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CITY LAKE ITY OF PRIOR LA �1
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El F Permitted ❑ C onditional C.O. Expires
P �"'° ll This Certificate issued pursuant to the requirements of Section 110 of the Residential/ ❑International : -.
, Building Code certifying that at the time of issuance this structure was in compliance with the various Il)
,1 ordinances of the City of Prior Lake regulating building construction or use. For the following:
Y 12 — 0931
Bldg. Permit No:
� 1 Occupancy Type 1
c
Use Classification SINN F FAM I I
R3 11 PUD 1. . 't9
, g
Occu T e Type Construction Zoning D
- ;�l
1 °I` ` Legal Description L40. R1 JFFFFRS WATFRFRONT
14406 PARKSIDE COURT '> >
= Owner of Building S ite Address
c . j l
lc` s M HOMFS
Contractor's &
. +-- ROBERT D. HUTCHINS giiej CityPlanner _�': ."
0 v
M' B uil ng Official
t , a Date: /o / 7 7 / 3 Date:
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. }il
CONSPICUOUS OUS
PLACE ; • u)
IN S
� POST I "_
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oi rxl04) CITY OF PRIOR LAKE BUILDING PERMIT, D zt R c' d
N TEMPORARY CERTIFICATE OF ZONING COMPLIAN
AND UTILITY CONNECTION PERMIT AUG 1 O'
• . T —
kNESO `" Fik p
.
ee Main. 1. White File B
2. Pink City PER
3. Yellow Applicant •
(Please type or print and sign at bottom)
ADDRESS ILIL o ( p _ A 4 2 Y u ) € _ -ov tz t ZON iG (office use)
7 0D
LEGAL DESCRIPTION (office use only)
LOT 40 BLOCK L ADDITION PID Zs 4 40 U
OWNER
(Name) 1 A T P. Nt `t' -}—t O M (Phone)
(Address) - 1 2 l IN A S1-1- t F-1 b i u +,l A Ni E S S`f_ 2.c 1 t=O t t■l 4\ M N S S L4 3
BUILDER
(Company Name) MS k -1--1- i - U M ES (Phone)
(Contact Name) S v E $ (Phone)
(Address) `12 L l I.", Pt S 4 lea C Av vl= S S i_? ,, t 1 -O t e h }.....1 SSL4 39
TYPE OF WORK $ New Construction gpeck EPorch ❑Re- Roofing ❑Re- Siding Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utilit Connection
CODE: KI.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B 114 0 t 00 0
Occupancy Group: A B E F III M R S U PROJECT COST /VALUE $
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��^ BL - 2.- , t , 2 j1 53a b o — 9 — t 2
Signature Contractor's License No. Date
Permit Valuation tCB 0 0 o _ Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ 6 1 41 -1e Water Meter Size "; 1 "; $ 4- e,0.,
State Surcharge $ 1 Cc .- Pressure Reducer $ (7—es_ .-
Penalty $ Sewer /Water Connection Fee # $ t S o0,
Plumbing Permit Fee $ t 5-4-,5Z) Water Tower Fee # $ ( v C)O, ,--
Mechanical Permit Fee $ ( s 4 , c , Builder's Deposit $ \ , ,
Sewer & Water Permit Fee $ S`o , S--0 Other S P0-1NK �e.� ' -
_ $ (SI-
Gas Fireplace Permit Fee $ 5-4 4 TOTAL DUE $ 90 ei
This A, lica '. , Becomes Your Building Permit en Ai) roved Paid 7- -7S/ Date . 7 4,-- R e eipt No. V� ��
1 � G�
6 .
:ui .ing S t.'• ate
This is to ce • that equest in the above application and accompanying doc ments is ' accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed e C' Planner constitutes a temporary Certificate of Zoning c mpliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. 4�
& E) L .■ ► L
' tanning .' - • D e 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
• •
111
• 40
.4 4
114 10; •
* It I.
pRlp Date Rec'd
N 1-':41Z! CITY OF PR IOR LAKE PLUMBING PERMIT
z.it-,_ cvg
iiNNES ,
,
2 ooW C'
. at, 2.iiy PERMIT NO.
3. fallow Applicant •
(Please type ouri and sign at bottom)
ADDRESS [�
0 \Q ` DC's - , r 4 V e C 1 �1 W ZONING taste use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK t ADDITION de - EkX S Pc.-- J PM
OWNER ,, � } � `� I
(Name) QY�(� -.t d (� 1�Yc�.t ry O 1/�l I lL (Phone)
(Address)
APPLICAN
(Name) ~ 23-00 qC.,1 Z� , CA-Ark
\\-\ (Phone) S
(Address) \'j \''
T t/\ S\11 f \'e- �'>S 3 31
(Add ess) (City) (Zip Code)
(Contact Person) L 1-6&\- ( (Phone) (J -1 C° " 2).6 4
A f
APPLICANT SIGNATURE ` / � '� DATE C I / 1. / t
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
2- Bath Tub with or without shower Rough -ins
\ Dishwasher { Water Heater
k - Floor Drain Water Softener
1 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Ti ^ Shower Stall Backflow Assembly
2 Sinks Backflow Assembly Test
-- Bar Sink 1 Lawn Sprinkler
4 Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi- family I% of job cost with a $49.50 minimum Residential, New One &Two- Family $149.50
—'] Residential, Additions & Alterations $49.50
The Minnesota Statutes § 32613.148 )st 5 J t ';> 16 - 0 0 Building Permit # q � ' •
"SURCHARGE" has been changed for one 0* !��'t����
year effective PLUMBING PERMIT FEB $ � ; r` .
July i, 2010, until dune 30, 2011. STATE SURCHARGE $ .50 ��`�„
The minimum surcharge fora 'fixed fee" permit TOTAL PERMIT FEE $
Is,F, beginning duly 1, 2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Baildine Official Date
24 hour notice for all inspections (952) 447 -98S0, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
i
/rRro CITY OF PRIOR LAKE Date Rec'd
� ,,,_.; . ` ` HEATING /AIR CONDITIONING/FIREPLACE PERMIT
{ `M
Nr
di.'
' = i t r c PERMIT NO.
a riia„ ALA M:13
(Please type or print and sign at (whom)
ADDRESS ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOTO BLOCK ADDITION e JC S DYN a PID
OWNER i \ r l
(Name) C - �J 3 1.�0 Y Y a--:t Vl_Q 6 �1 t (Phone) •
(Address)
APPLI
(Namee-41 P -\C3. rl (Phone)
(Address) _1 1 A) \ \.a �' s\ �1) r r SU 11e., GS 33
J (Address) (City) (Zip Code)
(Contact Person) CO f ( ✓\ ^ L.0 Sure (Phone) ( ) 7(0/ — I 8 S (47
APPLICANT SIGNATURE Al Air DATE Z
_ APPLICANT PLEASE COMPLETE BELOW
►i .. EW CONSTRUCTION G ❑ REPLACEMENT El ALTERATIONS
FURNACE MAKE AND MODEL ¶3 + ! I2SA1'20 Coe S F7 FUEL VC`-'t • CiCk--S
FLUE SIZE RETURN OPENINGS I 0 INPUT b 1 00 ID OUTPUT S3 3 (0 0
TYPE OF SYSTEM HEATING OR POWER PLANT
Warm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
echanical ❑ Radiation
, A ir Conditioning ❑ Special Devices Fireplaces with Box Additions or
['Vent. System ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi - Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) 564.50 Residential, AC Only $49.50
Estimated Cost $ g 69 5' 0 0 Building Perini( #
The Minnesota Statutes § 32611.148
"SURCIIARCl" has been changed for one
HEATING PERMIT FEE $ year effective
STATE SURCHARGE $ .50 Jaly 1. 2010, until June 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge for a "lived fee" permit
(Office Use Only) Is Sf, beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid Receipt licili � 1. 111 1
Date B p''
Bundina Official Date ��„�
24 hour notice for all Inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
4
• «46
° P R /r
o's< J*, CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
t-
b... 7 : TEMPORARY CERTIFICATE OF ZONING C()NIPLIANCE
AND UTILITY CONNECTION PERMIT
7
4;11%11.014 Ft L31 {Z - 1°
AWES ,
1 th 't t. • ¢
PERMIT NO./Z, 7,37
•
, t Please rape Car pet and sign at boll ,
ADDRESS i ZONING
,
1
44 PAR K:() ( i)C, --- • k' '1/4: tt• , - , _ .‘
LEGAL DESCRIPTION (offrce use
1
LOT BLOCK ADDITION
OWNER '.1
(Name) (Phone)
(Address) 72C) i WASt 1 0 ..). t1/4\c _ C-DitQA } i 1 `-s - e l
Bisittnita
CC To.
Z.
(Company Name) VI KC ':' 0 Cr.zi-L). c N d' 21:1 1 73.e 1.4- C 4- * 1 1 .- -i - - C . (Phone) -14 ' Z .1 7 —
(Contact Name) 1" V,.! 1 (Phone)
!!!;
(Address) it 1 t O 3:4!-)(!)...'4'k C.1% r1L..., ■—.IV-i-J-C. 1-- ' 1 0-: ......_ , 1 (.: .. Eri__.- .-.1 -1:-= 1 t-- K.) t-5
TYPE OF WORK OW, New Constructton OPt-ck OPorfr. DRe-Roofin CRe-S 01.4 Level Brush 0 Firt-piact
10A341tIon DAlterartot$ OUtility C,...asel.$:
CODE: I.R.C. J1.B.C. 0 mtsc
Type of Construction: I II III Pi 6 A
Occupancy Group: A B E F H 1 M (1, S U PROJECT COST/VALLT $
34- c ■.«.- -,-
Division: 1 2 a" 4 5 (excluding land)
1 heneby certify that 1 erre furresbed Informanon on eits an:east-LI: whacti u to th e best of my know ieu'ie tr.3C 4.7:. oarreet 1 aaso met} that I am the owner el author..te.d agrst tot the
absne-merraaned peppery and that all construceon cell; conform til .12- CXxsting gate and Socal Lawn ark: %III meted in accprdance swab submmed plans 1 an: aware teat the buds.'ir,
otru,-..1: can tes■oke MU FrVilit ti)r Nit cause Furrier:erne 1 e.ceet agree that the city otri,:u) or a 4dt/4:nee may enter 'dean thc rwe:rw to perform noeded uum
.* '1 *
\ (76,4?-} -;04-j-C41.4.4-(3: C - 14 F; /0- - /1
*nature- Contractor $ L:,:casc No aer
I
Per= Valuanon ! q, 000. 00 Path uppor. Fee g I S
Femur Fee ,
3 03. 60 SAC ,: : 5
Plan Check Fee : 5 6 . f5- Water Meter Sue 5/8', F. $
!-
State Surcharge , 5 ' Pressuir Reducer 2 $
. 0
Penalty ' 5 Sewer, Water CorineN.-rton Fee a S
Plumbing Permit Fee 5 Water Tower Fee g S
Mechanical Permit Fee 5 Builder's Deposl: 5
. .
Sewer & Water Permit Fee $ Other S
Gas PMeplace Per= 1' ,.%! t
. TOTAL DUE ! 5
a .
Thi l ition 13 comes `i our Building Permit When Approval
il Oir
i
4 44
Pate ,.. Ref VVITH
Initni-D Rcra.
L-nMli ,
B. g Otitail .11C
I Thd a to certey that the request in th, . 6 and a,:t-enlaartv,DA 1,cucottas ..1 in accot,I.an.:c wall tlx C.r 20e_ria: Csethe.arh.c am! may recce as tectucard 1.1 docuracrel
1 *ben pined by else City Planner cemsotwe, a crnipctanr Cer:6zatc ,.4 Locum; complance and a30% conc. .u. oxrtnurvar bcforc :wrap...nor a Ccrtsfscate of Cacrumar.., me he
' issued
P.aanaeg Daeulot 1A-1 Spec.al Comittwcta. at an,
24 hour notice for Ali inspections 19521447-9850, fax IV52) 44
1040 Dakota itreei ST, Prior Lake, Minnesota 55372
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 contractors 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 - , / -a
PROPERTY ADDRESS: 14406 PARKSIDE COURT
ACCEPTED BY APPROVING AUTHORITIES: CITY OF PRIOR LAKE
ADDRESS:
PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS YES ONO
EQUIPMENT USED IS APPROVED ®YES ONO
IF NO, EXPLAIN DEVIATIONS
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS YES 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 EYES ONO
2. CARE AND MAINTENANCE INSTRUCTIONS EYES ONO
3. NFPA 25 EYES ONO
LOCATION ENTIRE BULDING
YEAR OF TEMPERATURE
MAKE MODEL MANUFACTURE SIZE QTY. RATING
RELIABLE RES 49 2011 1/2 11 155
SPRINKLERS RELIABLE RES 44HSW 2011 1/2 15 155
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 Cs
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/0
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 MODFI SI IIERVISION 1 OSS AI ARM OPERATE VAI VF RFI FASE OPERATE RF1 FASE
"ES NO YES NO MIN SEC
HYDROSTATIC: Hydrostatic, test shall be made at not less than 200 psi (13.6 bars) for two hours o150 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 evel 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 El NO
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 ONO —
DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION
TESTS TEST SUPPLY TEST CONNECTION PSI CONNECTION OPEN WIDE /L 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 DE UNDERGROUND
SPRINKLER PIPING YES 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 ® NO
IF YFS
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES
COMPLY WITH THE REQL IREMENTS OF AT LEAST AWS 010.9, LEVEL AR -3? OYES ONO
WELDING DO YOU CERTIFY THAT T -1E 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 THIS INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? OYES ONO
CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL
CUTOUTS (DISCS) ARE RETRIEVED? OYES ONO
HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN
DATA GI YES ONO
NAMEPLATE _
REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: / L i "13
NAM F SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES, LLC.
\ TEST WITNESSED BY
•T "' 1 �1 ED) ^ TITLE r DAT
SIGNATURES 1045fC r 7// ✓/(
F. • •: NK -- ON •AC'OR (SIGNED) - TITLE DATE
- - cc (7: -lr't- t ji1 / `-/
ADDITIONAL EXPLANATION AND NOTES /9
Q� P � ° � De osit
Builders p
U
4r14, so v - City of Prior Lake
A $1,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposit is issued as security to
insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but
not limited to grading, sodding, landscaping, tree planting, driveways, siding and painting shall be completed 180
days after the date the building permit is issued. If the work is not complete within the 180 day time period, the
City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $1,500.00
builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the
situation.
A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of
one year. By signing I, the undersigned contractor, acknowledge that I am aware of the erosion control
requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors
handout.
DATE: SITE ADDRESS:
t L `P IN t 2 - v - " . ( U - 0-)-A PERMIT # ( 'q3 I
REFUND TO BE MAILED TO: 1'1 i TA M'f -1-1-0 t 1 ES
19— O t 1..1,1.51 -1- t1 1GTON Avv E S SU t "1 ZO l
-rD 1 t`l .k 1 t---t1 E49 AUTHORIZA "1'ION TO RELEASE
PLEASE REMEMBER 4/ 566.00)
iynda S. en, Building Services Amount
1. KEEP STREETS CLEAN DURING CONSTRUCTION f0. l( i3 Acct. 801.20204
Date
- e• -e• - e N PLACE
3. TEMP -ORARY-MAP -C'UP_ANCY PERIVIIT-MAP :- - , a - - -: - : ; ; , i ILL DE ronrEIT
SIGNATURE \ } --^------'
C: \Documents and Settings \sbare \Local Settings \Temporary Internet Files \Content.Outlook \BD8OXI9A \BUILDERS DEPOSIT
FORM.DOC
PRIOR LAKE , BUILDING AND INSPECTION
DEPARTMENT OF
INSPECTION
SITE ADDRESS ( ` 4 (a Pik -e-K i ns; Co0/2_4-
NATURE OF WORK S F 4 1N C - j - iq Pey -c-M op_ 1 ---- Ike', LL,
USE OF BUILDING �i ,,)GLC- F444 I L-i 4T-�r- reic_; -.
PERMIT NO. 12 13( DATE ISSUED 8/07
CONTRACTOR KA- -AEI y c3 tE:S PHONE 6 6 , z M ? -<v1Z<5
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE P F MIT IS B SEPARATE D UM T
d C--- ' 41-4(1/4 ' INSPECTOR N S � ��' �- {'�'-J5 C J� 1�J� -+ ��-��� DATE
I FOOTING 1 1 I
I FOUNDATION (Prior to Backfill) 1 1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
(A)ot,1 0 61 ROUGH - INS
SEWER / WATER / SEPTIC
FRAMING ? P ./ w .,, (p bo i n / /ijz
INSULATION (i iii‘ h---
ELECTRICAL
PLUMBING , /
HEATING (if required)
FIREPLACE
GAS LINE AIR / TEST l /,G /r�
� H COVLORK UNTIL ABOVE HAS BEEN SIGNED
� w ( 1 1
SPC -iNK t 12 iii? FIN ALS
GRADING (Prior to Sodding)
EUILDIN ,,, , 3i), t(g 6(15 ie-Ne) 1
ELECTRICAL
PLUMBING Q 'M I ? ,
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