9. PROPERTY DIMENSIONS
Width Depth
13. TYPE OF CONSTRUCTION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~5/- fD6-~~()()
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
1 O. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished 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 antat all co truction will conform to all existing state and local laws and will proc. eed in accordance with submitted plans. I am aware that the
building official..cjl1 revoke this pe it for ju ause. Furthermore, I hereby agree that the city official or a designee. may enter upon the property to perform needed inspections.
X ~J~__ /'YS-? ~-J-~ooU
,. / ( ,fignature License No. . Date
v
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
Sf A
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 100,000.00
Back
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Meter Hom ........<1 tt................... $
Water Meter .............................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
ir~~;~~6:;~~b.~~
Issued ~
Date By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdin nee and may proceed a reque ed. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 0 Occu ancy must be issued.
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
8el1.~c)
5~~.71
50.()o
100.ocs
/00'00
1~.So
Gas FirePlace!iit ";;fo" 0.. 0........... $ '10 .00
This I:).I~ ecom JunJing Permit When Appr~~. .-.
BY~' Date l..(- ((-~O
Certificate of Occup cy
City Planner
Date
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
o
o ENERGY DATA
Side
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $ 8!;J:) · ~ c::>
SAC .. ....................................... $~ OD .C!:lC:::)
Collective Street Fee ....................... $
Sewer Tap ................................... $
~(' $
Pressure Reducer .......................... $
45: lJO
~6U
k Ii
{2~.dO
11-:lM .00
Il'lO. ~l!:)
o
Special Conditions if any
24 hour notice for all inspections 447-9850
> " ".:.. ~
~
White - Building
Canary - Engineering
Pink - Planning
The Center of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I if
I \
1 .
l\ ') I \ II t
i "
/ j' (";
/ ,j
i I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I '~7
t..
\/ l \ r"'tJ
'\<' .
Accepted
V'
Accepted With Corrections
Denied
Reviewed By: /~ ~
Comments:
Date: '-1- l { -<<J
liThe 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
Tht' Ct'ntt'r of tht' Lakt' Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
N6N5MmJrJ
4/4/00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33/7 GL\jNvV!\TCP n<'
Accepted ~
Accepted With Corrections
Denied 2/J
Reviewed By: ( ~
'-" '"
Date: 4- (, ".. 20d-0
Comments:
!J:: ~ ..;v-.7...- ~.l-e. ~ 0~
5ptuCl~.
~
liThe 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.1I
Th~ ('~nl~r of I~ Lah Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t/\/ e^/5Il~1 (r7v tJ
4/4-/ DO
I I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3317 Gll/NvVA1~6j'?'T)?
Accepted
./
Accepted With Corrections
Denied
Reviewed By: IJI4LT'f:It E,.ul&s M4A1,J
Date: I./!J()!oo
Comments: .5EE 1H~ 8ulC..O,AJi..PEA,."r to.t 33/S GL."'AlW~ HtAu_
,
~ Cc!)~; I^"FoltAA-1"'lo~ 'f 1-J-rrA".,,&ff:AJ'rS
liThe 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."
-.t
Job Address '~317 &I(~ ~f (I
Heating contractor6M~J f?~
Name of Tester f( ,,{.e
9-1 (- ~
Date
Percent 02
7
o
3&e
~
Percent co
Stack Temp.
Percent C02
..
, \
/
"-
"
APR. 17.2000 6:50AM
GENZ RYAN 6513226147
NO. 90S
P.4/5
~~
~NE~
..... . ....
'II!LLOW . ~
8OLD. aTY
CITY OF PRJ:OR LAKE No.cf,:)_o~3
SEWER AND WATER Jf.a.dl:T
NOTE: Sewer and Water
contractors must
be reqistered
with the city.
APPLICANT: (l,P.f1'Z-- ~
ADDRESS: '\J~ ~ <;r ~'[a.J-
SIGNATURE: \k
1.
_PHONE :J..Qs;l- 4"l-.~"" t, l.4 L)
~,.. DATE: &.{'1:1J~
BLDG. PERKI'!' i rro - 0 ~Q3
Ar ~~ If - ,Z..! .PIO# QS - ,<{...s - ~3-o
FILL IN THE BLANKS
40,
Estimated lenqth of water service
I ,(
Size of w~~er service inch(es).
SITE ADDRESS: .'
feet.
APR I 7 2Wl
2.
. -::-\
I '.)
