HomeMy WebLinkAboutBuilding Permit 03-0691
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3, Yellow
File
City
Applicant
I PERMIT NOO-3- b9 f
(Please tyoe or orint and sil!Il at bottom)
ADDRESS
113g3 K\\/ifBr~ Httce 56
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 6- ADDITION h.ertiet J ----,nv
OWNER
(Name)
(Phone)
(Address)
BUILDER...... ':') \ \ A -r
(Name) .l..n<.... \T7)<"i'1N\ .Ll\.C.
(ContactName)..AII,'kt l1)nhfllrvd- k/J./
(Address) 2-9'O{rJO k~brl'JI1& e:t:~V/O{)
, .iflt:lA/I III I"vHlI Ri1)...., '--I
Date Rec'd
6-~-3
ZONING (office use)
R~
PID 85 -3Cfg-O 1<3-0
(Phone) qt;z-"tl1s-7eO~
(Phone) qQ___Z2-ir'-f1.~2-
,
TYPE OF WORK
!;iNew Construction
ORe-Roofing
DAlteration
DDeck
DPorch
DLower Level Finish
o Fireplace
DAddition
DMisc.
PROJECT COST IV ALUE (excluding land) $
Q&I ~q (
DRe.Siding
DUtility Connection
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
submItt lans I am aware~at buildmg offiCIal can revoke thIS permit for Just cause Furthermore, I hereby agree that the City offiCial or a deSIgnee may
enter on e property to t'erfi d mspectIons
X 'J)... ~ ~ ~Of)O cw,.'\7 iJ"30'03
- SIgnature Contractor's LIcense No. Date
/ (':87IJot),00
I Permit Valuation I Park Support Fee
I Permit Fee $ . , I SAC
~O 2. 7>
I Plan Check Fee $ 5.6(0.79 I Water Meter Size 5/8"; I";
I State Surcharge $ Lfg.5'o I Pressure Reducer
I Penalty $ - I City SAC and WAC
I Plumbing Permit Fee $ I/)~. PO I Water Tower Fee
Mechanical Permit Fee $ /OO,(:Jd I Builder's Deposit
Sewer & Water Permit Fee $ I Other
Gas Fireplace Permit Fee $ 40, 00 I TOTAL DUE
I
This Application Becomes Your Building Permit When Approved
~ ~~I-' faIt3/1)~
I Paid .5 /7e d "--
I Date I.. I J" . ~ 1
Building Official
r Date
#
#
#
#
r I
I Rectip't No.
By I'.
Y
$
$
$
$
$
$
$
$
~a,()o
/2 7<:". cJO
12eJ(j. O~
7tJa dO
$~1qf3. /)4--
<;t?k, L- I
I
This is to certifY that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
"'"~ -;1~ 1o~3107 ~~ 4I~ ~
Planning Director
Date' Special Conditions. if any
24 hour notice for all inspectious (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Job Address l2?$ ~/A:z-1...
Heating Contractor lJ;iJ)1vr /hI/-#"
IItrMiJ
, ~jrp!
,5J, 1"l"
4.&/
/~ d';
317 0/
..
Name ofTester
Date
Percent 02
Percent CO
Percent C02
Stack Temp
Combustion air is adequately supplied per
UMC Sec. 606 ~
input f-:lJ(II( ;/7//
.
"
~~
See Main File
C-While . Buildin0
~al1ary - -€ngineering
Pink - Planning
Th('C..nl('rnrlh..I.8bCoUnll')
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~((~
I/J - c'2~D G
The Building, Engineering, and Planning Departments have reviewed the building permit
application forconstru;; ~c;; ~~ fJ~
Accepted
~ Accepted With Corrections
Denied
(~/~
Date: c;J ~7
Reviewed By:
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."
~~
.".
See Main File
White - Building
~ana - ineering
Ink - Plannin
~=
Th~ ('Pnl~r of Ih. L.kf ("ounll')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
-
NAME OF APPLICANT I
APPLICATION RECEIVED
l
"
. )
). "', /' '--'
" ""
)-00
, '
~ , '
..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
fr;" v:": I''','.'. 3 ! \ /. ?, .. 1'" L A.J ( / /
"':" " L,../.- r ,;' "(/t._~. f,.,\=:~"'''L/&('..t~ I ,,''''~.--''
.
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
Comments:
~
-
~-dl~
Date:
t;,1/7/0 :3
"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."
i<i-
See Main File
White . Building
c: l.;anarv - EnClineerin~
Pink . Planning
Th~ ('~nl~~ of lh~ I..b Counl.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI!;;T
NAME OF APPLICANT
APPLICATION RECEIVED
I
;\'-
---1-----
[(;7'---
'"
(:...~: - () '(:1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whic:~ is proposed a,t
, -::.; ,....-. .- " .~",. ~_ ~.t';> -1 / - ;:,' .'_; / I, ,",' , .
/ r; '--' ?f:3 v" ,A(,{J t'o.-~,t,.('./,t..../ / . 11/<.------'
Accepted
c<
Accepted With Corrections
Denied
Reviewed By:
/Y)I:}b
S-c e_ J1k,r~
Date:
o ~ 7-03
Comments:
F"'( 1 ( <
''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
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
//
rr ,??CU
i :,':. ~:~ I PERMIT NO. -=>- / /;/ I
J. Yellow Apphcant ::> I/J LJ,
<?lease.!'(pc: or mint and sism at bottom)
ADDRESS
/7-.3cf:s ~v&~J ~0e -5'E
I ZONING(offioeuse)
LEGAL DESCRIPTION (office use only)
Lq:;(23'BLOCrc:5/ ADDITION
PID
OWNER DR HORTON
(Name) - 20860 KENBRIDGE CT
(Address) LAKEVILLE, MN 55044
(phone)
APPLICANT /1, /. /Z
(Name) /7'//./~ /./7 -"r~/.,g/
(Address)~ ~A..IA.. '! ~
(Addre,
(Contact Person) Aez/~_L~~
APPLICANT SIGNATURE -s-4- . ~ ___
(Phone) ~5 /.. .-;/.,:r-?..f''??.s-
~~~A' ~~f...1 ?
- . <rr.itr - - (Zip Code) -
(Phone) ~/. c;./'g -.,,? 77-2:
DATE
APPLICANT PLEASE COMPLETE BELOW
,
j!lNEW CO~TRUCTION 0 REPLACEMENT 0 ALTERATI9NS
FORNACEMAKEANDMOD~/r'-~ ~. .:?/a-9~4i"?70 FUEL",(..), ..4-........:.-..e.
FLUE SIZE"7"'~..hz~.A RETURN OPENINGS INPUT ~ OUTPUT ~_~
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Planls 0 Steam
DGravity 0 Hot Water
o Mechanical 0 Radiation
~ir Conditioning 0 Special Devices
~ent. System 0 Other Devices
PLEASE NOTE:
Air Conditioner Unils
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 & Alteralions
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ ~ a:> Building Permit #
Building Official
Date
$~/ AG!'V~~ P4l0
$ , .50 'l.DING WI.,.,.,
$ (7 ~f:h.
, . 'III("""
I~ ~ ~ ~I ~ ~,.ieceiPt No.
mteJUN 2 3 200.1 I :ll8y
0r
HEATINGPERNOTFEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9~ fax (952) 447~24~_:::
1'10. 9, 2003 3:39A~1
GENZ RVAN PLUMBING AND HEATING
No,6693 p, 21 24
Date Rec'd
CITY.oF PRIOR LAKE
SEWER AND WATER PERMIT
i ; ~'; I PERMIT NO-3 _ / r:. (
]. Gold AP'I'IIGU)C Co I
(Pte::l..!lC: ~~ or 'Dnnt and siJmat bottom)
I ADDRESfyg3
frtJte 13/~ P / <Sf.
ZONJNG (offi"'...)
LEGAL DESCRIPTION (oflice "'. only)
ADDmON !Jlda 3/
J
LOT
BLOCK
iJ~dd 7P?ID
OWNER
(Name) -00
(Address)
2O&nO ~Bi<-\t:6e. Or S;..~lm
(Add"",)
(Phone) _
~\JIII€'-.
(City)
qs2 -Qi1S- "73.1:2/\
e:J~U
(T", Codc)
u"':"'J"~r..e-"'''''''' ":iGmc:::'
APPLlCANT
(Narn" Gen~-Rvan Plumbinz & Reatin~
(phone)
651-423-1144
(Address) 14745 So Robert Trail
Rosemount ~ MN
55068
(Zip Code)
f} (Add<<:'S,) ~ (City)
(Cootacr Person) . I !J1 ~~. r (phone)
'..KANT SIGNATURE I ~ DATE
651-423-1144
;,/ !d!!!3
. .
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
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 line connection
Sewer cOWlection only
FEESCBEDULE
$35.50 Industrial, Com'l &; Multi-family 1% of job cost With a $39.50 minimum
$17.50 Waterconnectioo only $17.50
Estimated CoSt $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Offici. U~e Only)
I This Application Beeomes Your Building Permit Wheo Approved
BuildiDg OfficiaJ
D2.te
I Paid
I D:lte
I Receipt No.
I By
I
I
-'.~""
24 hour .ntl<< for all i.spections (952) 447-9850, fax (952) 447-4245
1,,0 9, 2003 8:39AM
GENZ RVAN PLUMBING AND HEATING
No,6693 p, 22 24
LU x OF PRIOR LAKE PLUl\'ffiING PERlVU:T
Date Rec'd
11'1= "(pe orurlnt ands!l>:n at bonum)
ADDRES/1383 I..r IIt~ 6/IlM
LEGAL DESCRIPTION (o/lke u::e only)
LOT BLOCK ADDITION ~/~ ~/
0.../
'OWNER
ON~e) DR Horton Custom Homes
I alII, Fil.
:. G.Wl elly
1 v..,""'" A9PlICllG'
I PERMIT NO. 3-(09/
PI ()E.
ZONING (ollke",e)
/)eaeh~k1 11t,PID
(phone)
9S2oOQ'XF,-i'iSM
(Address)' 2-ob~O KeI1B~l DGe:. Cr S~ 100
APPLICANT
(Nametr."6...."..~~.._l..-:...g ~\ u""'....r--f.....:
(Address) 14745 So Robert Trail
(Contact Person)
u,ILLvillG lMN 5604LJ
(phone)
~l;,1_1.'J"_ 1 16,b.
Rosemount
55068
(Zip Code)
MN
(Addres~) . (City)
011 Jets tt fat{ J (phone)
~.J~ ~/")
APPLICANT SIGNATURE .
Quantity
f
1
I
~
I
z-
651-423-1144
~/ (p/O'2,
DATE
,
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
LaundrY Tray (I or 2 compartment sink
Shower StaU' ,
I Sinks
I Bar Sink
Water Closet (Toilet)
Quantity
Type of Fixture
I
I
I
I
I
I
1
I
I
I
I .
JZrT
I
Rough-ins
Water Heater
I Water Softner
I Stand Pi?e (Washing Machine)
Sewage Ejector
I Backflow Assembly
1 Backflow Assembly Test
I LawnS prinkler
Oth er
FEE SCllEDULE
lndustnal, Comm.rclal &. Multj.fmllly 1% of job cost WIth a $:39.50 mmlm1l}ll' Residential. New One & Two-Fomily $9950
R""idential, Additions & AJtl:rations $39.50
Estlmaled Cost S
Bullding Pel1lllt #
PLU1vfBrNG PERMIT FEE $
STATE SURCHARGE $
TOTAL PE;RMIT FEE $
.50
i
(Office Use Only)
I This Application Becomes Your Building Permit When Approved
r~, .
t
.,
1-
lIuiJdingOfficiat
Da'"
24 hour notite for all io.pectlons (952) 447-9850, fax (952) 447-4245
Paid
I Receipt No.
I By
-Date
AUG.27'2003 06:31 651 633 8884 FIRESIDE CORNER #1999 P.015
CITY OF PRIOR LAKE
HFATlNG/Am CONDITI~G/FlREPLACE PERMIT
FIRESIDn~w E~,,,,, I PERMIT NO. '3 ~ to 9 / I
(Ph:a~ ~ or mint and 1rilP;n tt bottom) ~
ADDRF..5S 17383 roVER BIRCH PLAd~ Kt R T H 6- H 0 ME'"
Date Rec'd
J
ZONING (om" u,,)
LEGAL DESCRlPnON (omce 'J"" only)
LOT
BLOCK
ADDITION
PIn
OWNER
(Name 0 R HORTON
(Phone)
(Address)
APPLTCANT
(Name) ".LlED PJRESrQl'.J2!'. PJRR~lJ2E.HJ;~RTI~ & I-IQMF
(Phone)
65 J -633-2561
(Address)
2700 NORTH FAIRVIEW AVENUF
(Addr...)
ROSEVlLLE
(CiIY)
55113_
(Zip Code)
(Cont.act Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLTCANT SIGNATTJRE
fiR..fNI)A HUSTON
DATE
R12,7103
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AI. TERA nONS
FURNACE MAKE AND MODEl. FUEL
FI.lJE SIZE RETTJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PT-ANT
OWllJ'm Air Pilm!,
DGrAuil)'
D Mechanical
OAir Ccndl[]oning
o Vent. Sy,!.em
o Sto.m
o Hot W.ter
o Radiarion
o Special Deviu5i
o OU'" Device,
PLEASE NOTE:
Air Conditioner Units
C3IJnot Encroach into
Requirt<! Side Yard
Set.backs
, FIR.EPI.ACE MAKE AND MODEL
HEM N.-'~J.O ~L-750TR-C
-.---,
Indw;triol, Ccmmercial & Multi-Fomily
FEE SCHEDULE
I % of joh en!;t Rcsjdenrial, Ga.c;. rJrepl11cc
$39.50 minimum
$99.50 Residential, Additions & Alrer:nions
$64.50 Residenti.I, AC Only
$39.50
ReSidential, Healing & NC (New Construction)
Residenti..J. Heating Only (Nolll Con,'!mclion)
$39.50
S39.s0
Building Penni! If
$
~JR (iI '; r:'~,;; r,
L1 ~ L1 U :lj ,11
I I
U ~~' n'7, I,
This Application Bocome. YOllr Blllldlog P~rJllil Wh~n ApprllYed II. 1', "'d LUUj u I Receipt. No.
A Hearth di Hdlhe Jt!(;/lI ntfe~ ran ~
~~ 'Juiltie,' mvi, Dare By {h- "',.'.II~.>I
'g IJUildinIlOnJoJ.l\hr."i"";P\V~v{'mlf'N. ~ )ho ~{~-q l-~~ l:~~"1
""",';" ''''''ll. 3850 We,t 1-lj$~\YiI~ J~i~1ft9~'~.r1~1.'\j.Rrm~2r,jJpf-'8~~~~~ljM.!1h3~2-8CJO-540g ~J"j~WJ?>gN!~
~",w.n""~u~Il~~,('I)",, Mill C""fn1ftlJr I.I~CDSC ~ 10fJ'91'\'911
Estim:rted Cost. S
HEATING PERMIT FEE
STATE SURCHARGE
TOT AT. PERMIT FEE
PAID
t:tuII.DIN W,]"""
G P12J:ift.1rr
(Office U" Only)
PRIOR LAKE
INSPECTION RECORD
-R J'V&V "Bi ~ 'P14..Ge..
. Se MOp"
DEPARTMENT OF e . aID lle
BUILDING AND INSPECTION
SITE ADDRESS. J?313
NATURE OF WORK -P ~ W
USE OF BUILDING ..5F Jf-
PERMIT NO. 0"3. '- ell DATE ISSUED
CONTRACTOR n ~ HfJ,j-()N PHONE~" 'I,,:3:L
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING ~~;", I
I FOUNDATION (Prior to Backfill) ~~';'I\I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER f WATER f SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING tlvr-: t'f - '-I~O~
HEATING (ifrequired) M/ Q-lh:.0
FIREPLACE j/lIf./ q-((- 0->
GAS LINE AIR TEST rvP' q-(/- c0
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I
FINALS
lMa;"
VlffiI
IM,P'
q~ /(- c/)
q - ()~d>
GRADING (Prior to SOdding)
BUILDING 1<...&7 tJ"( If- ?O'O)
ELECTRICAL
PLUMBING
HEATING
DO NOT
,
~-e e. ~':Z,.." h i'e oO
~ 9/?0/6Y
iW'
tN.-/
OCCUPY UNTIL ABOVE HAS
NOTICE
BEEN
10-((,-0}
fO/);?vCT>
SIGNED
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
Ctlrdifieafr of <IDempaue)J
CITY OF PRIOR LAKE
~tparfmtuf of ~uilMuB JIusptdiou
/
J!i Final Permitted D 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 Classification
SINGLE Ffu'IILY
Bldg. Permit No.
03-0691
Occupancy Type R3
Type Construction VN
Fire Zone
N/A
Zoning Di,trict R:'
Legal De,cription Ll. B6, DEERFIELD 7TH
Own" of Buildino Site Address 17383 RIVER BIRCH PLACP. S. F,.
20860 KENBRIDGE CT.. SUITE 100. LAKEVILLE
Contractor's Name & AddressD. R. HORTON I INC. ~
ROBERT D. HUTCHINS /;@"
/0i1dil}8 Official
9/?/1 dL/
'/ - f
City Planner
DON RYE
Date:
Date:
!
J
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIMe
9~.v
ADDRESS
/~~-f-.5 IZLe.r g?/c~ /h~e
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
P-f'JNAL
o SITE INSPECTION
COMMENTS:
-----
/
/ ./
~o:)~
CONTR.
PERMIT NO.
tJ3 ~6.Pr
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-
-- --
~.~
/-7 t' e.- ./
.-------
~'/
~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!
''''''''''
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
tI"3?-3
et~ t.._t,
OWNER
CONlR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..P'1"INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
a--MECH FINAL
COMMENTS:
( l)
(j)
DATE TillE
((J-.J,.?~
RtV_
? -r. '" f
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
<;;rl,..! -+- T,r~<,)
r:,.... I t::?--rAb
a..~ J.-u.-/~/."uoO'
:..,?P....--OlJ.. I
, f
.-1-
((.~ Pf,ff/ 001-r {
()YSI( ~ 01_
I /-'30- (J~
o WORK SATISFACTORY, PROCEED
~ECT ACTION AND PROCEED
o CORRECT W~K. ~L FOR RElNSPECTION BEFORE COVERING
Inspector: f/' vr Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
-.iNt-t/3
ADDRESS
/73t'3
(J'(lA/I;"reh
OWNER
CONTR.
PHONE NO.
PERMIT NO.
?-r;qj
o FOOTING
o FOUNDATION
a FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o P~UMBING RI
o MECH Rf
a WATER HOOKUP
o SEWER HOOKUP
,P'PLUMBING FINA~
o MECH FINA~
o EXlGRADIFI~~ING
o COMPLAINT
o FIREPLACE Rf
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
'0 (eV'lft)/~
,t:>>hv.7>
o YORK SATISFACTORY, PROCEED
..,tr CORRECT ACTION AND PROCEED
o CORRECT WO~K' CA FOR REINSPECTION BEFORE COVERING
IO-Ifs,-~
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'NSNOn