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Home My WebLink AboutBuilding Permit 03-1121 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT See Main File~i~:' ~:;, 3. Yellow Applicant (Please ~e or print and sign at bottom) ADDRESS \l31o S beex~ et L ~l VG Sri. Date Rec' d g//-a3 I PERMIT NO. 03 - 1/2. I LEGAL DESCRIPTION (office use OnlY~ ~ LOT (0 BLOCK 2 ADDITION Va.rfiAA. ~ OWNER (Name) (Address) BUILDEIf\'.... R \ \ I ...-.. (Name) \). . ~J(\...l...lI:V (Contact Name) sr-?l~ t5r\ ~ev---. zt>~\f-O ke..vJ<>..q'qe =1-. ~+f'(P() (Address) . u[/ZA/l' 11-1. M H 55V Lflj I TYPE OF WORK ~ew Construction OLower Level Finish o Fireplace DAddition OAlteration PROJECTCOST/VALUE (excluding land) $12, ~ o Misc. ZONING (office use) ---.fb.-. PID.;(S- L/oO" ~35-'O (Phone) (Phone)(q~~ ~'9~790A (Phone) It 52-) 'l--z,(.o I =3~ DDeck DPorch DRe.Roofing 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 e building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may :ter they.vy..., tope r e d:~ons ~ooog"s 7 ?-gt)-fJ:l.., f 1/ I Permit Valuation I Permit Fee I Plan Check Fee I State Surcharge 1 Penalty I Plumbing Permit Fee 1 Mechanical Permit Fee I Sewer & Water Permit Fee \ Gas Fireplace Permit Fee $ $ $ $ $ $ $ $ (j~, 000- -I 4~LJ, 75 1 ~/tf. 07 LIe, ,,5 6 Lt)t) ,- 100,- 5550 UD ,- This Application Becomes Your Building Permit When Approved ~ -=f~ &~s Building Official Date Contractor's License No. Park Support Fee SAC I Water Meter Size 5/8"; 1"; I Pressure Reducer 1 City SAC and WAC I Water Tower Fee I Builder's Deposit 1 Other I TOTAL DUE # # # # Date $ g'SO-- $ /d-'75'.'- $ d).5lJ ' --- $ 4~- $ Id07J- $ 7-00 .... $ $ I' ~. (}$ ~a.OO ,'r;:71 I Receibt~. AJ 1.4"':J.. By .'- Paid "z.oo_r~ Date q rib) , G- 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 ~:: '~' ~~ prnnn~~mpo,~ Ccrtifica;t;nmg '::ane< and allows cons~eeen~aiii al1rle"upanQ mustb, Planning Di,ector ~ 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 ........1... .' .~ .-""....... ~ .~~ See Main File White . Building Canary - E:ngineering <TJ.nK . t',annm!p The ('cnler of the L.kc ('oOnll")' BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST . " NAME OF APPLICANT L' " .---- . ,I," I APPLICATION RECEIVED ({" ;-r/),:' ;) /{- - ~ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: , /', () / /..7 /~( //1 / t Accepted ,/" Accepted With Corrections Denied Reviewed By: ~ -:JILl .!J~ Date: 8j;~7~ 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." lit . -~ ~~ ue~ See Main File "'---White . Buil~ Canary - Engineering Pink . Planning -' Th~ ("~nln of lh~ I..kf ('oUnll'y BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT DR~ ?f -11--03 , APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activit hich is proposed at: '..LoPe{) ~ ( I/) 3~S/ ! Accepted ~ Accepted With Corrections Denied Reviewed By: ~ 7~P Date: 'iI bcrla 7 , , 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." Thll' (-Il'nlll'r of !tIll' I..kc ('ounll'}' See Main File White . Building Canary . Engineering Pink . Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT j'; ,..J I! C-_ If /\ ~ 0' I r-C.J,"- --- ;,~~/7-t_./ .' APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activit)Vwhich is proposed at: .- / I' i ; /l ,-, /1/" "", ,1...- J' \ , ')){. /' 1.) (n /' ./{-.>-' /\ _ ';(C':' \ " .::L-....'-..-~--_." ,...,J-., '-- ,,' ......._ . -~ - ~_. '1- . - ---"- Accepted X Accepted With Corrections Denied tf:r~'- Date: o/[~ 10) . . 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." CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd (Please .!'(pe or orint and sie;n at bottom) ADDRESS /7"??""'- ~~&/c/ /2-, ,# 2?3'7 ; ~~ ~:~ I PERMIT NO. 3 - /1--- \ 1 3. Yellow Apphcant (f I ZONING(ofliceus<) ~/- , ".Jr- LEGAL DESCRIPTION (office use only) LO-&BLOC~ ADDITION PID OWNER DR HORTON (Name) - 20860 KENBRIDGE CT (Address) LAKEVILLE, MN 55044 (Phone) APPLICANT /10 A (Name) /~///.b.J'~'''''_./A4./''-./ (Address) ~~ ~A..IA, f7 /2,-: -5!;Addre' (Contact Person) Aev-. . _~":..~ APPLICANT SIGNATURE ....... . p - _ (phone) h,5/.. q~-'. J??-2 ~ ~a..t' '*!F5"'- ? 7 - (~ (Zip Code) (Phone) ~/- c:;/9--177,S: DATE , APPLICANT PLEASE COMPLETE BELOW .'!lNEW CO~TRUCTION 0 REPLACEMENT 0 AL TERA TI<;lNS FURNACEMAKEANDMOD~/r""'" "t_ :?/0-4A~"'07~ FUEL d,..}, .4-.....:.-..e FLUESIZE.y'~k~.ARETURNOPENINGS if INPUT~ OUTPUT 6Z,;,~ TYPE OF SYSTEM HEATING OR POWER PLANT DWarm Air Plants DGravity D Mechanical ~ir Conditioning ~ent. System D Steam D Hot Water D Radiation D 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 & Ale (New Construction) Residential, Heating Only (New Construction) $39.50 $39.50 Slq/ :""'D 'V~ /.1IJ HEATING PERMITFEE $~/ ~~ 'G j:J~l'ty STATE SURCHARGE $. _ " .50 ~~)' TOTAL PERMIT FEE $ 'f'!-- (Omee Use Only) " :' .,;'1 This Application Becomes Your Building Permit When APprov]'ill A~.paii '.- 1i!;1 uLl Vii ,Ii 7 '-001 j,j . I Date CJI Building Official Date .li2'{ J 24 hour notice for all inspections (952) 447-=9~0, f.~(952) Ilrd5 Estimated Cost $ ~ a:::> Building Permit # I Receipt No, IBy ~ CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd ;~;::, ~:;y IPERMITNO.3-f!Cf/ I 3. Yellow Applicant (Please trJ>t: or print and sip>t bottom) ADDRESS 17365 DEERFIELD DRIVE S,E. ZONING (offi" use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PlD OWNER (Name DR HORTON (Phone) (Address) APPLICANT (Name)-AT.T .TFD FTRRSTDR DRUTRRSTDF HEARTH & HOMP. (Phone) 651.611-2561 (Address) 2700 NORTH FAIRVlEW AVENUE (Address) ROSEVILLE (City) 55113_ (Zip Code) (Contact Person) BRENDA HUSTON (Phone) _651-633.2561 APPLICANT SIGNATURE BRENDA HUSTON DATE IO/2R/01 APPLICANT PLEASE COMPLETE BELOW xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT OWarm Air Plants OGravity o Mechanical DAir Conditioning OVent. 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 HEAT N GLO SL-750TR-C Industrial, Commercial & Multi-Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 $64.50 $39,50 Residential, Heating & NC (New Construction) Residential, Heating Only (New Construction) Residential, Additions & Alterations Residential, AC Only $39,50 $39,50 Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE Building Pennit # $ $ $ ,50 SV/L~~D Wi7H G PI:RMrr (Office Use Only) This Application Becomes Your Bnilding Permit When Approved r ---- BuUdinl! Official Date 'I~aid I ~ 0.3 Z003 . Receipt No, By o , 24 hour notice for all inspections (952) 4/rI-)l850, fax (952) 447-4245 Aug. I:. :OOJ 9:04AM GEN= RVAN PLUMBING AND HEATING No.64)4 P. 4 9 ;~~;~ll0-l'<~ uLl....-..:)1'lJ :'.."c,sjl:.\,.;>:. .....,.....\~, . >1'~\\~41\\~'jo'NNE5o't Date Rec'd CITY,OF PRIOR LAKE SEWER AND WATER PER1\1IT (please rvoe ort>riJlC andS1eD. at bottOm) ADDRESS (73tf5 IJmljidd IJJJ C IG i =w ~;~ I PERMIT NO. /J -II") J. G.1Jd Mp/lClint 0 c:r ZONlNG (oftic,,,,.) LEGAL PESCRlPTION (ollice u,e only) II J LOT(O BLOCK ex ADDITION IdR112hJJ tJIh PID OWNER (Name) DI1 ,,~:-.'"- ~~~. ,,~-"~ (phone) _ gs2.-Q8.5-i6{){', (Address) 20&00 KeV1BK\:t:6e Cr SW,] f'I'o (Add='j La~\jllle... (City) 0Q-"Y-IU (Zip Code) APPLICANT (Name:' Genz-Ryan Plumbing & Heating (phone) 651-423-1144 (Address) 14745 So Robert Trail (ContactPcrson). flI1 fiSh -Glls '.JCANT SIGNATURE (!/lif;;};J ~~ Rosemount. MN (City) 55068 (Zip Cod<:) (Phone) DATE 651-423-1144 ~ -Id -O~ -- 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 ResidentJaI sewer and water lme conneCllon Sewer connection only FEE SCHEDULE $35.50 Industrial, Com'] & Multj.family J% of Job costwitb a $39.50 minimum $17.50 Warerconne<:tiononly $17.50 Estimated Cost $ Building Pe.unit # ~ ~/l) "'I Un... - ~/1f ~i14fJ].} SEWER AND WATER PERMIT FEE STATE SURCHARGE l'Ol'AL:PERMIT FEE $ $ , $ .50 (Offiet u.. Only) Iii! ~ -'I:-'~ ill ~ r ';1 I This Application Becomes Your Building Permit When Approv 111"\ I.Pald II'! uU AUG 2 7 2003 I, I I Dare' LJj Buildiug OtGdaJ Due =:?~_-~----- I H hour notice for all inspections (952) #7-9850, fax (952) 447-4245 ReceIpt No, By tr €~~ \, ;,,_::t.:.";{'.:"HE S01. t- -:;;('~\~'.:.~~;~\\~ ",w,.:,,,,,f~,~.," AII6.i2.2003 904AM GEN2 RVAN PLUMBING AND HEATING No.6474 P. 5 9 Date Rec'd CITY OF PRIOR LAKE PLm-mING PERMlT ;~; ~:~ I PERMIT NO. ."..) -It"J..f I 1 YellO\V ApptiQn.1 <..J C7 I (Ple;uc: _to{Ee or "rolt and slsm at bottom) I ADDRES/7 pft:lS" 'lh.R.h e f..cL J\~ rS;:; I ZONING (oI1k,,~e) Ii LEGAL DESCRll'TION (ollie: USe only) LOT ((J BLOCK;J., ADDITION ~h dc:t tfht- PID OWNER (Name) DR Horton Custom aomes (AddIE:") (phone) 9~2,qx.t=, -7'2M '2o"E,(yD K.b-1B~1 I>Ge.. Co Sie. IDO udu..vdJG ioUN EccL.p.J APPLICANT (N"amet~'''''''''''-'Or'';l''' 'P11tr'l:'~"': r. u.",,~""-I""3 (Address) 14745 So Robert trail (Address) r= / I (ConractPerson) Cf.1JQj<S,'.fi f"7vU5 APPLICANT SIGNATURE _& M~ '--::(;V~..-<I Quantity J ; / ;:;l. I / ,5) (Phone) t; <1_I,? ,_ 1 11./. Rosemount MN 55068 (Zip Code) (City) (Phone) 651.-423-1)44 DATE !(- j;)--d6 APPLICANT PLEASE COMPLETE BELOW Type oH'ixture I Quantity I Bath Tub with or without shower Rough-ins Dishwasher I ,'/, I Water Heater i Floor Drain /J j; , Water Softner Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine) I Laundry Tray (lor 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly I Sinks I Backflow Assemhly Test Bar Sink Lawn Sprinkler I Water Closet (Toilet) I Other Type ofFi:r.ture FEE SCHEDULE Indusmal. CommercIal &. Multl-famtly 1 % of job cost WIth a $3950 minimum PLU1vfBD'J'G PERMIT FEE $ STATE SURCHARGE $ TOTAL PKRMlT J!'F..:E ;C;"l;---' ./ 1) Lc; L' u ',JJ L II , . This Application Becomes Your Building Permit Wheo Approved I' Afffi 2 7 2003 I (Office U~e ODI)") Estunated Cost $ ResIdential, New One &. Two-Family $99.50 Residontial, Additions & Alterations $39.50 Building Permit # 8111l. J::-"iID /".. D1AtO r"Il"/.f P~!:i4117- ,50 Receipt No. Date By I"~ ~r Building Official Oatl: y. 24 hour notice for all Inspections (952) 447-9850, 121 (952) 4474245 PRIOR LAKE INSPECTION RECORD SITE ADDRESS 1~3~ U /)~ NATURE OF WORK USE OF BUILDING PERMIT NO. t:) - DATE ISSUED CONTRACTOR PHON~.3 'I NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT .JC~ IVlalll fiile DEPARTMENT OF BUILDING AND INSPECTION INSPECTOR OATE I FOOTING I I FOUNDATION (Prior to Backfill) I I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) FIREPLACE GAS LINE AIR TEST M"'.... fI/V/ //-.~~t17 /1~1~ t/W yyp ~ ~ /()- 3D-v} /I-<;-cn /( - ~'--tD /I-C:-,,(f'> GRADING (Prior to Sodding) BUILDING ELECTRICAL PLUMBING HEATING DO NOT COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS _ (PI" ~r). h:/P ,## t/~ ~ /C'/'/ /or /.?//r/~ f.). - / 't' --f/7.. lfzS/eJf - OCCUpy 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 QIrrfifirafr of (1J}uupanq! CITY OF PRIOR LAKE ~~Jlarfm~nf of ~uilMng JlnsJl~dion ~Final Pennitted 0 Conditional C.O. Expires I 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. 03-1121 Occupancy Type _ R3 Type Construction _ VN Fire Zone N/A Zoning District R2 Legal Description _ L6, B2, DEFJiFIELD 9TH Owner of Building. Contractor's Name & AddresP. R. HORTON, INC~ ROBERT D. HUTCHINS~ Date: /o~ ft)'g Official Site Address 17365 DEERFIET.D 20860 KENBRIDGE CT., SUITE DRTVE S.E. 100, LAKEVILLE) City Planner DON RYE . . , . Date: . JOB# 733 <t _ SUBURB Prt e? L k HOUSE HEATING TEST RECORD ADDRESS O?."S- ~<;,e...\J ~. APT._ FLOOR_CITY. OCCUPANT - R PeL- OWNER n.'/2.. (4..,<'11'11-'1 HEAT LOSS _ DATE HTG. INST, 11 In:' () _. 0 SOLD BY A.., ~ A LlLM ' INSTALLED BY A \ \ I ~ f~ Eleclrical Work By _ Gas Line By . i/Jr I \ .~ vY\ -e...,c..Jv,. TYPE OF HEAT GA_FA..LHW_STEAM_ SPACEHTR._ UNITHTR. OTHER qe.S DESIGN MAKF f.l-n^1 tMA r Model _.....-'1' Je\_Plv 07/ '" 01 0 Serial "' !f 0 ~ A ~ 1? 2 "2. (" INPUT /" {., k' -. MAKE OF BURNER Model Max. BTU Rating MAKE OF FURNACF Model Vent Size t..l'f [ KIND OF LINER _ --- Oral! Hood ~ 1\1 ",w (;" Filters \ Size Chimney Location Chimney Construction CONTROLS THERMOSTAT H-~t . Valve Heat Plu,:, .--- Limit t{ \ I Y U1'\ Limit Setting .;), 00 v Cft!) P Fan Setting-U tt d~ n EO I ~ '1 Pilot Type Pilot Mak,a Pilot Model Pilot Timing ~~!') S E c.. ~ L.W-CutOff f'Jt/IJ8' -. \ Pressure . ~ , -; I' W 6 Percent COz _jar!/ f) : Input CFH ......~. ~ Percent O2 . <t 0/" . Stack Temp. ~ 01= Percent CO ~ Smoke Bomb Oral! t ,,\ Door Pressure CONVERSION v "IZ" _ NONE Regulator 3::z.S- -31.- Number Inside. 'A; _ Outside V~ .J _Wiring _ Test Ta~ _ Lighting Inst. \/ J 12110103 Date Tested Company Testmg Alliant~cha..!lICal, 3650 Kennebec Dr., Eagan, MN 55122 Name of Tester 1(1, ~ _ ~ / /7~/ ~~":J,, " CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS / 7Jb"S- OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING ~SULATION FINAL o SITE INSPECTION COMMEIiJS: ~.e=,,L/l"a,/ ~ . ,h-~y4>L-'" /'~Ch~ ~_~/,---j" A I k'f'Y~" ~ DATE TIME SCHEDULED ~~~ ~......r M/ /' /J", CONTR. PERMIT NO. t!!J < ~,/ /2.. / t...... :'.jLUMBING RY" rJ ~ ~ECHRI r o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRAD/FILLING o COMPLAINT o EIREPLACE RI R-1IREPLACE FINAL ../[JGASLINE AIR TST o ~ /.., /../~'t /;)..r;/ --- r"h4 / --- ~I" - ~ - ~ -huvA,7/i'L. I ~,L ~/ t:.-1" c. /"? ......, ( ,U~ (/,. 7//' 6---/4;/ ~RK 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. Owner/Contr: CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! ImNOO CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS /?..5'Cs OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION ~AL o SITE INSPECTION COMMENTS: ~ (r~e -- DATE TIME SCHEDULED ~~~~ /Jter4C d /1r CONTR, PERMIT NO. 6$- //2/ o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLING o COMPLAINT o FIREPLACE Rl o FIREPLACE FINAL o GASLINE AIR TST o -'------- ~ ,,..-r / ) /-7 /p ------ ---- kORK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK. ~R 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! lNSNOn DATE TillE CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED J2/ /I(-6"? ADDRESS {7JG~ f),.~" h.../ d OWNER CONTR. PHONE NO. PERMIT NO. 3-/12- I 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 IPLUMBING FINAL o MECH FINAL o EXlGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: /0 Y~1A10K.. rr* CLi/7 o WORK SATISFACTORY, PROCEED )<CORRECT ACTION AND PROCEED o CORRECT WO~K. ;{'~R REINSPECTION BEFORE COVERING Inspector: YJ/ r--- Owner/Contr: I CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE, CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSIIOTI