HomeMy WebLinkAboutBuilding Permit 03-1599
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
1. Wh.ile File
2. Pink City
3. Yellow Applicant
(Please ~e or orint and sism at bottom)
I ADDRESS
~35 t~+ 0:Jc 'Fbvd-b('t\,.L
LEGAL DESCRIPTION (office use only)
LOT/9 BLOCKZ. ADDITIO~\e.J::L 'Of'--.
OWNER
(Name)
(Address)
(Phone)
Date Rec 'd
/2.5.03
I PERMIT NO. 03. /5'111
I ZONI~i"U")
PID 2-5. 4-6/. ()3fj. 0
(Phone[cf00)'78S-7808
(Phone{jS~d.1o -1./732-
BUILDBlt-;-... <;-., I 1 "')
(Name) l). 1<-, FiQ'L.,Ton iI}1e.... ,
(ContactName~__ /1)~
~OB(P9 ~l~ Ct. .stL'~"/OO
(Address) lo_k.Lm'LLL. VV\. W 5soL/t!
I
/51. /'8-~
J
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 budding offiCial can revoke thIS penmt for just cause Furthermore, I hereby agree that the ctty OffiCIal or a desIgnee may
~~ocsp;coons d,CXX:;5(pSL pJJ /03
) (J SIgnature Contractor's Ltcense No ....... Y~ate
f
~ /59 ~t!Jf), (}r)
$ 1,~;:;1.q: I~
$ trl {otJ.--,LL
$ 7&1.50
$
$
$
$
$
TYPE OF WORK
o Misc.
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
! Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
~ew Construction
DDeck
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
/0/1,00
ft:Jrl. tJ a
3~.~t:J
l./tJ,tJCJ
This Application Becomes Yout Building Permit When Approved
~~~
Building Official
/~P~:f
Date
DPorch
I Park Support Fee
I SAC .--,.
I Water Meter @ze 5/SJ 1 ";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
I Paid
I Date
1""Pry, .n--
/'Z.v, ..7
ORe-Roofing
DAlteration
#
#
#
#
~
I Recei]:/lNo.
By 1)/
rJ
ORe-Siding
OUtility Connection
?5~. 8-rJ
t2-7~.-
~a,OO
/Hi: IJ II
/ZOa,OtJ
/OO.O(J I
$~
$
I $~I 6&'1'.851
I:
1$
$
$
$
'rfVI Y d-
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
"'~ ~ /~)?,/b3 See-M3in File
Planning Director Date 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
.
..
,
Job Address 52~5 E.~/fL.Pr4e
Heating Contractor /7/1~ ~,GcLr _ -
Name of Tester ~~ (~
Dale 7'!/~y
/0 '2"~
~<Z^'
~_;(J9A
/(jjoF
Percent 0,
Percent CO
Percent CO,
Stack Temp
Combustion air is adequately supplied per
UMC Sec. 606 1:.'" 1>
III~ul t3~
"
..~~
See Main File
~Ite - BU~
~18flt .. t:n~;"","",I~I'~
Pink - Planning
Th~ (tnlr. or lhr l..kr Count!'}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
."
J .'
, !
" I
r;.._ .,' J't"
"f (
I .
,f-"f') /,l'lf. --,/
! c/,
f"'''~'.~
!
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'.'S' ,-J 3 S'. -f..- !
Accepted
x
Accepted With Corrections
Denied
Reviewed By: IYJ4 i~
Comments: <...,., tfk/h h'lr
Date:
1:J--/7-03
"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
Canary -!;n ineering
""'-l'lnK - t'lannln
The ('tnln of the L.kt (.'ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
...
NAME OF APPLICANT
APPLICATION RECEIVED
()
I
Ie
, I
l/( t
!-ol'j
,- -.
>
-,
...
,..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ / -::' )" / l
.,.-
,
Accepted
t../"
Accepted With Corrections
Denied
~
Reviewed By:
Comments:
~
':j, , t2~
Date:
;.;r// 9 A '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."
~~
See Main File
~e - Building
Canary - Eng," erlng
Pink - Planning
rht'('..nft'.nfth,l.ak..('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT f)
fZ '1dOY+Otcl
I ~ - :;---3
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Sd3S-~ Gr (flak. P-I- /~
/'
Accepted With Corrections
Accepted
Denied
~t' /f...-r - e
,..
Reviewed By:
/~,L-
Date: .I.)-~9;0 'J
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
(Please!VJ2.e ornrint andsim at bottom)
ADDRESS
,~2-5~ ~ c::;:/~C' ~:-c-/- L::J
LEGAL DESCRIPTION (office use only)
Lovl9'BLOCKd ADDITION
OWNER DR HORTON
(Name) - 20860 KENBRIDGE CT
(Address) LAKEVILLE, MN 55044
APPLICANT /J ~ /. ~
(Name) /-7'///~ ""AJr../A~,/"'~
(Address)~ ~4,61 P /2:
(Contact Person) Aev';;:J4;:~
APPLICANT SIGNATURE ::r4.- . > '$'.___
Date Rec'd
I. pink
2,~n
3. Yellow
#/5/3
~:~ I PERMIT NO. "7 _/59C'
Apphunt "') / I
ZONING (office use)
<-s-e-
PID
(phone) .
(Phone) h,5/- 4':r'?J?7~
~c.A'~ ~~~-:l
- (~ (Zip Code)
(Phone) ~/- c;/g--177~
DATE
APPLICANT PLEASE COMPLETE BELOW
I t!fNEW CO~TRUCTION 0 REPLACEMENT. DALTERATI9NS
FURNACE MAKE AND MOD~/ r""'.J ~ :::?n:::>AA d!:::b?'7"CJ7~ FUEL ..Lf ,2 ~..J ..;...- ~
FLUE SIZE"""~h~.A RETURN OPENINGS ~ INPUT ~ ~ OUTPUT ~~ ~
TYPE OF SYSTEM HEATING OR POWER PLANT
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
'_ ~~a::>BuildingPermit #
$ ~/ &...//~BUI~~r- WITH
$ ~ .50 Q p!:.p~'(/'
$ 9"'.
OWarm Air Plants
OGravity
o Mechanical
~ir Conditioning
lJ'LYent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
I Paid
I DjAN 0 Ii 2003
J Receipt No,
iBY rr
Dec.19. 2003 9:53AM
GENZ RVAN PLUMBING AND HEATING
No. 48 i 3 p. 4 5
Date Rec'd
~~ PI<IO~
€2J~~
':",:>-,
'-'.,... ".'\'..'i:.:!.~\'.i.,..,
i;'~~'~~\ \\.,\,.,>~~,.\,) ""-
~~'i\fo '~~~:,?"..\*,' ...,..,..< c
.\. l.\W,Wh
CITY.OF PRIOR LAKE
SEWER AND WATER PERMIT
(Ple~e tvD~ Ot1)fLDt and sten.a.t bottam)
ADDRESS
5JCD' 73dM Cttl0 'l1!l Ylr t10
LEGAL DESCRll'TION (ollice use only)
LOT I q BLOCK a. ADDITION 6{7 ~ vl
OWNER
(Name) ];IR RorrQa r...~.^~
(Address)
2oUcO ~13f<-\U-e Cr SOl7!(V,
(Addn,ul
APPUc'''>NT
(Name) Genz-Ryan Plumbing & Heating
(Address) 14745 So Robert Trail
(A~r.,.)
(ComactPeISoa). OVl fV81 -Fit/IS
"JCANT SIGNATURE -CJ)..}~-)1)
"fa1LY1.
- -'-----
; ~,:., ~~~. I PERMIT NO.A' ~..,
3_ Gold .+.ppliC4nt ~ .,..,-",
\f-.
ZONING (offi.,.",.)
I fJ-!Vv
PID
(phone) _ Or62-Q85^,g,'\I,
La.~\JIIle..,
(Ory)
"Src::t)W U
(Zip Codo)
(Phone)
651-423-1144
Rosemount, HN
(Ciryl
55068
(Zip Code)
(phone)
DATF
651-423-1144
la "I!L-{} ~
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
RcsJdentlal ~ewer and water hoe connection
Sewer connection oa1y
FEE SCHEDULE
$3550 Industrial, Com'l & Mull1-family 1% of job cost WIth a $39.50 mmimUm
$1750 Water conaeclion only $1750
Estllllated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Un Only)
I This Application Becomes Your Building Permit When Approved
,
~-
BuildiQg Offld.11
D~te
$
$
$
.50
PAiD WiTH
BUILDING PERMfT
I Paid
1 Receipt No~
IBY q
:0-
DtYtc' 3 0 2003
24 hour notice for all Inspections (951) 44'7'-98~O, (3': (952) 44i-t24S
f~~
'.'~.~".-, Z'."'l'I'E$01.'"
~."'!'/"\\\';\\""':'_
~~\~fQ~~t.
Dec. I 9. 2003 9:53AM
GENZ RVAN PLUMBING AND HEATING
No 4813 P 5.5
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I EII'lll Fil~
2. Gold wry
3 Ydlo- ^~)le$t:\(
I PERMIT NO'Q3../.!JIIj'ff
I ZON1NG (otlk....) I
Q?~ase n:ee or 'Orint and sism. ll-t bottom)
ADDRESS
5CJ2:6
E:a11 0 at:- ~ 1 nf- i.J12JJ' e -
LEGAL DESCRJl'TION (olliee use ollly)
LOT jq BLOCK&< ADDffiON 6-17 e).c& 1!)!1v
PID
OWNER
(Name) DR Horton Custom Homes (phone)
9S2-Q)?F, -7BDC
(Address). 2-OSwD }{etttBl'Z.Il:Xe.. Co S,e leQ
udu_vtilc. HAN .56'::,1..j0
APPLICANT
(Name)...Go.""<?_"y~'" 1?1,,'wl?j~e ;.. T-l""~+-"'''''g
(phone) h, 1 _I,? 1_1 11,1,
(Address) I4745 So Robert Trail
(Contact Per.;on)
Rosemount
MN
55068
(Zip Code)
(Jj1 Y!J17J WJ~
(y /iiJi )#, f l./i
(City)
(Phone) 651-423-1144
DATE Ja-Il-r1/~
APPLICANT SIGNATURE
Quantity
;),
I
I,
l.{
I
,Q
I
" ~
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture Quantity I Type ofFix~re
I Bath Tub with or without shower -!'RrJUgb-ins
I Dishwasher I Water Heater
Floor Drain I I Water Softner
Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
Laundry Tray (J or 2 compartment sink Sewage Ejector
I Shower Stall BackfJow Assembly
Sinks BackfIow Assembly Test
Bar Sink I Lawn Sprinkler
. Water Closet (Toilet) Other
I
I
I
I
I
I
I
I
I
FEE SCHEDULE
Induslf,.l, Cornmer,;.1 &; MuJn-famlly 1 % of Job COSt WIth a $39 50 minimum Rosldennal, New One &; Two-F.mliy $99 50
Residential, Additions &; Alterations $39 50
Est,mated Cost $
Bujlding PermIt #
PAiD WiiH
BUILDING PERMiT;
PLUMllING PERlvJIT FEE $
STATE SURCHARGE $
TOTAL PERi\:l1T FEE $
.50
(OffiCl! t1~e Only)
This Applic.tion Become. Your Building Permit When Approved
Paid
Receipt No
d
By
DIIIt C 3 0 2003
Building OfJicjsl
Dare
24 hour notiee for.Ji i.,peetions (952) 447"9$"0, f.; (952) <147-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
LPink
2_ Grecln
3. Yellow
file
City
Applicant
I PERMIT N06 -15 ~
(Please me or Drint and siu at bottom)
ADDRESS
ZONING (office use)
5235 E. OAK POINT DRIVE S.E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Namp n R HOR.TON
(Phone)
(Address)
APPLICANT
(Name) AT-UFD FTRF.STT1F DRA FIRESTDE HEARTH & HOMP.
(Phone)
1\51,1\33,251\ 1
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633,2561
APPLICANT SIGNATURE
BRFNDA HUSTON
DATE
3/10/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent SYSlem
HEATING OR POWER PLANT
o Steam
o Hot Waler
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATNGLOSL-750TRN-C X 2
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & Ale (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 Permit #
$
$
$
.50
2Y'N?JJJD ~_
-'~DillJ~ip~W
"~Wrr
(Office Use Only)
This Application Becomes Your Building Permit When Approved I Paid
I ~~ 1 6 20U4
Buildine Official Date
24 hour notice for all inspections (952) 44;:9850, fax (952) 447'~,,?:,,::\
, Receipt No.
By
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS -5'235 C'~r "A)( ~11;#r .lJ/tIi/t!j
NATURE OF WORK Nliw t:YJ..~rA.uc:n~~
USE OF BUILDING S.~ A .
PERMIT NO. (J3 ,1.5'99 DATE ISSUED ~/9/~:J
CONTRACTOR "'!he. Hdar~ I ItJ e. PHONE~'Z..Z~. 1":12-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See Main File
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING IM""I
I FOUNDATION (Prior to Backfill) l{V..o.'"" I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS _
SEWER I WATER I SEPTIC f!l./I/' _
FRAMING /11#1"
INSULATION //0//
ELECTRICAL
PLUMBING lJ,(r J/J/ 1Yr/A 7-/-fr1
HEATING (if required) M-: ~ . (Cf-c)t;
FIREPLACE fir Z-N-()I{
GAS LINE AIR TEST ~. ?"-No:/
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~~ dr, Ol/Ia-/tfV I
J ' 'FINALS
GRADING (Prior to Sodding) _\ ee. ~ ~
BUILDING 1~ (ltl'},l ~\/I-!I"\ ~
ELECTRICAL
PLUMBING
HEATING
DO NOT
/ - tDOLj
's - (q ~O ~(
"5- /...2-r()( I
I'.'
h/e. .
/op/tJt/
. ""
I/VV"
//f;P
OCCUpy UNTIL ABOVE HAS
NOTICE
BEEN
5, (g-ou\
$-' kHJC1
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
QIrrtifiratr of OOrtupaurl,!
CITY OF PRIOR LAKE
/ ~tp(trftUtuf of ~uilMug J1usptdiou
;!(Final 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 Classification
SINGLE FAMILY
Bldg. Permit No.
03-1599
Occupancy Type R 3
Type Construction VN
Fire Zone N / A
Zoning District
R1
Legal Description
L19. B2, DEERFIELD 10TH
Owner of Buildin~
SileAddress 5235 EAST OAK POINT DRIVE S. E.
20860 KENBRIDGE COURT. SUI TF 100. LAKEVILL
Contractor's Name & AddressD. R. HORTON. INC...
ROBERT D. I/UTCHIN:V'~
~ /_ ~~~i,.Official
/0// /CJ7
City Plannp"
DON RYE
Date:
Date:
. .
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
S;2SS-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
COMMENTS:
~
/ - /'
~ c-/<ue
TIME
DATE
/t;f/~
~/ ~tf J?/ ..tt
SCHEDULED
CONTR
PERMIT NO.
Q3 -/59'7
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXJGRAD/FILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
"~
/1'/ ~
r-; /e.- /
-------
AoRKSATISFACTORV. 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!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
.. 1 .
..: /"o3S-
Oq!L
~
OWNER
CONTR,
PHONE NO.
PERMIT NO.
o FOOTING
D FOUNDATION
D FRAMING
D INSULATION
ITFINAL
D SITE INSPECTION
o PLUMBING RI
D MECH RI
o WATER HOOKUP
D SEWER HOOKUP
o PLUMBING FINAL
..la'1IIECH FINAL
DATE nME
.5;- ,).o()<f
Pi
~~t5""o/1
o EXIGRAD/FILLING
D COMPLAINT
D FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
D
COMMENTS:
.n) V~..W1~iU....-t o."-'~I
(2:;) r-:"",~ I ..,..-a..k <PJ d:?-o1At-1
C.-) ~O.J 4--~..,S ~ d~,-J~~+-
'l-c~ Vi'! +11
$'(~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
D CORRECT ~O~CALL FOR REINSPECTlON BEFORE COVERING
Inspector: 1/VI Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
DATE TlME
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDUI.ED
S --G.d'(
ADDRESS
.{2.JS
& tis. f t::Ji( fJ1r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
"3 -IScrt!
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAl.
o SITE INSPECTION
o PI.UMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
PI.UMBING FINAl.
o MECH FINAl.
o EXIGRADIFII.I.ING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAl.
o GASl.INE AIR TST
o
COMMENTS:
(i) Sa ( a1~.Ltr
(7) r -li1AO/,C YIJtJFLWJ5
o WORK SATISFACTORY, PROCEED
Iiil"'"CORRECT ACTION AND PROCEED
o CORRECT ~~R~, ",OR REINSPECTION BEFORE COVERING
Inspector: r y r./ OWner/Contr:
CAI.I. 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
H<SNO"