HomeMy WebLinkAboutBuilding Permit 00-0725
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, CIT'f OF PRIOR LAKE
: \ ',', BUILDING PERMIT,
JJI. i1~MPORARY CERTIFICATE OF
'i' ZONING COMPLIANCE
~TILlT'f CONNECTION PERMIT
1. DATE
Permit No. ()O.0725
DIRECTIONS
SPACES NUMBERED 1 Tll"w I rlUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS J!
/,<(' "3 /J./"lA-7~' j.
3. LEGAL DESCRIPTION
LOT / t BLOCK
ADDITION C /C/A/ tv Iff' '1'('1"
/
14. OWNER (Name)
15. ARCHITECT (Name)
6. BUILDER (Name)
lve-,.- .~
JJ~
7. TYPE OF WORK Fireplace 0
New Construction V-- Alterations 0
I. White
2. Pink
3. Yellow
File
City
Applicant
d~
J>~.;J-UU
Q~~O
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) {Width} (Depth)
12. NO. OF STORIES
I
PID .;J.5.J, 7-
0-//
1J/6-0
.'1
~"
13. TYPE OF CONSTRUCTION
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15f5(A'/i~ ~
f t:? , a-.-.. :nz-.
S~tic 0 Deck 0
Addition 0 Finish Attic 0
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~fl- '/06- ~~Ou
SEATS
16. PROJECT COSTNALUE
As-roofing 0 Porch 0
Re-siding CJ Finish Basement 0
Chimney 0 Misc.
lB. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 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
buildin~icial can revore t !; permitjpf just cause. Furthermore, I hereby agree that the city official or a design.ee may enter upon the property to perform needed inspections.
X-L..,J ~ ~. J '""- / 'r' ~,r d"-.2- 00
/ // Signature License No. Date
V
100.00
10b.00
:IS". ~-o
" ....................... $ "(j .0 ()
oomJyo Building permi'lrn.1troved.
By ~ Date ( - -?t:>Or)
Certificate of Occup/cy
Issued
Water Tap ................................... $
Builders Deposit ............................ $ - t'J
Other ..... .... ................................ $
Paid T1;sf:.4-f;.......~~~~i;~ 1J~' fJO
Date %. I('W By 1jYL.
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed'S requested. This document when
sign y t e C' ner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
g ,Ii!)' (fb
Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUIL'lJ.NG
:::>FA-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ..... ............. ..................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
17. COMPLETiON DATE
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
'is,non d'r>
.
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
ve" $
Pressure Reducer .......................... $
Meter Horn ... .... ............................ $
Water Meter ................................. $
Sewer & WaterConneclion Fee ........... $
WaterTowerFee ........................... $
12.t:;;'.Ot:J
//2aO.OO
'?tJt1 . 0 l)
~o
55G,. tI (:)
47,C:::;-O
!3s0.C)C)
I.'~,.., ./"l:!
.
l./-;;.on
SpecialCondrtions ~any
24 hour notice for all inspections (952) 447.9850
./
DO -07Z6
Thr CtlUtr of lilt ulr.e COIl"lry
White - Building
Canary - Engineering
Pink - Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
\ f\. ') n l(\>' tY\L! J\ f\ ~\\Y\~ ^
0Lu )(~.....n -\- ::J \ d.C)rr'[\
\
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
\ S5 h4S! fJ (ll )U'\ r-1 L I o.J'dL...
Accepted
./
Accepted With Corrections
Denied
Reviewed By:
Comments: ~e.
Cca..d: (1,.h",e. Date: ,f~/a1
j ,
.fAt' rt!II't!/"ft' 5/L..(;. e:?/d':~d"'~/ /A,f,~",r??Pt.
.......-"'-'...;-~"'._.
:;ee allat'41!!blh-: I h;,../ hr.:z/'t- 1hfs7~--- 1i1(i,-M.tt)./bt .P. ~."Iy)%
'3. Eng,,~ a~/ ~drp/1"C' ~ br:?.f/d7r /Z.~/ #--.
"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."
. $~~
00 ,012 ~
Thr C.nle, of Ihe L.ke Counl"}'
White . Building
Canary - Engineering
Pink - Planning
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~~I\f\ ~
Lt~9 \ ~U([)((j}
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
155 h15 -g. lHl)'\t.~.d 1)-, I Q.K'\il .,
Accepted
,/
Accepted With Corrections
Denied
Reviewed By:
~~~~
Date:
~ -u!), 19:?
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 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."
./
~\
/'
00 ,072:J
Th. C.nl..r of lh.. L.k.. Counl,.,.
White - Building
Canary - Engineering
Pink - Planning
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~t\ ~O.l(\XTY\G f\f\ Hr~"
APPLICATION RECEIVED CU.l )('G.LRt- ::J I d,Drrf\
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
ISS b'3 r?..A 1ll1~--\r1 L I CL.("\.O-"
Accepted ry.
Accepted With Corrections
Denied (] /')
Reviewed BYV"' V~ fl..- ~
r
Date: . a -I&.-~
Comments:
I. ~ (SS(,\ ~n-a~<;i~ h.... J:r 7f~_ ~ ~rvv ~..
"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."
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No. (")()-(')~ 015
Prior Lake, MN 55372 .
[J)
"'"
~ ~ HEAnNG APPLICATION J PERMIT
0.: Dale 9..\?_c...,\t"'/) PIO' ~,,~ .~'1-()lb-('\
- - -. -
CD Site Address . l~~ ~rt--.\{ ~IDl' LI'-i
~ lot JJe. Block. \ Addftion C -:> \ 1 ..vi" lA.il. ).u- <~ A.t1fN
z: Own."s Name_~ lc 'ItLll""-v.,-y\ .n '^ ~.~rn 0 "
Addross \ 't,C'J~ \='\P,"Lo. ~ ~ "7r<r--. h~N
Healing ConlrackJr (''"'9 V")? - (l ~ >A I-'"
o
Addross IU.,U (:"" ~ lob> Jot' -r --riLL- er-.<..( ~_,_nT"
I ot)l- u.7..~~ l\L\.L\
~~
To'ephone II
FurnllC8 Moke & Model . L.e..vuru-,-,,_
Model Size ~2r~ 'Ll ";)...-,~
,
Conn. load
Fuel NA-' r """~Jue Size
Supply OpenIngs II
'-I
t--
"
"'"
<1l
N
N
fIl
"'"
i2 Relurn Openings
z:
a:
>-
D::
N Edr.
z:
bJ Clm.
4'1
TYPE OF SYSTEM
Warm Air Plan's '(
Gravlly .
Mechanical
Air Conditioning )( L 1 h
~LvTr Venl. Syslem
HEAnNG OR POWER PLANT
Sleam
Hol Waler
Radlallon
Spacial Devices
T>-. . )
Input.IS,Clao Output lc{).fTt....il..
:E
a:
III ADeratlons
"
;g Repair
OIhor Devices
TYPE OF WORK
Replacemont
Esl. Comp. Dale
'l
New Cons'mc1ion
ISI Est. eosl $
ISI
ISI
"'! HEATING P~RMIT FEE $
III I
"'! STATE SURCHARGE $
'-'
::>
a: TOTAL PERMIT FEES $
. Building Pennft tI
/'
/.50
/
/
Dn- O"l.q S
p~\O 'l-Jrn'\
6U\\,.O\NG pERt.\\l
Recelpllt ..
TVPE OF STRUCTURE
I. Pi.1I
'- 0..
:J. Yell..
I'll.
cOJ
C'DnInl:wr
Single Fa mily
Commercial
'/...
_ MuUi-Famlly
Public Olher ~
Two-Family
Industrial
Fee Schedule
Induslltal, Commercial & Multl.Family
Resldenllal, Heating & AC
Resrdenllsl, Heeling Only
Reslden~sl. Go. Fireplace
Residential. Ad~llions & AlloraUons
ResldenUal, AC OnTy
t% 0' ob C08t ($39.50 minimum)
S99.5C D'
$54.SC
$39.Sf .
$39.5( I
S39.5[
[~ @ rn 0 '0!J ill: ~-'
- ~ !
i
6 2 8 2OO.J
I;
i':
ili
---..-__-.JL~
Remembsrlo add the Slale Surcharge on Ihe bottom 0' IUI.. 1I1',..'KO:i:lUUIl.
The.p.lce 01 youl heallng permi! Includes one rough-In and OIle IInal InspseUon.
AddillonalmspocUons will be billed al $35,00 each.
House Heating lesl Record musl be submllled wllh IlI!ikIlng IlMIIlil number before build-
ing cer1f1icsle 0' occupancy wltl be issued.
I:1fAI CALCULATIONS REQUIRED wl1h number 0' supply and relurn openings Ilsled per
.oom wllh CFM'. per openmg. New slrucluras or additions send Iloor plan wl1h supply
and relurn localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
CII)' Hall business houra are B e.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH.IN AND FINAL) .. CALL CITY HALL
447-4230
I hereby apply lor a mechanical ayalams pormlt and I acknowledge 'hat the
InlormaUon ebove la complele Bnd atcllrele; Ihellha work wfll be In conlormance
wflh Ihe ordinances and codes ollhe city and wflh Ihe slele building/mechanical
codes; lhal this lorm does nol become a permll unlll signed by Ihe BUILDING
OFFICIA ; Ihallhe work wTll be In accordence with tho spprpved plan In Ihe
case 01 a work which requires ,evlew and apploval 01 plana.
lA OA- S\h.s G()
. [ale
"9s'"' h ",JU)
/ - Dare
AUG. 25. 2000 10:45AM
GENZ RYAN 6513226147
NO. 138
P.6/19
!
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant:_~ ,("\7 - el"l Yl
Address: IU,u':'" ""-~~Ir! .''J.T' .,..~'-
Signature: I.l.-\ '" . ~ a
~. ,
Legal pescriptlon: Lot I C-. Block I SUbJ.!.,( '6V\'~ .3'Y
Site Address: I~ ~ ~ \ i':L 1,...) 4Qm.L
8uildingF'ermit# M- (jf1::JS F'ID# as-:?{,7-(]!f,-O
NOTE: This permit will not be precessed without complete information.
RXTURE UNITS
I. Bh,o RLo
l. Cictl4 c~
3. YoU... "llP1icml
# aL1 - (\ ry::;::,-
Phone: LCI~ l.(?~- J' 4U
Tlli. C"'ftorof 11l1f wk. e..nIIT
" 'Im@[g.n~l?,
.282000
Quantity Type of F'lXlure Quantity Type of RJrture j
\ a 8ath Tub with or without shower ,~ Rough-ins I
I Dishwasher , Water Heater I
l Roor Drain (<./ I Water Sollner I
Z- Lavatoiy (bathroom sink) I Stand Pipe (washing machine) I
\ Laundry Tray (1 or 2 compartment sink) Sewage Ejector I
\ Shower Stall Bacl<1low Assembly IRP!. Double Che<:k, PVB) I
\ Sinks Backflow Assembly Test I
Bar Sink Lawn Spnnkler I
2- Water Closet (toilet) Other I
FEE SCHEDULE
Industrial, Commer~ial & Multi-Family
(1'l'o of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential. Additions & Alterations
Slate Surcharge
GRAND TOTAL
I
I
I'
$ /.50 Wo1'U "'"
/ PAID Iln IT
BUILDING PERM
$"
$99.50
$39.50
$
$
$
16200 Eagle Creek Av. S.E., lor Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAr"{ (612) 447-4245
An E~u:l! Oppurtunity Employer
This permit i, gr.ulted upon the e~prcss condition lh.. ,aid
eonuoc:tor. .hllll comply in 111 lOS)lOClS "'ith the orcli"""a:s
Of[heSt..ePIlJl!l~7fr.ngc ~..th.r""f.
r R In'NO fl DATE
. , ,) '..A lTIEST
C I for all ins~~ns 24 hours in adv~ce.
AUG. 8.2000 11:13AM
GENZ RYAN 6513226147
I
I
I
NO. 483 P.7/9
_.......
nuo. . -.:.wr
........ en?
I .
PRIOR LAKE
WATER PEmaT
NO. (')(j - (\'7;)S
u-s.
NOTE: SeWer and Water
contractors must
be reqistered
with the City.
',.
I j
APPLICANT: p."".,~- ~ Pt"".,r-.'''::>r_ U."'T"I.O("~ PHONE:~I-l..j.2.'3-II4l-l
ADDRESS: 14,LlE>Sn €"....~,. TA2.1 f6..,::~~""r .,.CIoo'2 .DATE: ~ )~)
SIGNA'I'URE: rA l~ BLDG. PERMIT II OO-o.7~-
SITE ADDRESS: IO;--1vJ3 ~"i ;'~Il1. W PIDII cx5-3b'7-01?'-O
i FILL IN THE BLANKS. I
1. Estimated length of water service ~
I "
2. Size of water service I
I
. J. Location of any c9uPlinqs from structure
4. Type of sewer ~ip,. ABS PVC X Cast Iron
S. Estimated length df sewer line~1 feet.
6. Clean out (if required), located at
structure.
feet.
inch(es) .
feet.
feet
from
- --- .L. .
-~--==-----=------,_._-------- --==-----~--- .-- . ~._-----
I
Thi.s ?P%~n b~ your permit wnen approved. .
BY; (_ . tl / .i~:^ ~~TE: Q:/JU--j77J
~-;::-,;t:-s.:<r - and ':::-'In-:-:o''';~t1:~- p."" t. -
~ ~ .50 Surcharge
$ ~~.50 I TOTAL
Fee for elther sewrr ~ water individually is $20.00 plus
$ .50 surcharge.
Sewer and water pekmits issued for new construction must be
recorded on the bu\ldinq permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. ,/ ..l. /
./ . .~\~~;..~"\
DATE PAID, ~ ~Q~'~~UNT PAID
RECEIPT II ~ 1GP\~~ RECiO BY ~
~ ~~ ~
*
*
. 4629 Dakota St S.E., Prier Lake, Minnesota 55372 I Ph. (612) 4474230 Fax (612j 4474245
AN EOUAr nPRrlDTr"'r"", C'a.l"'_n
J
PRIOR LAKE
INSPECTION RECORD
~""-
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 15~(" <. 'Kr-mk s,oeo
NATURE OF WORK Ak~
USE OF BUILDING S t=A
PERMIT NO. 00,072..5 DATE ISSUED e -/G.-2oCJO
CONTRACTOR (J.@IA.'~,^~'" ?~~i:"" (",)"/-(/0(...4(/CJiJ
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING ~ &it I 16/11 (~D I ~~SPECTOR I d1f9''';
, FOUNDATION {Prior to Backfill).v~.......I~. ~d-p;/~ I f:?-J.. ?/3/ JCfb
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
k~'
i}:],
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
'ft, c1- r?
Pb
b
,
f'fJ
!yZ z/tTD
1/17/~
i//Q/17O
'/1 -
I 0 -~o~oU
If~/n
(1:> -"7,o-Cjl~
. GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~~
- J~h;).. III
/;:}..,;:)7Jno
l~
'-
\
-gJ
<1. ~~tl..
OCCUpy UNTIL AB~~~Y1AS
NOTICE
This card must be posted near an 'eleclrical 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.
/2 j :;17) ()O
~,.
1 (J()
BEEN SI NED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
QLtrtifirat! at (JDcrupanry
CITY OF PRIOR LAKE
~tpartmtnt of .uilbing 3Jn~ptdion
~Final Permitted 0 Conditional C.O. Expires
This Cenificate issued pursuant to the requirements of Section 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:
Occupancy Type
Bldg. Permit N"
T . VN F' Zo NI A z . Dis' R2SD
. ype ConstructIon If'C De omng met
Ll6, Bl, GLYNWATER THIRD ADDITION
Legal Description
SINGLE FAMILY
00-0725
Use CIassificatil'"
R3
Owner of BuiJding ~iteAddress 15563 BROOKSIDE LANE
Contractor',Name&Addres, WENSKANN HOMES, 1895 PLAZA DR., EAGAN, MN 55122
DON RYE
ROBERT D. HU<vuLNS
. \ Building "fficiaJj
b.\)~ I;) 104 or Date,
, POST IN A CONSPICUOUS PLACE
City Planner
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
ld.l(4)OI
ADDRESS
15563 BROOKSIDE LANE
- PERMIT #00-725
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADfFlLLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
Is.sw"_ L.O.
CJos.e-. 1,..;/ e.
XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~,\CALL FOR REINSPECTION BEFORE COVERING
Inspector: "3-u (LUIJ Owner/Contr:
CALL 447-9850 FOR TLE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH,{ SAFETYI
lNSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
I F).") In '? iJ.ec-n K- ~(I) e
OWNER
CONTR.
PERMIT NO. IJ - '7 i'.-S
PHONE NO.
DATE TIME
I~Z-~O
/(): '30
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
lIlFINAL~ 0 PLUMBING FINAL
/0 SITE INSPECTION ~ MECH FINAL k
COMMENTS: "E1"o~,
J
V6'vew~ LV)
.~ ~ ) OIl () (
'\ I I f
,) '6-fol~1 C/AJ s. 01 f-if ClE?AJeAOf-wMt'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/
~ORK SA TISFA RY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~FI{<' CALL FOR REINSPECTION BEFORE COVERING
Inspector: \J) ... '\IJ..AM Owner/Contr:
CALL 447-9850 FOR TlE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
@11m ~:Ob
ADDRESS l~:-;- L:<' ~ V1ltl !r-, i do _ I QJ.. ^ L
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~MECH RI
ATER HOOKUP
SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:(/) ~~
, .Lh~~. .~-~
~~~.,~
~ I'~ ~ cf,;
()() - n '7 OJS
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
~J
/I
t
I !
il.
1 ,
1 I ,
I' (,'1/
I
r-
"Z / f2-tlc..- ~. fa - 5~
A T: -a1-t---
I~~ f/(~'lr-tr ~
~ ~ r......""'& V.... p. [) ,
o WORK SATISFACTORY, PROCEED
~CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:~. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/