.. -1-."
-'
3. Location of any couplinqs from s~ructure
4. Type of sewer pipe. ABS PVC X cast Iron
5. Estimated lenqth of sewer line ~' feet.
6. Clean out (if required), located at feet
structure.
feet:.
from
---
Thi~ app1ic~tion b~~es yo~t wnen ap~roved... .
~~ ~ /, ___~ --t /k~~J-..j_ D~TE~ ~)
~-_-.- -- -- -...--.- --...........-- --.... - - ....--
....------
- -
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharqe
TOTAL
* Fee for either sever or water individually is $20.00 plus
$ .50 surcharqe.
* Sewer and vater permits issued for ne~ construction must be
recorded on the buildini permit card at the time at issuance
to insure that no dup11cate Sewer and water permits are
issued.
,.OJ
l....,J.
DATE PAID r
RECEIPT # _
AMOUNT PAID
REC/D BY
. 4629 Dakota Sl S.E.. P.:-. Lake, Minnesota 55372 I Ph. (612) 4474230 J fU (612) 4474245
NI !QUAl OPPOrm.NT'V EMPL.OVSt
MRY. 24. 2000 6: 59RM
GENZ RYRN 6513226147
NO. 348 . "-P. 5/11
". C~*" -t .... I.u C ..., .
CITY OF PRIOR LAKE .~ a E-
. PLUMBING PERMIT 11 ()t)'-OOB~
Apprec:ant: & .,~ - (J ~n Phone: LD~ ,- 4 '- ~- " 4l.J
'Address: JlJ..'1 U< ~ er.:;.'z:l" ff? r 'vz-t- ~~~-r fi:'<;O&.c, ~
Siglfature: '\l." A.Jl~,~ 0 ___ . ,
-I.:ega/ Description: ~ - ~ B/oCk:<: SUb f..:-, \,!Y"\li\Jr!k:r ~rei!iwv
Site~: p;.'?-.I.., r~~"'IA"re.L ~I2-L
Building Perm~#. 07) - r.~ ,PIC" G cS:"- ~)~()-~-()
NOTE: This permit ~11 not be precessed without complete information.
FIXTURE UNITS
-;"
Quantity Type of F~re Quantfty Type of FIXture
t Bath Tub w;th or without shower 3 Rough-ins
\ Dishwasher \ Water Heater
\ Floor Drain Water Softner
2- Lavatory (bathroom sInk) t stand Pipe (washing machine)
laundry Tray C' or 2 compartment sink) Sewage EJector.
\ Shower stan Backftcw Assembly (RPI. Double Check. PVB)
\ Sinks BackfJow Assembly Test
Bar Sink Lawn Sprinkler
..--:"\.
,-- . Other
~.W 2- Water Closet (toilet)
J -::;
.....-:r-.
,....
.- ~ ._"~ .
. ..
.1 .~
. ...~
.. I:. .;.
.~. ..
t\
. ..L;.. ~ ';:1,,: ..
..' .,. ;1;':; . . 1.
,.........'" :" -'. ..
.. 'I :,o......l. "
.~ .I'. . ~.., fl-;
't. ; ,_.. C'" ;,. 0# .
rea:: SCHEDULE
"'....~, .,
J
!
..,;
J- lndusuiaJ, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
ResidentiaJ, New One & Two Family
Residential. Additions & Alterations
S~te-Suf!;harge -
'-s
'."1
.'~~~
S
$99.50 S. / ~~q.~~
$39.50 $ /
$ Iso ~~e ~~
~~
_24m
GRAND TOTAL
~~.;.
. ..;.. ..Ii'
t'~.~
. ~
This p....._.;t is .":"'.MJ upon me c.'r.~ c:ondidaft tbat said
Cbnractar. ,hili _....ply in aD. respeCEs with die cm:Iinances
..o(tbe Slate ~umbing c~ "'" ~ rh..._,r.
/ A ~I' 0.::;/ ~ DATE
--(,. /fJjilk, I ~ lob--, /t~~V A~ &J:Sr
& for all ~ 24_ bOUtS in advance.
16200 Eagle CreekAv. S.E.. Prior Lake. Minnesota 55372/ Ph. (612)' 441-4230/ FAX (612) 447-42~5
AzJ. Equal Opparmnity Employer . -
IndUllrtaY, CommefCIaJ & MulU..Femlly
Rnldenlal, Heat1n, & AC
Reatdenllalw HeaUng Onti.
Residential; 0.. Fireplace
Realdentfal, AdcItlona " Alterallons
R81ldenUatl AO Only
fN:..t JrllOU.Y\'- ,P
.' .r 'Remember 10 add Ihe Stale Surch8lge on Ihe bottom of thIs appIlca~lort4
..-l
..-l
.......
CD
11.
iF
, - COY OF PRIOR LAKE' ~~
. 18200 Eagl. C188kAv. S.E. 'ermllNo. ()O - ()~~3
Prior. uk.. MN 55372
CD
"\t
(T)
o
z
TeI.phone' .
I F~~ Make & Model' '~.I/\. ~ 'k
Madil fUle c;2:~~3"2-)-::r, -1~
TYPE OF SYSTEM
Warm Art Plants X.
GravTty .
Mechanical
h ~, Conditioning X 2. \ 1"2... ~.
4 fN~ V.nL Syllem :.
.
'. HEAmO OR POWER PLANT
Steam
Hot Wale'
Rad lallon .
Sped.JD.vlce.
Conn. Load
~ Fuel k. \A'r. ~fu. Sfze
..-l .
~ Supply Openings c , \
(T)
if) Rarum OpIning. , L\- '
l.D .' . .
~ r~UI' 1S: rl1:) Oulpul-U~ l'fl1)
>- .
D::: _ Ed,.
N .
Z
~ elm.,
Other Devices .
TYPE OF WORK
Replacement
x
E
~ AII,raUanl
~
r:- Repel, . elL Camp. Dale
~ EII.Co.l. .. · 'DUId1n9P'J~' 00 -;..~3
re HEATINGPERMITFEEe, / ^~q~.
. . ~ . ~V0
~ S~~~.~~CHARGE . ./ .50 . ~~
~ TOT~ ~ERMrr FE~ R9celpt~
rl ,.
Ii
New Construction.
rYPE OF STRUCTURE
1. 11"0*: RIe
2. ~ iv'I'a CkJ
1. VIi - Canb'IICIIII
Single Famlti
Comm8rclaJ
K'
Muni..FlUIlr~
Public r aher
. 1\w-FemIIy .
. fndustrlal
Fie Schedule
1% of 'ob cosl (188.60 minimum)
$99.&0
184.60
139.60
139.60
$39.&0
"
The.plca of your healing permft Includ.. on8 lotJgh.n and one hi Jnapeclton. ·
Addllionallnspectlons will be billed at $36.00 ~ach.
'- Hoose "eaung Teat Record must be aubmltted with buDding RIDI1llDlllDlm belo", buld-
tng cedilca1e 0' occupancy wit belasued.
t-IFAT ~A,' r':'" ATlnM~ RF'N ItRl=n wHh number 0' luppIv and relum openings .'ed per
"ioom wfth CFM1. p"openlng. New I1rucb.ue. or addHJonB send 100, pl8n wtlh aupply
and lelUm lacallone Ihown. HEAT LOSS CALCULATJONS~ PAYMENT AND
APPUCATfONS MAY BE MAILED TO THE CITY OF PRrOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 56372.
Cnv Hall business hall... .re 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGtf..IN AND FINALt · CALL CII'Y HALL
., 447-4230
I hereby apply for 8 mechanlca' syslema permit and J aCknowledge that Ihe
Information above I. complele and .ceurale: thai Iha wo," wII be In con'ormlrial
wl1h the ordinance. .nd cod.s of the arty and with 1he ellle buUdlnglmechlnJoaI
codes: that lhr. form doee nol become a permit until .Igned by Ihe BUILDING
OFFICIAL; 'hallhe wo.k wIll be In accordance wllh Ihe approved plan In the
eeae ol.aU work which require. revIew and approval of plane.
~t. ~ · s-)2L1/~
. - (AppU~Sfgn.,tur8. . .-J oal8; -
lA1~, ~,v/ tA'rJ/~.~ ) ~ c;lY (J1)
G Building OIlif!U'i SIilnalu'8 · Dalll. ·
,:
.:t....
. I
PRIOR LAKE
INSPECTION RECORD
bEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS "3'317 (;.f '(',~ 'I r-
NATURE OF WORK Na,. ("'~
USE OF BUILDING ~ FA .
PERMIT NO. (rJ - O-Z2..- ~ DATE ISSUED 4-(( -~oaO
CONTRACTOR LU~v ~ ~ i -
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR E- / DATE
FOOTING : t7r,--, ~# : 5"/3/tn'
FOUNDATION (Prior to Backfill) (.J Qtol(j{)
PLACE NO CONCRETE UNTIL UOVEl HAS BEEN SIGNED
ROU~H ~,^INS .
- 'J~, Lf)J.b/Vo
~/r;t~
" i t
4 J)
/f;:r. 7 /;;2 ~/fl)
f3'V tf.ifdU
....
~ t!4; ?// / tJ7J
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
FINALS J
-~'7
\'1-1--0 (
'B: \~ 1d.11:7.}OI
E ~~ ~~P'
~..\J~ Ct,~ f)J
HAS B~EN I SI~GNED
OCCUpy UNTIL ABOVE
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
Qttrtifiruu nt <<)rcupanry
CITY O~l PRIOR LAKE
~tpartmtnt of .uilbing Jnsptttion
~Final Permitted 0 Conditional C. o. Expires
This Certificate issued pursuant to the requirements of $ection 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances of the
City of Prior Lake regulating building construction or use. For the following:
Use Classification
SINGLE FAMILY
Bldg. Permit No, 00-0223
N / A _ Zoning District R2 SD
Occupancy Type R3
VN
Fire Zone
Type Construction
Legal Description L7, B3, GLYNWATER 2ND ADDN
Owner of Building
Site Address ..31.l7 GLYNWATER TRAIL NW
Contractor's Name & Address WENSMANN HOMES, 1895 PLAZA DR., EAGAN, MN
JENNI TOVAR
Date:
ROBERT D. HUTCHINS
. Building Ofi~~} ." \
~ \~ t~ Hf12-' Date:
POST IN A CONSPICUOUS PLACE
. City Planner _
".~
,
DA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
1kt/Od / " 30
I
J:3/S /7 /1.21 GILlNJktcL
I / :::::'O~;:~ 223, ZG~' 2.2.-5
"" /"
.......-...-...---..,
o PLUMBING RI ----=--- U t:JJuKAOTFILuNl:J
f\ 0 MECH RI 0 COMPLAINT
^ ~ WA TER HOOKUP 0 FIREPLACE RI
1-:) ~ SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
SCHEDULED
ADDRESS
OWNER
PHONE NO.
CUM
40 PI/('/
o~
(lJ~d- l,>,-\-e ~ LAcJ~
~./)y\. Je,,~- (~
r f
~~'<< (~ ~
sf#-
IJf~
,
~s
~
wofJ(' ;
./
/'
~SAT FACTORY,PROCEED
o CORRE T ON AND PROCEED
o CORRE ALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
/NSNOT/
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
9./3.00 .3: 00
ADDRESS
33/7 GLl//\/w/j 1t:;;;P
,
$. oF:;s:
, ~~tr
~ ~ ~vv;'
. .~
/,- - L
(~~ cJ)-P
----v---.- -----
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA TIO~ r V\.
~FINAL N n
6 SITE INSPECTION
~
o~
CONTR.
PERMIT NO.
- 22...3
o PLUMBING RI
o MECH RI
o WATER HOOKUP
1 ~EWER HOOKUP
)?)~LUMBING FINAL
~ MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
() ~
C!J JoJi t~
,. .
~ ~L." l.. c;, A-
f/ tA. I~ ~
o WORK SATISFACTORY, PROCEED
~ORRECt~ON PROCEED
(,..:ORRECT OR CAL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9"50tOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQU~ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
33/7 6Iv~""" I-u--
( .
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~Al
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
bl'J" (7~
(,v' l, 801- rrL
DATE TIME
I z, 7-01
,;../
W~$,"~'\Y\
~
~1=X1GRAD/FllllNG
-CitbMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASlINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpector#~ _____ --o.wner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED I~.DI
ADDRESS :.s317 ~+M ) r.
OWNER CONTR.
PHONE NO. PERMIT NO.
D FOOTING D PLUMBING RI D EXIGRADIFILLlNG
D FOUNDATION D MECH RI D COMPLAINT
D FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
D SITE INSPECTION o MECH FINAL 0
COMMENTS:
, -sSU yo (.f)
-
Close -\,' e
P"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
D CORRECT WOR <. CALL FOR REINSPECTION BEFORE COVERING
r7)\
Inspector: ;") _ ~ Owner/Contr:
CALL 447-9850 FOR ~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI