HomeMy WebLinkAboutBuilding Permit 00-0875
~\
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
!c,T, 00
POD
c;: 6.00
~ DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please.Erint or Type and sign at bottom)
12S~tDlJ\Q W ~O~C.K b\vf: AhJ
3. LEGAL DESCRIPTION
'X"
ADDITION ,...t+S. IAII L.D (
.
LOT
BLOCK
':<. a t)
\ PID 2!5~337- ()0f3-0
AS>"bl\70.J
--"
14. OWNER (Name)
15. ARCHITECT (Name)
6. BUILDER (Name)
1Yl11~.l.Si'/lC.PT ~,~ r
C<ltJ.s"M14C-1l0N, ~c.
7~ TYPE OF WORK
New Qonstructi~
Chimney 0 Mi~ --
Fireplace 0
Alterations 0
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
sF/'J
TYPE OF CONSTRUCllON: 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 ....................................... 'I:
Plumbing Permit Fee ....................... 4:
Mechanical Permit Fee ..................... 4:
Sewer & Water Permit ...................... CI:
(Address)
(Address)
(Address)
d 1/2..-q t/"'!;;TtlJE&., f.
::r G 1+
Deck LI
SepticLl
Addition LI
(Tel. No.)
(Tel. No.)
(Tel. No.)
(pSJ-S~-J?')1
Finish Attic LI
Re-roofing LI Porch LI
Re-siding LI Finish Basement LI
FOR ADMINISTRATIVE USE
Back
Side
18. PROPERTY AREA OR A~rst 19~ PROPERTY DIMENSIONS 1'0~ CULVERT SIZE
Sq. Ft. \ C\, '::::, '/ W;dth I iJ<:l Depth I \.{ v( Yes No
eby certify th t I v f mished 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 ve and that all construction will conform to all existing state and Jocallaws and will proceed in accordance with submitted pia s. jam aware that the
Guildi offi i p~ cause. Furthermore, I hereby agree that the ~ qc~iJ. designee may enter upon the property to perio ,ner~pections.
Signature License No. Date
Side
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN ~ :s f.o" (DO 0
PERMIT VALUATION ~~ _~. .J'~
S U
City:
ItS1lJ.2~
',n,!'..,1
IIB,CO
loo.t!>O
IPO./1 0
~S" . SO
Cfo .(PO
~o
~.
Gas 7't7L"":)~'''''''' .............
~~iS~O:S~n. ~~:~'~~e/~~5;;;o
Certificate of Occupan
Water Tap ................................... $
Builder's Deposit ............................ $--1" 5"~ ~
Other ......................................... $
Total D~e .............................. $
Pa;d H & ~ 4(p Rece;pt 1ft "
Date 4.,;Jfj .Of) By AJ 'f
rtify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may prace s re<iuested. This document when
theC' I nercons"utesatemporaryCe~fi~mpuan~d~l~s,con~~~~wncy,~rtif~~~;ssued.
Planner ! Date Special Conditions it anl
Issued
Amount Brought Forward .................. $.
Park Support Fee ........................... $
SAC .......n..............................., $
Collective Street Fee ....................... $
Sewer Tap ................................... $
I,f $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $.
24 hour notice for all inspections (952) 447-9850
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
OO'Q~/&'
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) "7ii~" .j9!vt~G f,
12. NO. OF ~RIES
13. TYPE OF C~~TRUCTION
W,~j) H<(1t- fL-./S.
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEAT.O
~.~~~O~Ngto
11ct(~N r&-o
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0
PLANS & SPECS 0
SURVEY LI
PLOT PLAN LI
PERCOLATION TESTS 0
SETS
COPIES
Rsn~
1,.{ 00 .d7J
70. QO
"2 Sl:1. 00
I, -:> en J!)t!')
""&-:l...IU!J
.~~
o~. O~1~
Th", e"'nlt. of Ihe L..... Counlry
~
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Ill/ / I cL .5 7716- UT L? k os .
APPLICATION RECEIVED q. 5 . () ()
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
. -'3 J it: Ie tv QuO Du (X {) fc:.. N VV
Accepted
Accepted With Corrections
V'
Denied
~~
Date:
qjmGO
Reviewed By:
Comments:
1'-1~~J.AMA ~~ ~)~ <:fMJ ~
JJ....... (0 '6.) <<r?? ~ ~ ('.u.A .
"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."
~~
D6'()~7S
Th"("f'nlnofth..l.ak..Counlr)'
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT j111 / / t:;-LS771S Dr 8R-O.s.
APPLICATION RECEIVED q . 5, () ()
, -
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.'5/0h lIvoOD D(/(!K De NW
Accepted
Accepted With Corrections ~
Denied
Reviewed~f Date: 9-/ ?-2x9o
Comments:
(2~a20 n tfctcW ~ <:.., ~-
"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."
66 'D~l~
Tilt Ct..11't of lbt t.kt COURlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT J11 / / / t:::.-LS77i 6- Dr /3 e OS .
APPLICATION RECEIVED 7, 5"' 0 ()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.3/00 wooD DuCK.- De
Accepted /
NW
Accepted With Corrections
Denied
Reviewed By: (;r-a.nf ~rb(}lZ. Date:~?
Comments: ;5e.e -!he rel/-el'"<;e $/~ -t:1'" ~'f/~n.d Mlin"lI!i---.
See a-#~ell+~:: i. hit,,-I. (J/iftk JA~ec.:f/dn. Z&u:/I14lilA Cl G~'Y~/v....
.1. F r(i5/i'Jrl (1Jrc/. ~tir6 If. ert75'1ff1r. i!t7A/;gj fY~ .
"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."
lU/U/~~ THU 1J:14 FAX 6124474245
CITY OF PRIOR LAKE
@OOl
I. Blue:'
2. (icld
J. Yellow
Tite
C;ll'
^rr1iCMl
# ,(l - <?I"J 5'
U Phone: tflS#I/II.t. / ,)1;2/1
/'" ~/fdr/ll1k, MiV .(.{?s:-z.-
CITY OF PRIOR LAKE
PLUMBING P RMIT
Applicant: ~
Address: qQf) Z bY'
Signature: (i j J ':A ~
'. 1 Legal Description: LDt ~ Block I
Site Address: ,5/ljtP Ijf>ft) _.U(jiPt :0 /'
Building Permit # PID #:.11) - ?J--J'I- UU6-U
NOTE: This permit will not be processed without complete information.
l~'('rfl'n""""'I..ktC'~I""n- 0
~. c=.' ~~._.,g,JJ
I D"" 0/1"'-
Iii ~-_~-,I_ " '
ii j :
lV(', ~ 172000
! 1\ \'
UuL
___--ii_/
FIXTURE UNITS
".--
Quantity Type of Fixture Quantity
~ Bath Tub with or without shower .J
! Dishwasher !
f Floor Drain
J Lavatory (bathroom sink) I
I Laundry Tray (lor 2 compartment sink)
! Shower Stail
! Sinks
Bar Sink
.s Water Closet (toilet)
FEE SCHEDULE
Industrial. Commercial & Mulli-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL
,
SUb~ (j)L1)~-)0
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
BackffDw Assembly (RPZ, DDuble Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$
.50
$
Thi:,; permit is granted upon the express condition that said
contractor. shaU comply in all respects whh the ordin:tncc$
or the St:ltc Plumbing Ct)(.)e .ond the amendments thcrc~
,~ . &CEIPTNo~'7/0-tATE
f!:a ( J AA...2 ^ ITEST
Call r all inspections 24 hDurs in advance.
PAID WlTn
BUILDING PERMIT
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equ:>l Opportunity Employer
09/28/00 THll 10:43 FAX 6128902753
STOCKER EXCAVATING
1aI001
~ @ ~ ~~~~~.. ~
~\;i f\ ~ \\\\\,
~~ITY OF PRIOR
AND WATER
~91-1'LIl;
'ff.u.aw . .YPUc&1IT
GOLD . caT"
LAKE
PERMIT
0,- (>15"
NO. 0
NOTE: Se~er and Water
contractors must
be reg'istered
with the City.
APPLICANT: DC Mechanical/Stocker Excavating
PHONE:
890-4241
5:i.lZ.a.-DATE:
q I.2UJJf.l
SIGNATURE:
est 12~th S~~,MN
\ .
SITE ADDRESS :.3166 Wood Duck Dr. NW
BLDG, PERMIT iI O'l'?5'
PID#,d5 - ~~-()()i?-o
531
ADDRESS:
FILL IN THE BLANKS
1, Estimated length of water service
feet.
inch(esl.
2. Size of vater service
J. Location of any couplinqs from structure
feet.
PVC-x-- Cast Iron
4, Type of sewer pipe. ABS
feet,
5. Estimated length of sewer line
feet
from
6. Clean out (if requiredl, located at
structure.
====~~======-=========~~~~~~~~~====~------=~=====================
BY
This application becomes your permit when approved~
DATE:
FEES:
=============------------
SE~___~==============________~~~C
$
$
$
Sewer and water line connection permit.
Surcharqe
TOTAL
35.00
.50
J5.50
* Fee for either sever or water individually is $20.00 plus
S .50 surcharg'e.
* Se~er and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate 5ewer and water ~~~~~ are
issued. ' Fi '
eUILDll'llot PERMIT
DATE PAID
RECEIPT #
AMOUNT PAID
REC'D BY e ;tAA/I~
16200 Eagle Creek Av. S,E., Prior Lake, Minnesola 55372/ Ph. (612) 4-47-4230 I FAX (612) 4474245
An EqWli Oppoltunity Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION (.-
I
I
!
I,
SITE ADDRESS .3l1d ~ l JlYYO D (Ie k l1)HIIQ
NATURE OF WORK ~e.u ') -
USE OF BUILDING ~I=-j"
PERMIT NO. /JO'I'Jf37~ DATE ISSUED 9 -13-7QQO
CONTRACTOR tli.J..I....I~k".~ \<~ r ~ . CIS I J. S5~.I'l" I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING IJ/e. I ~ tJ:t, I /4 i/~
I FOUNDATION (Prior to BaCkfill)"~~ I t'tI1. I D/5/ In I h. II) ,A /~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
~.
~,
~
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LfNE AIR TEST
/~1111l1
/0~/~
/Ij J./ fr;
/6(3~/tJV
/~/3~/~
~~
.
t
~
~ (J/3d / tn
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNE.D
I ~ -....-.1:1 I I
FINALS
~~Jlj
6V ....~~~ "Iqlor
~ ..
%1) 17-1,Q)oo 1
1 /I~ \) ("",./ I:J.. 1C1 Of!
,
OCCUPY UNTIL ABOVE HAS BSEN SIGNED
NOTICE
GRADING (Prior to Sodding)
BUILDING-r60 7V 'l ~ I- 01
ELECTRICAL
PLUMBING
HEATING
DO NOT
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have "'''ell,approved. On buildings and additions
where no service cabinet is available, card shall be JlIaced near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
J
J
FROM : SABER Heating and A/C
PHONE NO. : 6124738565
Nov. 08 2000 01:45PM Pi
HI''' ,'Hi flf"'flM~~
IIr . HI (Hk~Lt~r;t~
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f. "I . lif r . _
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C) r;. 1 I
-- -......, .-.............
~...'..'~n TW~ '.!~T nDT ../6n/nr
QLtrtificau of (lDccupanry
CITY OF PRIOR LAKE
:mtpartmtnt of .uUbing Jn~ptdion
JiFinal Permitted 0 Conditional C.O. Expires ~
'"' ,~.- " ' \
/"~ ~.~ (--,.., ,
This Certificate 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:
Use CJassificatir ,~
SINGLE FAMILY
Bldg. Penni. No DO-DB 7 5
N / A Zoning District PUD
Occupancy Type
VN
Type Construction Fire Zone
LB, B1, THE WILDS THIRD ADDITION
Legal Description
R3
Owner of Building
ContraclO,'sNamc&Addres' MITTELSTAEDT,
ROBERT D. HUTCHIN~~
Date: \ II J ifll DI Builcling OffiCIal . . \
"1 ,I
'iteAddress 3166 WOOD DUCK DRIVE NW
2425 96TH ST. E., INVER GROVE HEIGHTS, MN
DON RYE
City Planner
Date:
POST IN A CONSPICUOUS PLACE
,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/o.z..o/
AT.
ADDRESS
3/ (oft, WOOD DU(!K
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
?tAt
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECHjF.INAL
SOD ~
f
00-0875
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
IJ If L r
bL(O/..- 1 {' e e.-- IZ>
10 tte-
~^,.y 1 )IU(~ <
l
c.u ~
\.e-.
II} q/~I
.
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR~O~~. CALL FOR REINSPECTION BEFORE COVERING
Inspector:"p .....-VQA.AlI Owner/Contr:
CALL 447.9850 FOR ~E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Ku€M. ~
lNSNOTl
b s,,-(- '5'S'~-f77f
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/0/9/00
,
//;00
ADDRESS
3/ (" Co
WOO r7 Du('f<..-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(J-M"
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~ 0 MECHRI
WA TER HOOKUP
SEWER HOOKUP
~ PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLiNE AIR TST
o
COMMENTS:U2) U"&h'- .Ilf;;;".-!- (~.)
02~~.1;:::- ~~~~~\
~,.~. <J." ~ <:l~-" ~O ~,
~ ~~. IJJ_~ IJJ~ (\~
--
~l"r - I,q ~,," 1<" ('''15'/'' '/ ~ <t~
t.~. .J&-rO ~/~
, l.-v ~ f?~
ofl' ill ~l".ML..atl" '..;4J r't/(L-
--t../J .;:;'~ A,T, -~,
o WORK SATISFACTORY, PROCEED
~CORRECT ACTION AND PROCEED
:S::~:ECT W~ FOR REINS::::::::FORE COVERING
CALL 441-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSfVOfJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
0.1\ TE TIME
I~ fl;d;)
ADDRESS ~J (p 0 wooddu.J:.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(}o- fJ 7S-
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
jlf PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
IlIA () ..vW fA A e...l"F r?!::
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~ORK1CALL FOR REINSPECTION BEFORE COVERING
Inspector: U5 .IJ~ Owner/Contr:
CALL 447.9850 FOJTHE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3/6'
w,?fJ,[cLJ<:
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o JNSULA TlON
Jif'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
"B"MECH FINAL
DATE TIME
/;Z!J..:JloD ;;:2:(1)
I)tJ - ~ Z-")
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: '----
~~.or-~ '+JVc.. -WOw. ~"'<NVP P.I!PArl5 I
€lNJ i "-- e,WO,;t< t-!" ci.,~e c:,., cL
ii-ees. Ct-<-\6 socL fer .deueJof0-'\ c",.-f-
1N\a.~+a(IA to.rr9!;;.V~^ mill ~
Ml'Jf'~~ ~. ~t ",d--ct,~
S- 1M. ~__ ff\l\P_
I
~ 10 (. >>, 1M.\, +-71 ~ -1-0 I
.~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~. V~J Owner/Contr:
CALI. ~7-98S0 FOR ~HE NEXT INSPECTION 24 HOURS IN ADVANCE
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/VOTl
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
Y-13-o/
11,..-,
ADDRESS J 3/t?
PHONE NO.
L.{ cJod "/)yc. /( p,...
yV" I f-I c{ s/"...cI1
CJO - s> '1 <;'"
CONTR.
OWNER
PERMIT NO.
o FOOTING
o FRAMING
o INSULATION
-lrFINAL
-O~UNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
~."X~L1NG
~KJ~~ "~;i~TLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
hr(/d, - oK
:J..YJ<i<.11 /.<10 0", / .o/n r<nX
OK3\
::WI
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~.4Jt- --
Inspector:/~ _ Owner/Contr:
CALL 4474230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
& -;z.-<:;)1
ADDRESS
3/(,t, W~kIL
PI'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(l}!)$ '1.s-
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 EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
r.ll//" )5".,)(/ c')!::
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:~ --- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTI