HomeMy WebLinkAboutBuilding Permit 03-0648
(Please tvt?c:. or mint and sign at bottom)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
See Main Filehi"
2. Pink
3, Yellow
5'd/i~03
I PERMIT NO'03- (PLf8 I
ADDRESS (l . .
17?{j2 f}ll~'1)rl'~ eG,
File
City
Applicant
LEGAL DESCRIPTION (olliee use only)
LOT 13 BLOCK '?J ADDITION 'D~..jA qnv
OWNER
(Name)
(Address)
BUILDER '1\1 '"7::> \ \ A ~
(Name) ..1./. f"-..-.,'~c..-
(Contact Name) ~1....L~~~
(AddreSS)2D~I6,,~ vn'd<.(.. d., Sk> ,LOc)
, -7. ~;rr.;- 11.",'Jl Ef::::?JeKj
- -. ~ ,. . - -
TYPE OF WORK
o Misc.
)1!New Construction
OLower Level Finish
(Phone)
ZONING (office u,,)
12.d.-
PID ;)S-L(OO-OS'/I?
(Phone) 952.-'1 g,C; --z.OOf:l
(Phone)9Sc'Z:Zk-l??i.J
DDeek
DPorch
ORe. Roofing
D Fireplace DAddition DAlteration
PROJECT COST IV ALUE (excluding land) S If) r;: #7
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
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
entme property!o ~eded i~spections.
X /1.;thAy:d(I AU.Jh :Z()()(j~~ 7 6 /Z--t{o ~
r - Signature Contractor's License No. I Dat
II
I Permit Valuation
J Permit Fee
I Plan Check Fee
) State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
/dfJ{Obo.nD I
$ I 1136, s..c; I
$ / (/'175.010 I
$ 54.00 I
$ I
$ (Vd,OO I
$ lou.dO I
$ 35.50 I
$ 4-0 V 0 I
This Application Becomes Your Building Permit When Approved
~::f~ ~//~103
Building Official Date
I Park Support Fee
I SAC
I Water Meter SiZe@I";
1 Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
1/1050 .6 ,II
. .f/1 -- I q - .' "l
#
#
#
#
$ ~<;;D.O 0 I
$ 12-75.00 I
$'?_GJ.OO I
$ 4- c;,O 0 I
$ I.z.-OO.DC) I
$ '70CJ.OO I
$ ~ ,
$ j
I
$ U. J t,:J. II
I ReceintNo. i./l-;ft'J
Bv r:t,-"" ./
Th~ ~ to certify that the request in the above application and accompanying documen~ ~ in accordance with the CityP8'~an~~y pni'eed as '~. Th~ document
=; signed by the City Planner consti~tes a temporary Certificate of Zoning compliance and allows construction to ~fOl Vl.alnficat 0 11ancy must be
~ 1~ ;;/12./0"$ e
Planning Director . nate 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
,.
t:jJl
Job Address I '"7 2>~;l. pau ~
Heating Contractor ~ \~:
Name ofTester ----r\\\\o,~.
1dl":'. r 03
~
(K) Qp1'"
In 1>10
<z,-IoDO p"
..
,
Date
Percent 0,
Percent CO
Percent CO,
Stack Temp
t' 'I"~ IC~
( I
Combustion air is adequately supplied per
UMC Sec. 606
input
~ K frT1.l
'<
See Main File
White . Building
Canary - Engineering
(pInk - t'lannmIY'
I"h..('..nl..r of Ih..I..k..Countf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
.
NAME OF APPLICANT
APPLICATION RECEIVED
i /
/
· /-?l.____
/.
.~)
" . ()::,
I ..
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I :)3 eJ:;J- I, /"', ,,0 L,..-<----
/ !
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
Comments:
~.
~
-:t~,u
Date:
(p f.;.~ 3
.:w:t.th~i{"
"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."
~1
See Main File
CWhile - Building~
vdlldlY ~ Engmeerang
Pink - Planning
The c-fnlef of lhf I..kf COUnl'1-
BUILDING PERMIT APPLICATION DEPARTMENT CHI;CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
/)R~
6'-dJj-OO
r-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propQsed at:
/~3cfd-- l(b-{)~ ~
Accepted
",/
Accepted With Corrections
Denied
Reviewed By:
~
r
'1.Lvf'~
Date: &'/;~t1:3
, .
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 - I;!uil!'ling
r'" Canarv.. t:nalneerin.,g::::,
Pink - Planning
Till!' C'''nlfr of lht' L.kr ('oun.",
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
)' ..
f k' -1',1
.' i>,r l '___~'
/""
.~
::::::;~
/'~ '~,7
oW' {~_."
~....~~.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propc;>sed at:
'/'
I / co;'"' /",,: 4...-..)
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
/1114 g
S < <. Me;, (n,
Date:
~-9- 03
Comments:
~/IG
"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."
IlIn 2, 2003 12:07PM
GEN2 RVAN PLUMBING AND HEATING
No,5677 p, 13 36
"'~:2Ei PRl()~ 0(
... ~
_ :0:
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../f'i:!."
"';ii"'\!;'",
~~5f~N"'E.O"""
Date Rec'd
CITY,OF PRIOR LAKE
SEWER AND WATER PERMIT
i. ~w ~I~ I PERMIT NO. :z _ / / /0-1
l 0014 Applu::aDt ,-) to '1._p
(Please ~c QJ'Drmt a3ldsi,g;n .'1tbotto:m)
mDRESS /1 obi ;A /Juf:21i~ ( cI 42. s t.
ZONJNG (olli'" ..eJ
LEGAL DESCRIPTION (ollice use only)
LOT !c~BLOCK.3 ADDITION lJetR..h"e.1c1 q-fr--.
PID
OWNER
(Name) ~'i
(Address)
2oSl.ll0 KeY1Bg,,\DL-e. Cr Sw/(\T\
(Adllr<s<)
(Phone) _
Lau\lllIe...
(CIty)
qs2 -qgs- 7M/i
0~V
(Zip Code)
u_:""~,....":'.......~, u..,:':......~
APPLICANT
(N~~ Genz-Ryan Plumbin~ & Heating
(phone)
651-423-1144
(Addre.,s) l4745 So Robert Trail
~'uldres,)
(Contact Person) . _J!JJ)OSh fa J) r
'.ICANT SIGNATURE (fJJ.j'::1:F) 'f~
Rosemount, HN
(Cily)
55068
(Zip Code)
(phone)
DATE
651-423-1144
1j1-I--~,~
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 pve
Estimaied length of sewer line feet.
Clean out (if required) located at _ feet from structure.
feet
o Cast Iron
FEE SCHEDULE
ResIdential sewer and water line connection $35.50 Industrial, Com'] & MultHamiIy 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
rOTAL PERMIT FEE
$
$'
$
.50
PAID WITH
BUILDING ~ERMIT
(Office Use Only)
I This Application Becomes Your BuiIding Pernu! When Approved ~~ iE~ [~ D \'11 It G~\I :ce;.pt No.
::";"'" Buildi.gOfijcial Dale ~'I JUI; ~3g3 ~
24 hour notice for an inopections (9S) 447~O' r". (932) 447-4245
- I,
~---I
By ----=
-
Jun, 2. 2003 12:0JPM
GENZ RVAN PLUMBING AND HEATING
Nn5677 P 20 36
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
. .
rPle.Me type or 'DmZ: Qd nlm al bottOm)
I ADDRESS .
11.~q(), khe/d tJl2 6E.
LEGAL DESCRIPTION (of6t:e USe only)
LOT l3BLOCI< c 1) ADDmON llet!ZhfJd q fr,
; ~ ~i~ I PERMIT NO. 3 -14 (> ./ I
) '{~Iaw A.pp/jom ~ ~ X'
ZONJNG (offic,'w.)
Pill
OWNER
(Name) DR Horton Cust:om Homes (phone)
(Addre-ss)' 2.o~t.oD ~1BtCl~. -Or Sre. !DO
APPLICANT
(Name)r.A~~-"yall PlI,lIl"<-g r. u=-t.,<-:::
(A~e$)14745 So Robert: Trail
(Contact Person)
Rosemount
902-Q')],<=, -7'6D()
urlu..vtlle- l-u.tJ .E;.€':t,l.i It
(phone) ~"Lfi?1_11fi"
MN
55068
(Zip Code)
(A~ess) (City)
CflJeluh faLl! (phone)
rrlA. {~,) -=(r{,l/ /I DATE
APPLICANT SIGNATURE .
Quantity
,
I
!
~
I
I
,.,1
651-423-1I44
ItJ~1=- a.'i
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture I Quantity
I Bath Tuh with or without shower I ~
I Dishwasher /.
I Floor Drain I 1L-1-
I Lavatory (Bathroom Sink) I
Laundry Tray (1 or 2 compartment sink I
I Shower Stall
I Sinks I
I Bar Sink
I Water Closet (Toilet) I
Type of Fixture
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
Sewage .Ejector
I Backflow'Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
lndustrial, CommercIal & Multi-funnly 1 % of job COSt Will> a S39..50 minimwn R"",den~al, New One & Two-F.mily $99 50
Rc:sidenti.l. Addition. & Alterations $39 50
Estimated Cost $
Building Permit #
PLUM:BING PERMIT FEE $
STAJE SURCHARGE $
TOTAL PE:RMIT FE]; $
(Office Un Only)
I This Al'l'lic.ation Become. Your Building Permit When Approved I
~...- .
i.
, '.-
Building Om...l
Do"
24 ho.r notice for an inspections (952) 441-9
.50
PAID W/rH
BUILDING PERMIT
Paid I Receipt No.
R. [C CG L~ u ~j if! ,fff ( )rp ./
1 JII II I /
fax (.J!1) ll-dt72t803 I}J
J
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
#7/,99
i;;;::" ~:~ I PERMIT NO. ~- / /;0' I
3 Yellow Apphcant :J l.IJ Lf 0
(Please tvDeor orint and sim at bottom)
ADDRESS
/ ~59c:? aq~/c/ Ll. :5~
ZONING (office use)
LEGAL DESCRIPTION (ollie" use only)
LOV.31LOCK3 ADDITION
PID
. OWNER DR HORTON
(Name) - 20860 KENBRIDGE CT
(Address) LAKEVILLE, MN 55044
(phone)
APPLICANT ./J 0 ~
(Name) ./-7'///LJ'J' '?r.-//I.A/'/'~
(Address)~ ~~~~p ~
~AddreS
(Contact Person) A. . _~~
APPLICANT SIGNATURE- - - _
(Phone) ~5/.- q~,?...I'.?;?~
~4!!..6~ ~5:f.-"1 "]
((JjJ;jff (Zip Code)
(Phone) ~/- q~--177.s.
DATE
, APPLICANT PLEASE COMPLETE BELOW
~NEW CO~1RUCTION 0 REPLACEMENT o ALTERATIONS
FURNACEMAKEANDMOD~/r.oi?'''_-,t ~1'~~.y'07""'" FUEL /f.J, ~f~..e.
FLUE SIZE9'M~.A RETURN OPENINGS . INPUT.~ ~ OUTPUT 6Z, L.c...L......
I
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants
OGravity
o Mechanical
gbir Conditioning
pilYent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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 Only
$39,50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$39,50
$39.50
Estimated Cost $ ~ a:> Building Permit #
(Office Use Only)
$~/ ~.//~ P.
$ ~ .50 SUI \C\/O WITH
$ (/ l..OlNG PERMIT
This Application Becomes Your Building Permit When Approved ~1 ~i~ ~ ~ If) ~ .l~ Receipt No.
-. 0_' ,..,"CO",.., :,:~..."'... OS) u!~::')3u::, ]11 " tp
By .
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
" SEP.ll'2003 06:14 651 633 8884
fIRESIDE CORNER
#2692 P.003/006
CITY OF ~~R LAKE
HEATING/AIR CONDITJ~ " GIFIREPIJACE PERMIT
FIRESIDE~ !~;"" I PERMIT NO. "3 ~ (plj i?
Date Rec'd
q'teasc.!'le orm.at ~rtd silU1.t lurttoml
ADDRESS
HEAKTHo-!:iUMb'-
] 7392 DEERFIELD DRIVE SE
ZONING (.ffice u..) ,
J.EGAL DESCJUJ>'TJ.ON (offioe ... only)
LOT
BLOCK
ADDITION
PID
VWl"'J:"Jl
(Name DR HORTON
(Address)
(Phonc)
. APPUCANT
(Name)...-.AI,J-TJ;D Ft~~ DBA F11l.r:Ji!!:m ..." ^ R'rJ.1..!<. ""ME
(Phone)
65 J .633-2561
(Addrcss)
2700NOR.THFAlRVTEW AVENUl'
(Address)
(Coneact Person)
BRENDA HUSTON
ROSEVTLLF
(CilY)
(Phone) _651-633-2561
55113_
(Zip Code)
APPLICANT SIGNATURE
B~f!:JM /iUSTO/::L
DATE
9/11/O:t,
APPLICANT PLEASE COMPLETE BELOW
XO NEW CONSTRUCTION 0 REPLACEMENT 0 AL TEM TIONS
FURNACE MAKE AND MODEl. FUF.:T_
FLUE SIZE RETURN OPENINGS TNPUT OUTPUT
TYPE OF. SYSTEM HEATl:NG OR POWER PI_ANT
DWltrrn Air )>bnt~
DGroviry
J Meohoniool
JAlr Conditioning
JVent. System
] S,eom
J HOl Water
J RlIdiDtion
o Special D<vice~
o Other Devices
PLEASE NOTE:
Air Conditioner Unit<
Cann.ot. Encroach into
Required Side Yard
Sctb,cks
FTREPLACE MAKE AND MODEL
J1EA TN GLD SL.750TR.C
Tndustrial, Commerci31 & MUlti.Family
FEE SCHEDULE
1% of job e.,~. Rcsidenti<i', Gss; Pircpla.ce
$39.50 minimum
$99,50 Re.idcnti.J, Addi,ions & Alt,."tion$
$64.50 Residential, AC Only
$39,50
Residential, H""ting & Ale (New ConslrlJclion)
Residential. He',ting Only (New Conotruetion)
$39.50
$39.50
Estimated Cost S Building Pemit 11
HEATING PERMIT FEE $ ~ ~U .b..q
STAm SURCHARGE $ , 0 . ~DlI'D f1",
TOT AJ_ PERMIT FEE $ r I ~G 7l)."
(Orne. VA< Only) II' S E P r .0.$',9,
. "'.''"''''" _.~ V... SO",., "'_.. '" "~, ~j I, Receipt No. ~',i I"
F? II ,...--
Builder Divi.". j"ti:I!t>----,. I ~ /'
01: 'lIulldlncOm<ldU FOIf'1l0W Avenue Now Ro:llMtle, MN 55113 I'hode 65"-633-2561 'n.~ 651:-1;3;/-8884 /
nuitmllYl c.,un,
PRIOR LAKE
INSPECTION RECORD
" ,~ D~e ,.p, 'e IJ Q.,.
,
DEPARTMENT OFSee T\/r ain pOI
BUILDING AND INSPECTIO~ 1 e
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO, Q..3. t.-" DATE ISSUED
CONTRACTOR ----D..Jl ~r+.J#I' PHONE.;l~(.' 13 ~1.1
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING fM&W
! FOUNDATION (Prior to Backfill) [M~", I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
fV1/
JI'l;'F
t/l.IY/
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING ().(, n{J r~
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
q-J..'sSt6
C/ - ~tY<f3,
j/1/}// -
t/lf
f///1"
r/l/
tf-IYr-a:1
q '1--5' ~
q~ U-,rfJ
q -1.-) --I)
GRADING (Prior to Sodding)
BUILDING 1'< w() V'I \-II
I ELECTRICAL
I PLUMBING
I HEATING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
--See ~,h /~i /e. .
~ z6d/~
'd.(J1
-
vvr
~/
OCCUpy UNTIL ABOVE HAS
NOTICE
BEEN
/1-'14;
f). - C-eF"1
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
QItrfifiretft of @rrupanru
CITY OF PRIOR LAKE
~~parfntlmf nf ~uilMng JInsp~rfinn
pinal Permitted D Conditional e.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 FAMILY
Bldg. Permit No,
01-0641\
Occupancy Type R3
Type Construction VN Fire Zone N I A
1.13. B3. DEERFIELD 9TH
Zoning District
R2
Legal Descriptior
Owner of Building
SiteAdd,e" 17392 DEERFIELD DRIVR S.R.
20860 KENBRIDGE CT.. SUITR 100. LAKRV1LLE
Contractor's Name & Addren. R. HORTON: .}!_7
_ ROBERT D. HUTCHINS /~
/' ~Ui y'ng ffi,ial
Date: q /7....) C-^
, -
City Planner
nON RYE
Date:
DATE nMe
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/1~4~C"7
ADDRESS
n1Cf L
D.,.,,-h--t I J
OWNER
CONTR.
PHONE NO.
PERMIT NO,
'3-~ '1r:
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
)if-PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
(j) {CWl{)/k.-
~/..4t?s
o.~K SATISFACTORY, PROCEED
, CORRECT ACTION AND PROCEED
o CORRECT WO~K,;A~OR REINSPECTION BEFORE COVERING
Inspector: r V T 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
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o JjlSULATION
..e:('FINAL
o SITE INSPECTION
COMMENTS:
(tJ
~
P,""4 r
~o..L
C..bU///
SCHEDULED
17312-
Ow&/ J Or-
DATE TIME
/ 2~)-tJ3
5-- Cc{ Ii'
o EXlGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
c-l~V#'/~_ r
t"".c ~,;._
r-/c:Jc.../
o WORK SATISFACTORY, PROCEED
~RECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ OWner/Contr:
CALL 447-9850 F9R, THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
J7MECH FINAL
t?J-rt~ Cla:7~ (
-I- ~--.-S 0.,,-
,
..+c. /,_ -h-.
rl ~P<f,r? CA-t ft' /
"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
""NOT.
DATE
!?A,,/t:1</
/73'7;2. A(lY ,4~/"1 ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,JOi' FINAL
o SITE INSPECTION
COMMENTS:
~~
( ~/?
"-. (_ 1":5-€
------
TIME
SCHEDULED
CONTR.
PERMIT NO.
o.s-6Y"Y
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 GASLINE AIR TST
o
...~
.~/ l)
h /e. .-/
~
pORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
OwnerfContr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INSIWTl