HomeMy WebLinkAboutBuillding Pemrit 04-0077
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
Date Rec' d
2-, '2..-.04-
I, White File
2. Pink City
), Yellow Applicant
I PERMIT NO,O+, 0077 I
(Please '!ype or print and sign at bottom)
ADDRESS
11~ Jl~~ldbn.'ue. dE
LEGAL DESCRIPTION (office use only)
LOT20 BLOCK ( ADDITI~d q-tv-
IJ
OWNER
(Name)
(Phone)
<Address)
ZONING (office use)
PIDZ5". 400. OU;. 0
~~~;~'~l ~aUcJY1 JY1c- ,
(ContactNam~'~ ~a1..LtJ.sc<'-
<Address) ~~~~~ ~q:,%t-~ /00
(PhonlCJ52-.J 18 5-7808
(PhOne~~da;/ ~-1732
o Fireplace DAddition DAlteration DUtility Connection
PROJECTCOST/VALUE (exc1udingland) $ /2/. 6S0
f
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 fficial or a designee may
-:teru~ontheywy<,", to~er~fu~::s c!l:vO~SI ' J
~ Signature Contractor's License No.
I Permit Valuation ....r/4.//. tJOO.()tJ I I Park Support Fee
I Permit Fee $' 1~'19. S'a I I SAC
I Plan Check Fee $ Ro/~ C,8 I I Water Meter (Siz~ I";
I State Surcharge $ ~tJ. ,e:;(J I Pressure Reducer
I Penalty $ I City SAC and WAC
I PlumhingPermitFee $ 100.ot) I Water Tower Fee
1 Mechanical Permit Fee $ / () () ~ 0 tJ I Builder's Deposit
I Sewer & Water Permit Fee $ 3~. 5""0 I Other
I Gas Fireplace Permit Fee $ ~tl, 00 I TOTAL DUE
TYPE OF WORK
~ew Construction
DDeck
OPorch
ORe-Roofing
DLower Level Finish
OMisc.I,g.<:.,. Cac>es
(l-3
i:B
This Application Becomes Your Building Permit When Approved
t., pyr-;/j'
.....J..~)_(/ JC.--'
3o~
~
oi/9~~
Date
Paid
Date
Building Official
#
#
#
#
ORe,Siding
$ ~a.t:Jo
$ /3<So.Oo
$ d<:'rl.Oo
$ f'!> . 0 "
$ / 2-0t:J. 00
$ 700,"1'
$
$
f. $ ~I ~~S, /0
I R~Ct::O' rtPdJ<JI
BY~X ~
ol/9 fr '/
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 as requested. Jhis document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~ ~ 1~1--
See MaiaEile
/ /[)ate Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Planning Director
~==-
..~~
See Main File
White - Building
~qarv - t:.nQmeenn~
Pink - Planning
rh~ ('~nl" nf Ih~ I..kf ('ounlfy
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
11 r~' He-, '-,7\. )
'/. '-. / C, I V 1',_
....., ';
.:... . -'
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1'74/7 D Et k~,FI c.Le) C)L.,
Accepted
,x
Accepted With Corrections
Denied
Reviewed By:
/h4'B
5ee. /fled/.. f,' {r
Date:
2-ro.-oi{
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."
~ry>
~~
See Main File
--Whit.. - Buildinv
Canary - Engineering
Pink - Planning
lll~ (.-nlrr of lhf takr ('ollnlr,-
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. e . H()/Gt ut0
2,2-.64-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J74- 17 D StA2...Ft ELO DE-
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~
~
Date:
d/9/o'l'
. I '
Comments:
See Main File
"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."
t~1
See Main File
White - Building
Canarv - Enaineering
~-
. - ::-.:: Plannli3J>
lh~ Cenlrr of the I..ke COUnlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1
I
1'-.
)
~.
/
-~, -
,-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I /'~r 17 I CLi___ 1/,_.
Accepted
...-/
Accepted With Corrections
- Denied
Reviewed By:
~
~
Date: d/ q I () <I
. 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."
..
Job Address /7Jf/7 ~1~rJ ^ (
Heating Contractor ~AJ7' ikR;v
Name ofTester ";7a~ _~
Date ' 7 /yq~
Percent 0, 7, { 11'6
,., t2k",JC-
~;96
-::?SL:PF
Percent CO
Percent CO,
Stack Temp
.
Combustion air is adequately supplied per
UMC Sec. 606 ,V..,- 5
input ~~ 19,acou
\
CITY OF PRIOR LAKE tl1(;~)-
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
i ~~ ~:~ I PERMIT NO.AI ^~
3. Yellow Apphcant 1.fIIIII'.1.III 11 ,
(?lease type or orint and sign at bottom)
I A/;;~ '1 1> p pr C # I d
---
()r,
-
ZONING (ofliceuse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER DR HORTON
(Name) - 20860 KENBRIDGE CT
(Address) LAKEVILLE, MN 55044
(phone)
APPLICANT /10 /L
(Name) /7'/-'i4'..L~ ~.-/AA,/;-a.../
(Address)~ ~"'-'~~ ~ a:
;3Addre'
(Contact Person) A ez.;-. , ~
- /<
APPLICANT SIGNATURE -::., ,- 1.;' - ___
(phone)~~/- 4.5'''/-.-? .??5
~~ru>..L ~..s-.h?~
- " ' (dJiIr (Zip Code)
(phone) ~ - c:;/~ -~ 77~
DATE
, APPLICANT PLEASE COMPLETE BELOW
.I!lNEW CO~TRUCTION 0 REPLACEMENT .DALTERATI<;>NS J
FURNACE MAKE AND MOD~/r'-,; ~, :?/CJA,,4~qc?7c? FUEL.-( 4? .<.-..... >-1
FLUESIZE~~k...A RETURN OPENINGS 4:/, INPUTU ~ OUTPUT ~_/~
.
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarrn Air Plants 0 Steam
DGravity 0 Hot Water
o Mechanical 0 Radiation
~ir Conditioning [J SpeciaIDevices
~enl. System 0 DtherDevices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Ooly
$39.50
Residential, Heating & Ale (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
(Office Use Only)
Estimated Cost $ ~ ~a::>BuildingPermit #
$ ~/~/c4/
$ -' .50 r1JS?J; ~~~r.jTl~
$ /' ~ ~_c_-; -"~~0 r.~""'1 ~'T
c.J' _ ,. . "~<';;-"'_'~ ,..,:..
,
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Official
Date
I Paid
I D'f'EB 2 4 2004
Receipt
This Application Becomes Your Building Permit When Approved
By
.
24 hour notice for all inspectioos (952) 447'9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I,Pink
2. Green
J. Yellow
File
City
Applicant
I PERMIT NO. w''7'J
(Please type or lJrint and sism at bottom)
ADDRESS
ZONING (office use)
17417 DEERFIELD DRIVE SE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PlD
OWNER
(Nacre T) 1< U01<TOl'J
(Phone)
(Address)
APPLICANT
(Name) ATUED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
(Contact Person)
RRENDA HUSTON
lWSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
4/21/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent, System
o Steam
o Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO SL-750TR-D
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39,50
Residential, Heating & Aie (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEA TlNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
-:-1\"CJM"'1'::'L
i-del \l~UU6-D
~rr"~r,,\!,~,..,...~
. ., oJ- .\\,., L~'~I",i:I~1
, ..... I.tV'UU lJ
(Office Use Only)
Buildin!! Official
Date
I Paid
I IMlR 2 7 2004
Receipt No.
This Application Becomes Your Building Permit When Approved
By
rr
24 hour notice for all inspections (952) 4~7'-~850, fax (952) 447-4245
FeblO 200410:19AM
GENZ RVAN PLUMBING AND HEATING
No, I 198 P, 8'9
"'~Z~F~O~~
.. I\?
- I \ "
(,J '~~
,. .,:..,,,\,-:.).',,,.0,
;""'\.~'\~,"(",1\;\';.'\-"
~'~~~\~~~NJltEtO~ tIo
Date Rec'd
CITY.OF PRIOR LAKE
SEWER AND WATER PERMIT
(.I?1euc: _type or p1'iI:lt and :l1J':D.<l't bottom)
ADDRESS
n1(7 ~efd M -ffi
l. ~w ~~, I PERMITNOA.I. "D-r1
3, Galt!. AppliCUlc ~A~I
ZONING (Qflic:<uot)
LEGAL DESCRIl'TION (otlice "'" o!liy)
LOr.t6BLOCK I ADDITION ~-h'pj J Cf-U1
PlD
OWNER
(}Tame)~:D u....Y"............ f"',,"".......... u.........o.~
(phone) _ O/~ -q85- 18 tV"
(Address)
2ofuO Kev\i3K\b6e C:r Sr? l!1r,
(Address)
Lau~'llIe..,
(Ciry)
,~i.-JU
(Zip Code)
APPUCANT
O'~~ Genz-Ryan Plumbing & Heating
(phone)
651-42.3-1144
(Address) 14745 So Robere Trail Rosemount. MN 55068
(Addt:esl (:;, (City) (Zip Code)
(Contact Person). C.III JJ j/;f1 Izd { \ '-... C _, (phone) 651-423-1144 . I
".ICA.NTSIGNATURE (lJjl~ ~/l DATE 2--(D-O,+
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from stru~-ture
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
feet.
o Cast Iron
ReSidentIal sewer and water Ime cOlUlection
Sewer connection only
FEE SCHEDULE
S3S.50 Industrial, Com'l & MullJ-fanllly 1% of Job cost WIth a $39.50 mmimUlJ1
$1750 Water connection only $17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~D WDYH
Bf!.OfiIL~G [O':r':)AIT
,
I
10m" u,. Only)
I This Application Becomes Your Building Permit When Apprq".d
Paid
Receipt No.
.
~-
Buildiag Offici!!
D...
L"f11I:B 1 8 2004
By
24 hOQT ootic. foc.1I in'p.ction, (952) 447-9850, fax (952) 44'42~5
Feb,iO 200410:19AM
~
(€~1
.~.,.~tlV 0"'''"
',?~~~:!~:i~~h,,: HE;
""\~:\\\!';;~'"
GENZ RVAN PLUMBING AND HEATING
No,1198 P 9/9
Date Rec'd
CITY OF PRIOR LAKE PLUlVIBlNG PERMIT
I la1ue 'fi1.
2. Geld Cicy
3.YtllQ.... A.ppr~1
(.Please tV'Oe ortmnt and si9.n at'bottonJ:)
AD/1LJ11 tJmd? fJd ~,(\ b-
I PERMIT NO()tl1-. Om
I
ZONIN'G (office use)
LEGAL DESc:RIPTION (office use only)
LOT ~LOCK I ADDITION MfK-H (j J ~'
PID
. OWNER
(N"ame) DR Ho):"ton CU6t:om 110mes (phone)
(Address)
%24<;?r:; -i8M
2.01;(,00 ~>1i3~1 b&:,. Co SI'::' iDe
Lcdu_vrlk:.. HAN S6ci-! lJ
APPLICANT
(Name)-G......=Ji:e,"- P',,~,,<_g "--Ha.'<-~ (phone) <<;'_"'0_' 'L.b
(Address) 14745 So Robert Trail Rosemount MN 55068
(j (Address) (' ~ (City) (Zip Code)
(ConractPersOlJ) \//0 '}(j~ml L';. (Phone) 651-423-1144 r
APPLlCANTSIGNATURE (1j~~~_ DATE Z.~/O-{)<I
I Quantity
I :;;L
, I
I I.
I 4-
I
I .;z
J
I
I. ~
APPLICANT PLEASE COlVIPLETE BELOW
I Type of Fi.x:ture I Quantity I
I Bath Tub with or without shower Rough-ins
Dishwasher I I Water Heater
I Floor Drain I ILr Water Softner
1 Lavatory (Bathroom Sink) . I' Stand Pipe (Washing Machine)
Lauodry Tray (J or 2 compartment sink I Sewage Ejector
Shower Stall I Backfiow Assembly
Sinks BackfJow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) Other
Type of Fixture
FEE SLJ::UL.uULE
Iodu,trl.l, Commerelal &; Mulo.famlly 1 % of Job eoS! with. $39.50 minimum ReSldennal, New One &; Two-Fanuly $99 SO
Residential, Additions & Alterations $39.50
(Offic:e t1u Only)
EstlJllated Cost .$
BUlldmg PermIt If
PLUMBING PERJv1JT FEE $
STATE SURCHARGE $
TOTAL PERMIT FF..E $
50~ADEl Wmi
~:y .';~ 'i1~,~r1':l r;:):r-r:'";~,~'.:l~T
. . ___,"~\;...:' -':1'-,- ',;,
D...
I Paid
I DflfB 1 8 2004
Receipt No.
This Applic"t!on Becomes Your Building Permit When Approved
By
Building 0tl1ci41
24 hour notice for all inspections (952) #1-9&50, fa., (952) 447-4245
J
J
I
I
I
I
1
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-............--...-,"'"'.""'...
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT oSee Main File
BUILDING AND INSPECTION
SITE ADDRESS J 74 17 ~1::1f!_F::"'E1 J) ~ S".E'.
NATURE OF WORK NEAl ('IJNrrltl,u:"r~6~
USE OF BUILDING Sot:":A...
PERMIT NO. 04. 007 7 DATE ISSUED ~I/
CONTRACTOR D,~. ~IZD"). 1t.>C. PHONEm- 22~2..
.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING
: FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER 1 WATER 1 SEPTIC
FRAMING
INSULATION
ELECTRICAL
-
PLUMBING YW/ _ L(~ 230(/
HEATING (if required) 1M!, '~/l C-I'3-v<-/
FIREPLACE '/L{ / h ~17 'Ill'
GAS LINE AIR TEST . /1/ .~~-I)-(.,<.,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
YlIP
(2. 11-
[;- /S--CA- r
5,)7A<t
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
.
, \~ e t?'~'~h k /-c .
~~ 7h~/Q,/,
, 7/~~'/
M 7/9~y'. .
d# 7/.?O/"'~
,
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 ______
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/7t((? fJc<,,()~1d
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
.a PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
4 C; IJ. Iy /)f
DATE TIMe
Li - :n-Cft/
4-r7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
P WORK SATISFACTORY, PROCEED
o 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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
/NSNO"
DATE nME
CITY OF PRIOR LAKE f{'-/S-t:A1
INSPECTION NOTICE SCHEDULED
I
ADDRESS l7L./n 0t-r, ;;',:1 ,J.
OWNER CONTR.
PHONE NO. PERMIT NO. 1-f-7i
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION )7MECH RI o COMPLAINT
~RAMING o WATER HOOKUP ~IREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL ~SLlNEAIR TST
o SITE INSPECTION o MECH FINAL
COMMENTS:
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-98 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
JNSNOTJ
ADDRESS
/7'1'/7
,TE TillE
SCHEDULED ~~~~
A~/;J~/d -d
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
c:P~/.-> 77
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.".gFlNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~~UMBING FINAL
~ECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~REPLACE FINAL
o GASLINE AIR TST
o
COMMEN'JlS: /
f/""Gf7lcCcI r~'l /4h-<- ;:b/dY'
~
//4-d 17:.; / LJi
kc~e\c/~ eJ/:.C"c;- -(- 7-t:;S'~
- --
/jf/?kce.. hj.~/ ~,
U'At e.- tZ? A"4",! -h;/ A
~) /f/;~i ~TU /'}.n ~r:r~;;;'-
~k
--
--------~---.__...._--.
~ /7
( .,..,..--~_'e.
~ORK SATIS~RY, PRoCEEll
/ri ~ORRECT ACTION AND PROCEED
o CORRECT W~RK' CALL OR REINSPECTION BEFORE COVERING
Inspector: ~ ~ OWner/Contr:
v
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~~
r;'/e_ )
--------
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
""""',
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/7Y/7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~~
/JPt?/ ~ // - d--
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
:!~R HOOKUP
~~~~BING FINAL
o MECH FINAL
COMMENTS:
/1/ /
/",/6 p:.r 6/ "'9
"./
ex/'- 1'7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ /
~"->Gj7/
j,/ /'
~~.,____e ~/
/ ?
T?.s r-
/'"1/
c./('--
0/
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector:
OWner/Contr:
CALL 447.985Q FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
Il'ISNOTJ