HomeMy WebLinkAboutBuilding Permit 00-0709
CITY OF PRIOR LAKE
JUN - I 2000 BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. Whit.
2. Pink
3. Yellow
File
(;;ty
Applicant
Permit No..
DO-01.I4-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (please Print or Type and sign at bottom)
2. SITE ADDRESS
"J-j 44 - J5DtIL st,
3. LEGAL DESCRIPTION <9 n. Q5 bl.L.i H- 5 LU'Ve j
LOT s:: I (Jb i o-.t W W' BLOCK 111'. r.,l- \,.I-
ADDITION ILL <; ""7 h
4. OWNER (Nal!i'e) (Address). (Tel. No.)
Joe<\- mDII~ (Me bl-fJ.t'-l-15c>>-k~r\o, la..lie JfJ-jo-hi-l-'i\1
5 ARCHITECT (Nome) (Address) (Tel. No.)
~.~ri,=> Doer.emo...nQ /5l10-:lb+ .f1\1e1liuJ lVeuJ'V>ho,hj-OQ ~5)-b2/1-0Jfbq
6. BUILDER (Neme) (Address)' - (Tel. No.)
~..k.~e!ll-\om~.Tnl!._ll-fp1n eOIh/!teree AV<=.#_~on'Pl-ior l.qke. J.j'l-1'?~'07
7. TYPE OF WORK Flreplace 0 Septic 0 Heetlng 0 Plumbing 0 Reroofing 0 Porch 0
New Construction LJ Aherations a Addition CI Finish Attic q Residing (] Finish Basement 0
Chimneyo MiSC.~ ~ cirtvL~
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 1'0. CULVERT SIZE )
Sq. A. Width Depth Yea No /J A
I hereby certify that I have furnished r " ,.. on this appttcatlon which Is to the best of my k ._,~.. true and correct. I also certify that I am the owner or authortzed agent for
the above mentioned property and that all construction will cxmform to all existing state and local taws and win proceed In ...........,........... with submitted plans. I am aware that the
build~OfflclaJ can ~~~ ~1s ~It for Ju ~se. Fl- .., .', I hereby agree that the city oflIcIaI or a designee may erHr upon the property to perfonn needecllnspections.
x_ ~ -=r.i1d!J'L- ~ ,(. &. ,Ie 1J-tlL] .JJ1J.~(}OO
\ """.... ;; Uconoe "". Dato
FOR ADMINISTRATIVE USE
1. DATE
5/ab}9-0DD
RI5D
BUILDll!!1lNFORMATlON
11. SIZE OF ~''''''''.' JRE
tHet.-., .-.n) (Oopth)
PlD 'R 35IS'iOO'lD
12. NO. OF STORIES ~ Twa..1 kOu.+
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCIII'ANTS OR SEATS
OCCUPANTS :~
SEATS
1~: ESTIMATED VALUE
11UJ,OOO.QO
17. COMPLETION DATE
SETBACKS: Requir'ed
Actual
Frnnl
""""
....
-
MATERIAL ALED WITH APPUCATlON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS LJ SETS
SURVEY 0 COPIES
PLOT PLAN 0
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING ~ AI, I <-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl H R M
Dlvlsion 1 234
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ->>"""".CJO
City:
Amount Broug1l Forward ............. ..... $
ParkSupponFee ........................... $
SAC ......................................... $
CoUectiveStreetFee ....................... $
S8werTap ................................... $
UcenseCheckFee ......................... $
PressureReducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Plan Checking Fee ......................... $
state Surcharge ............................. $
penalty ....................................... $
Septic SysterTl ............................... $
T!'I. 7~
2 ~>T,. .51
15',00
~
~.\~.oO
Permit Fee ................................... $
LJ Sewer&Water......"".....u....Fee ........... $
Deferred 0 W_Tower Fee ........................... $
W_Tep ................................... $
Other ......................................... $
()ther ......................................... $
_ T7:t;t;~.~.......~:;;;;.~'1&~
Date 9- /. /Jf) By /{fff ___
the uest In the above application end accompanying doct.vnett8ls in accordance with the CIly Zoning Ordinance and may = requ9Si8d. ThIs document when
rconstluteS8" ~. "",Ce.l:1~as ';"'" .. aRows commence. Before~,a . of~mustbeissued.
. PI::'~44- ,b o.:~C f~ !'~~~5..
24 Hour notice for all inspections 447-42309:00 a.m. . 10:00 a.m.
Check if
Other ......................................... $
.......... $
ding Petmll When~.
Date 6-o-~o
1003.3.3.6
1003.3.4.4
2. Handrails may have starting or volute newels within the first tread
on stairways in Group R. Division 3 Occupancies and within individual
dwelling units of Group R, Division I Occupancies.
The handgrip portion of handrails shall not be less than
11/4 inches (32 mm) nor more than 2 inches (51 mm) in cross-
sectional dimension or the shape shall provide an equivalent grip-
ping surface. The handgrip portion of handrails shall have a
smooth surface with no sharp comers. Handrails projecting from a
wall shall have a space of not less than 11/2 inches (38 mm)
between the wall and the handrail.
1003.3.3.7 Guardrails. Stairways open on one or both sides shall
have guardrails as required by Section 509.
1003.3.3.8 Alternative stairways.
1003.3.3.8.1 Circular stairways. Circular stairways conform-
ing to the requirements of this section may be used as a means of
egress component in any occupancy. The minimum width of run
shall not be less than 10 inches (254 mm) and the smaller stairway
radius shall not be less than twice the width of the stairway.
1003.3.3.8.2 Winding stairways. In Group R, Division 3 Occu-
pancies and in private stairways in Group R, Division 1 Occupan-
cies. winding stairways may be used if the required width of run is
provided at a point not more than 12 inches (305 mm) from the
side of the stairway where the treads are narrower, but in no case
shall the width of run be less than 6 inches (152 mm) at any point.
1003.3.3.8.3 Spiral.;';" "'.J J. In Group R, Division 3 Occupan-
cies and in private stairways within individual units of Group R,
Division 1 Occupancies, spiral stairways may be installed. A spi-
ral stairway is a stairway hav lng a closed circular fonn in its plan
view with uniform section shaped treads attached to and radiating
about a minimum diameter supporting column. Such stairways
may be used as a required means of egress component where the
area served is limited to 400 square feet (37.16 rn2).
The tread shall provide a clear walking area measuring at least
26 inches (660 mm) from the outer edge of the supporting column
to the inner edge of the handrail. The effective tread is delineated
by the nosing radius line, the exterior arc (inner edge of railing)
and the overlap radius line (nosing radius line of tread above).
Effective tread dimensions are taken along a line perpendicular to
the center line of the tread. A run of at least 71/2 inches (191 mm)
shall be provided at a point 12 inches (305 mm) from where the
tread is the narrowest. The rise shall be sufficient to provide a
headroom clearance of not less than 6 feet 6 inches (1981 mm);
however, such rise shall not exceed 91/2 inches (241 mm).
1003.3.3.9 Interior stairway construction. Interior stairways
shall be constructed based on type of construction requirements as
specified in Sections 602.4, 603.4, 604.4, 605.4 and 606.4.
Except where enclosed usable space under stairs is prohibited
by Section 1005.3.3.6, the walls and soffits of such enclosed space
shall be protected on the enclosed side as required for one-hour
fire-resistive construction.
Stairways exiting directly to the exterior of a building four or
more stories in height shall be provided with a means for emer-
gency entry for fire department access, (See the Fire Code.)
1003.3.3.10 Protection of exterior wall openings. All openings
in the exterior wall below and within 10 feet (3048 mm), measured
horizontally, of openings in an interior exit stairway serving a
building over two stories in height or a floor level having such
openings in two or more floors below, shall be protected by fixed
or self-closing fire assemblies having a three-fourths-hour fire-
protection rating. See Section 1006.3.3.1.
1-110
1997 UNIFORM BUILDING CODE
EXCEPTIONS: I. Group R, Division 3 Occupancies.
2. Protection of exterior wall openings is not required where the
exterior openings in the interior stairway are protected by fixed or self-
closing fire assemblies having a three-fourths-hour fire-protection
rating.
3. Protection of openings is not required for open parking garages
confonning to Section 405.
1003.3.3.11 Stairway to roof. In buildings four or more stories in
height, one stairway shall extend to the roof surface, unless the
roof has a slope steeper than 4 units vertical in 12 units horizontal
(33% slope).
1003.3.3.12 Roof hatches. All required interior stairways that
extend to the top floor in any building four or more stories in
height shall have, at the highest point of the stair shaft, an
approved hatch openable to the exterior not less than 16 square
feet (1.5 m2) in area and having a minimum dimension of 2 feet
(610 mm).
EXCEPTION: A roof hatch need not be provided on pressurized
enclosures or on stairways that extend to the roof with an opening onto
that roof.
1003.3.3.13 Stairway identification. Stairway identification
signs shall be located at each floor level in all enclosed stairways
in buildings four or more stories in heigbt. Such signs shall iden-
tify the stairway, indicate whether or not there is root access, the
floor level, and the upper and lower tenninus of the stairway. The
sign shall be located approximately 5 feet (1524 mm) above the
landing floor in a position that is readily visible when the door is in
either the open or closed position. Signs shall comply with
requirements ofUBC Standard 10-2.
1003.3.4 Ramps.
1003.3.4.1 General. Ramps used as a component in a means of
egress system shall confonn to the requirements of Section
1003.3.4.
l
EXCEPTION: Ramped aisles within assembly rooms shall con-
form to the requirements in Section 1004.3.2.
1003.3.4.2 Width. The width of ramps shall be determined as
specified in Section 1003.2.3. but shall not be less than 44 inches
(1118 mm), except as specified herein and in Chapter II. Ramps
serving an occupant load of less than 50 shall not be less than
36 inches (914 mm) in width.
Handrails may project into the required width a distance of
31/2 inches (89 mm) from eacb side of a ramp. Other projections,
such as trim and similar decorative features, may project into the
required width 11/2 inches (38 mm) from each side.
1003.3.4.3 Slope. The slope oframps required by Chapter II that
are located within an accessible route of travel shall not be steeper
than I unit vertical in 12 units horiwntal (8.3% slope). The slope
of other ramps shall not be steeper than I unit vertical in 8 units
horizontal (12.5% slope).
1003.3.4.4 Landings. Ramps having slopes steeper than I unit
vertical in 20 units horizontal (5% slope) shall have landings at the
top and bottom, and at least one intennediate landing shall be pro-
vided for each 5 feet (1524 mm) of vertical rise measured between
the horizontal planes of adjacent landings. Top landings and inter-
mediate landings shall have a dimension measured in the direction
of ramp run of not less than 5 feet (1524 mm). Landings at the bot-
tom of ramps shall have a dimension in the direction of ramp run of
not less than 6 feet (1829 mm).
Doors in any position shall not reduce the minimum dimension
of the landing to less than 42 inches (1067 mm) and shall not
reduce the required width by more than 7 inches (178 mm) when
fully open.
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-l or R-2
BY:C~- I A
o"'Wt. ~
Building Permit #
Site Address f/l1t/t{
Date: I#t /- j:c90
PID:
IS'OA ~
Legal: L
B
Existing Structur~~)r NO
CONFORMS TO ZONING
ORDINANCE
Zoning:
Subdivision:
Existing Nonconforming Structur[~~)r NO
.-- ---
/~ YES' ) NO
~
- Yard Setbac~"!.!-bf1".t..IC~
(' MEETS CODE
~or :e:~:~:~~age i;'i:fiIl lot) On60 -Ok~)
I. Side Yard
(25' if abutting a street) ~~\ tMA
q I. Side Yard "
I. Rear Yard
I.
I.
vr-I.
Sidewall exceeding 40 feet required additional
side setback of 2" for every foot over 40' long
From 100 year flood elevation ofWetIand
Fro}.f _~~ (Prior or Spring Lake)
1CJtP"t9ll leD ~
Requirement Proposed
25' ~ cC1<
10' S:~
10' r 3.77
25'
-
Wall over40'?
-
30'
I 75' or setback average of adjacent
structures no less than 50"
Yard Encroachments: NOT ~PLICABLE
c1lE~-
Eaves and Gutters no more than 2 feet in width and
no closer than 5 feet to a lot line.
I AlC and other equipment cannot encroach on
interior side yards.
I Lot Coverage (Structures Only)
--- ..-;-- ---
. Significant Tre : NOT APPLICABLE
. Total Caliper Inches
I. Can remove 25% ofT.C.!.
I. Caliper Inches Removed
I. Caliper Inches Preserved
I. Replacement
L:\TEMPLA TEIBLDGLIST.DOC
{b (. es-
,---
30% Maximum
Requirement
Proposed
V,:I
RESOLUTION OO-OIOPC
A RESOLUTION APPROVING A 25 FOOT VARIANCE TO PERMIT A 0 FOOT
BLUFF SETBACK INSTEAD OF THE REQUIRED 25 FOOT BLUFF SETBACK
BE IT RESOLVED BY the Board of Adjustment of the City of Prior Lake, Minnesota;
FINDINGS
1. Joseph R. & Molly Cade have applied for variances from the Zoning Ordinance in
order to permit the construction of a deck and po"ch addition to an existing single
family dwelling on property located in the R-l (Low Density Residential) District and
the SD (Shoreland) District at the following location, to wit;
6444 l50th Street SE, legally described as follows: The east 100 feet of the
west 300 feet of tract H, registered land survey No. 76, files of the Registrar of
Titles, Scott County, Minnesota, according to the recorded plat thereof.
2. The Board of Adjustment has reviewed the applicailOn for variances as contained in
Case #00-052PC and held hearings thereon on July 24, 2000.
3. The Board of Adjustment has considered the effect of the proposed variance upon the
health, safety, and welfare of the community, the existing and anticipated traffic
conditions, light and air, danger of fire, risk to the public safety, the effect on property
values in the surrounding area and the effect of the proposed variance on the
Comprehensive Plan.
4. Because of conditions on the subject property and on the surrounding property, it is
possible to use the subj ect property in such a way that the proposed variance will not
result in the impairment of an adequate supply of light and air to adjacent properties,
unreasonably increase congestion in the public streets, increase the danger of fire, and
danger to the public safety, unreasonably diminish or impair health, safety, comfort,
morals or in any other respect be contrary to the Zoning Ordinance and
Comprehensive Plan.
5. The existing house, deck and porch on the lot of record does not meet the current
bluff setback requirement. The proposed deck and porch are 178 square feet less in
area than the existing deck and porch. The proposal also removes 756 square feet of
impervious surface that previously existed on the site.
1:\OOfiles\OOvar\OO-052\.ppres.doc 1
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
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\ EXISTING , a: ~~ Pl\..........:.,;..;... , -..:.~ ~~".:..1.:.\; .
I I HOUSE 1~ ~- R'~ DECK ".00 = 4' ",0',,; '.
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EXHIBIT A SURVEY PROPOSED
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6. There is a justifiable hardship caused by the fact the eXlstmg structures already
encroach into the bluff setback. The proposal will actually improve the stability and
condition of the bluff.
7. The granting of the variance is necessary for the preservation and enjoyment of a
substantial property right of the applicant. The variance will not serve merely as a
convenience to the applicant, and is necessary to alleviate demonstrable hardship.
8. The contents of Planning Case File #00-052 are hereby entered into and made a part
of the public record and the record of decision for this case.
CONCLUSION
Based upon the Findings set forth above, the Board of Adjustment hereby approves the
following variance for the proposed structure as shown in Exhibit A:
1. A 25 foot Variance to permit a 0 foot structure setback from a bluff instead of the
required 25 foot bluff setback.
The following are conditions which must be adhered to prior to the issuance of a building
permit for the proposed structure:
1. The proposed structure must be located as shown on attached Exhibit A.
2. The resolution approving the variance must be recorded and proof of recording
submitted to the Planning Department within 60 days.
3. An Assent Form must be signed and, pursuant to Section 1108.400 of the City Code,
the variance will be null and void if the necessary permits are not obtained for the
proposed structure within one year after adoption of this resolution.
Adopted by the Board of Adjustment on July 26, 2000.
~EST: ) /J
\.. ~)~ 1:: /
Donald R. Rye, P ~Director
/~ . U~?1
Thomas E. V onhof, CommissiolvChair
1:\OOfiles\OOvar\OO-052\appres.doc
2
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00.o1oq
White - Building
Canary - Engineering
Pink - Planning
,
ThO' ("0,'01... of lh.. I...... Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT _ rR o..):::J< (" f\ \--tr ~i y!\ f> ~
APPLICATION RECEIVED .:;;.J'0J_ J \'\ \ .;) 0 CO
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
(_ ijL/Lj -. / C"f--.-t-11 Q I..J t
._:> -0 (J ,.) 11 U ./
Accepted
Accepted With Corrections
,/
Denied
~~~
Date:
93 -/Y- ~
Reviewed By:
Comments:
I..~~\ ~A' /.),..-seIo'''''''1. ,q,-aO~L.
1-, A- \~V3~.f)V~" ~~ ~ C~ I
VJ.&.~~v-~ ('~U~5 AYe ~ A:r~
('rftA/~ F~ 'bll~ ~~J:J~L\~ #
"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."
00-0701
White .. Building
Canary .. Engineering
Pink .. Planning
Thr (-..nler of lh.. I..r.... rOunu",..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~o...KKE' J\ H-r"'\Yl'\t> So.
APPLICATION RECEIVED ~~ ~ \ ~~ \ .;:::J 0 U 0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~ Ljt..; 'i / f:Jlt-'tl ~.~
Accepted
Accepted With Corrections
~
Denied ..
Reviewed By: ~ VI-~ -
Comments:
Date: fA -5~2000
I. ~ s.,-,~ rJ~ ~
z. See SrHc.l Stc."~\.L~"'U- ~.:~,.~ OHC4C.~J
"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."
Barr Engineering Company
4700 West 77th Street. Minneapolis, MN 55435-4803
Phone: 952-832-2600' Fax: 952-832-2601
BARR
Minneapolis, MN . Hibbing, MN . Duluth, MN . Ann Arbor, MI . Jefferson City, MO
June 20, 2000
Mr. Joseph R. Cade
6444 150" Street
Prior Lake, Minnesota
Dear Mr. Cade,
This letter report concems the impact of the proposed deck and three-season porch on your property at
6444 150" Street, Prior Lake, Minnesota with respect to the stability of the bluff slope in accordance with
the zoning ordinance subsection 1104.305. Philip B. Solseng. Barr Engineering Co. reviewed the property
on Saturday, June 17,2000 and the plans were received and reviewed on Monday, June 19, 2000. The
following is a summary of the findings.
The existing deck and concrete patio will be removed and replaced with a new deck and 3-season porch.
The existing deck and patio are above the bluff but within the bluff setback (as defined by Zoning
Ordinance 1104.303 and 1104.304) and OP a relatively flat area in back of the house. The proposed
addition will be the same. A landscaping plan by Yardscapes dated January 25,2000 and updated March 4,
2000 shows a retaining wall along the bluff slope where the slope is steeper than about 30 percent. The
proposed deck and 3-season porch are shown to be generally greater than about fifteen feet away the
retaining wall. The west side of the house is an exception where a small retaining wall is proposed along a
slope of about 18 percent and the distance is greater than about five feet away from the footing. A
discussion with Mr. David Kophmann from Yardscapes, who performed more extensive excavation for the
landscaping than could be visually observed, reported that the soil was a hard sandy clay, most probably a
sandy clay till.
A plan prepared by Chris Doehrmann Architect Inc. dated May 19,2000 shows the plan and elevations of
the proposed deck and 3-season porch. The deck and 3-season porch are proposed to use 6x6 timber posts
on 24.inch diameter concrete footings for a foundation. You mentioned that there have been no reported
incidents of instability on the bluff. Therefore, based upon the Yardscapes landscaping plan, the Chris
Doehrmann plan. discussion with Mr. David Kophmann, and visual observations of the t'~Vt'''''B)', the
proposed deck and 3-season porch will not impose loads or cause an adverse impact on the structural
stability of the slope.
The landscaping plan by Yardscapes shows proposed drainage contours that are essentially unchanged from
the existing drainage condition. The concrete areas shown on the plan by Chris Doehrmann Architect Inc.
are slightly larger than the existing condition but will not affect drainage more than the existing condition.
Therefore, the drainage from the site and djacent properties is essential unchanged and will not impact the
quality of runoff, downstream properties, '.Ietlands or bodies of water and will not result in erosion or
sedimentation any more than currently exists.
I trust this letter report is satisfactory and provides the necessary documentation for meeting the
'rements of the Zoning Ordinance with regard to construction on the above referenced property.
(
)
~pf /~
1 tPrP
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS (AL/l/tl 150.....~.
NATURE OF WORK [)pc\:....?"..J--..
USE OF BUILDING <;;'t;:t)
PERMIT NO. 00. 070Q DATE ISSUED (;'"5''2/::00
CONTRACTOR P"kKQJI\. ~....... pt\ot..!e.... q4'7-S:;l?'"I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING
,
I '1/fJ/bO
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPjCTOR
f:'Jri
, DATE
FRAMING
INSULATION
ELECTRICAL
bR.
N If Z./ /)7)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
- I
FINALS
,
~
BUILDING
ELECTRICAL
..
DO NOT 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTtCE
ADDRESS
G Cf4 LI
SCHEDULED /LJ.j(~
(JZJ 111 ~ r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
no- 0701
o FOOTtNG
o FOUNOATION
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 EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
;
(_( OS-c
I -/
1- ( (--C
in - o.c..tlv"<.-
iO-j(~(
~.SATISFACTORY. PROCEEO
o CORRECT ACTION AND PROCEED
o CORRECT Wo;K~~R REINSPECTION BEFORE COVERING
Inspector: --.f:...1t! --- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lJiSNOTJ