HomeMy WebLinkAboutBuilding Permit 04-0022
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I. White File
2_ Pink City
3_ Yellow Applicant
I'"' _ 3D ~o3
C,\
jPERMIT NO, M. 00 z...u.
(Please type or Print and sim at bottom)
ADDRESS
.39.~ 'fO~ ~i L \y~ I Nw
I
I Z~lG(Offi"U") I
LEGAL DESCRIPTION (office use only)
LOT 4 BLOCK \ ADDITION\h.t. WHd,s. IoTit AdrJ.trlllh
OWNER
(Name)
\01\".
I
4.011
l \ \ ~C k I ( ol\el.lY'\.
O~~~l.>.n
,<J-:
(Phone)
S 4-tCvf'- t>>- IY1 r-J
PID,PiAII;)..' OOLf-D
0s-..) 'Z.~a,./3~7_
.~< 7C7
(Address)
BUILDER
(Name)
(Contact Name)
(Phone)
(Phone)
q
GjK '11.:w /
~~o,~. 1),35
.,;l..Cj~-1'l3~
ORe-Siding
~~~.~
c...1\~~\p. ~ DCa' ,.
(Address)r.:y.o, ~~'I'3~ v.u.u;I\a. ,4,J
. .::B:N4
TYPE OF WORK
Lst"tjew Construction
cfower Level Finish
nf1: 1\& &
.....1
DPorch
~
DDeck
ORe-Roofing
D Fireplace
DAddition
DAlteration
Dutility Connection
2.1 It. Drf1) . eN
o Misc.
PROJECT COST IV ALUE (excluding land) $
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
:terG:9y~-:::~~orm~Q=s~ ..J~'9lln3DI ~')M
() Signature- YCJ Contractor's License No. I Date
1 Permit Valuation ., t9,9P 1)00,00 1 I Park Support Fee # $
I Permit Fee $ ~~J./I, 501 I SAC # $ 1350
1 Plan Check Fee $ I L{.~/".qF 1 I Water Meter Size 5/S"Q:U $ 800,0-0
I State Surcharge $ li/q.DO 1 I Pressure Reducer $ 70, e 7J
I Penalty $ ~ I 1 City SAC and WAC # $ r~o,'Uo
I Plumbing Permit Fee $ IOn. 0'0 1 I Water Tower Fee # $ ~o, Dt>
I Mechanical Permit Fee $ /00. OD I I Builder's Deposit $ ISoo.oo
I Sewer & Water Permit Fee $ :Js; 0:.-0 I 1 Other $
I Gas Fireplace Permit Fee $ 40 ,00 I I TOTAL DUE ~ ,_ ,r. 04-- $~ 242. 9B
"' -)
This Application Becomes tpUf Building Permit When Approved I Paid {.jZ~ Z. '1 Y I Recei~6ro. ,H, z.#
~ ~I-J 1/12./6<1 I Date, / /(,. t 4-'-- Bv"""" ~
0
Building Official I 6.te
This is to cenify 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 consauction to commence. Before occupancy, a Certificate of Occupancy must be
~~ ~~ 1/;~ADO.tet/ - ~ .4I..Jr-'~_:-+' ~
Planning Director '/ ' - Special-Con<~ions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~1
c- u/~i.- .. Ruildina ~
Canary - Engineering
Pink - Planning
lh~ Crnlrr of thr I..b {'ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKIJSI
NAME OF APPLICANT ,1 ~M-~&v'~
APPLICATION RECEIVED IJ!- 3W-o
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: '\
Lq d.- 19 fOy,--Yad ~
Accepted
Accepted With Corrections V""
Denied
Reviewed By:
~ ~?-/
/e.rdJ M.{l ~~
Date:
I/~/o"-/
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."
~~
White - Building
Canary - Engineering
~nK - PIRnni~
The ('en In of lhfl' l..kf Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI!=iT
NAME OF APPLICANT
..-"
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
\
Accepted
Accepted With Corrections
.,/'
Denied
,""",
Reviewed By:
~
;(~
~
cJ.{l ~-
Date: J/l.-~ c(
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."
~~
White - !l!ill.<!.!!:lll.
..........pnarv "I::~f~~~u",~
Pink - Plannrng
Thf('tnltroflhtl..hCounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
. ,"" f' (I'
/'- /r'\ /\
/
/
~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,'.';
..'('''')
7
"I
_J
.v
/.(
()..A..-\',
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
/l?1l"5
Date:
/-l~- 0,/
Comments: ~"'''' RAverse Side for Additional Information!
~ J~ /rthL
1
u~~-7f
~~
~ , <::J
~
See Attachments: 1) Grading Plan, 2) Erosion Control MeaSuTp.<:
"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."
_ ---;____._ __ ~~..:.~.....~' r.t\.l,ult L.UE
I@ 001
CITY OF PRiOR LAKE
1f.EATING/AlR CONDITIONINGIFIREPLACE PERi'1lT
Pate Rec:'d
Ql~~I'm-~falld.si~J':lat:'bottom'
I ADDREsS --- .
:<,..Qqq m~
::~. ~~ I PERMIT NO. ILL hI'n ..
'.YDII_ ApJl'lko~ ~~
7,4";'/ - /?J?-//
I ZONING (o~us<1 I
LEGAL DESCRIPTION (olii" "'" o.ly)
LOT
BLoep:;
ADDmON
PID
~V:::e~R~-Ak j2 fl
~P7eS
(pbone) CR'~-~Sq
(Ad.dtessJ
I APPLICANT / ('..
(N=ol ("' AA ,r/,('j/lp~ )
(AddTOSS)-~/d /("\ */'?/h. ot )
(,Addrm)
QJ.....
/If )rc:
(ContAct pason). ,-/,' /
APPLICANT SIGNATURE ~
~~
(pOOhe)
ffl T:::...
(J COty)
(phone)
4"t<'i - ~;:;) ~
~1J's:C0) ~
(Zip Code)
.DATI
c APPLICANT PLEASE COMPLETE :BELOW
....eJNEW CONSTRUCTION 0 REPL....CEMENT 0 AL TERA noNS
FURNACE MAKE AND MODEL --;0Q.l lP' /iJ, x ~.C'bCl FUEL L),4)-
F'L~SIZE ,"\" t:>tX_ k-ruR1'lu,.""",,GS 5f INPUT ~rYY'l 01JTI'UT _7,~ 600
TYPE OF SYSTEM HEA.TING OR POWER PLANT
DW.:mAJrPlints 0 St=n
DGr&vit)' 0 Hot Wat<r
.E}l<ecllanja>1 .' 0 Rodiallon
~t Cond.itioning 0 Special Dcvica
:J3'1oo,- Sy5tctn 0 {)thcr Devie""
FTR.EPLACEM'A.I(EANDMODEL~1 ^) ~ ~L -7.::0.
l'UASE NOTE:
Air Condition", Units
C=ot Enc::-oach into
Roquired Sid. Yart!
Setbook.!
FEE SCHEDUL"E
TCl.d~ial. cornmc;:rcl&l &. M:u.ltl.?amHy 1% cCjgb ~O~ ~iC::~e.I. Gu Fb"epla.~o
$39.50 minimum
Residcrttiel, HQatln~ &. Ale (Nc..w COhnruct!on) , .t9~,SO R.~~.d(;tlti.\ll. A::I'dttlo;:s &. A,Jtcre.tions
ResidcntitJ.. aeating Onl)' (Ni;;...... COl'lstrut.:tion) S6~,SO ~e:i"<l.c;n1:I:.(AC Onl)'
.l'39.S0
.39.50
$39 SO
Estimated Cost S
Building Permit ::
HEATlNG PERMIT FEE _ $
STATE SURCHARGE $
TOTAL PERMIT FEE S.
PAID WITH
RI III n!~ Oc:q~~IT "-
-. _. uwq'.
(om", l1S< CnIJ)
r
1'bi. Ap.pllcatiotl Becomes Your Building Permit When ...pproved
Bu.Udlng Omell'
Pale
I.?~id
I Date
JAN 2 !I 2QC?
'j Receipt No..
I By
14. hotlr n,otiec for a.1I iI"l5p&di~ns (952) 447.:.9S.s0l {a.x (;lS2.) 44074245
100121
lilY <I::!110l!.lNOJ
9L6909t1S9 YYd 1C:90 <13M t006/S./10
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
2.. "Z- ,04-
(Please tvPe ofnrint andsien at bottom)
I ADDRESS
31. '1 "I ~OX..r;4 C '-
I. G,,~ FH, I PERMIT NO 2f
2. y,lIow CII>. 'r.4- 0 0 '7
]. Gold Apph~nt V' ~ L-
ZONING (office use)
,/2
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID?b 4--12.-.004-.0
OWNER
(Name) ~ATC--L i'r,c
(Phone)
(Address)
(Address)
(City)
(Zip Code)
. APPLICA.NT
(Name) Od-6S'1.J6/L k XoOC.
(Address) I'" /19 1: D P L-- ':-.-J vJ /1-"(
(Address)
(Contact Person) {J, lA Ie.... /.I
. APPLICANTSIGNATURF ~t_,_:t0~ ()A
(Phone) q...~ -R' ":J-~ 70 ~
t-.;q./Le t.lJ:..lt ~
(City)
J J7J1-/ '-I
(Zip Code)
(Phone)
DATE
J~//)q..
APPLICANT PLEASE COMPLETE BELOW
Size of water service ~ inches,
Location of any couplings from structure -
Type of sewer pipe. 0 ABC, ~ PVC
Estimated length of sewer line S- () feet.
Clean out (ifrequired) located at - feet from structure_
feet.
o Cast Iron
Residential sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35.50 Industrial. Com'l & Multi-family 1% of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
",;
Estimated Cost $ '1 0 0 .
Building Official
Date
Building pe~it # 04-oO~ L- 0 r3V
$ ~ .50 fA I ,..-rL.
$ ./ IOt/"-
'" 6 (,II v
.-
'RB~ye -
D! )7-- .o~ IY)'JJ;l(
1
-~
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
03-24-04 04:29 PM FROM FGTN ?LG HTG
Te 9524474245
PO I
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
1Plw< ~ or DMlllld Ii... at bDaDDl)
I ADDRESS
3), 9 (I Fc,,,
T....().;{
LOT BLOCK
LEGAL DESCRIPTION (ollic< "'" only)
ADDmON
~':~R /(0. ~J \a { f
(AddIess) :aD73D . 1-1010"'/<_9 lk"
APPLICANT \
(Namel ~""\^'O~ PII.l,^^l...;.~ t'l Jl. l~ (phone) J~c:, )-4($>3- ?R;)'~
(AcIdIl:sS) dIO-::\'-I r_~"'A:,.oaI.. fL~ 1i.rl'Vll~.J..~ ~lJ
(MYs) lQIy) (Zip Code)
(ContaCl Person) ~ U~ (phone) /0<;; ,-(Jfo.~ - 7g~ lJ
APPLICANT SIGNATURE ~.J 0iJl::~1. DATE~' ri.l./-04
Quantity
;:L
\
I
4
I
I
I
.~
ff., WI e..c,
LJc_" "', 11-lL/
;:;:;: ~:~ I PERMIT NO., .I~ ~""" I
) ~..'- Ap,l"- ..., ~""---.J
I ZONING (ollie< .,,) I
PID
(phone)
9<;1. - Cj?'S-C;<f59
C,S(\41.J
APPLICANT PLEASE COMPLETE BELOW
TYPe or Fb:tare Quantity
Bath Tub with or without shower .3
Dishwasher \
Floor Dnlin
Lavatory (Balhroom Sink)
Launclly Tny (lor 2 compartment sink
Shower Stall
Sinka
Bar Sink
Water Closet (Toilet)
Estimoled Coat $
Bulldinl Permit ~
Type or F'oxture
Rough-ins
Water Heater
WalQ' Softner
Stand Piee (Washing Machine)
Sewage Ejector
I B8ckt'iow Assembly
Baclcflow Assembly Test
Lawn SDrinkler
Other
FEE SCHEDULE
lodlUlrial, Commen:iaJ " Multi.flll1Uy I" of Job COSl willi. S39_S0 minimum Residential, New 00. 01: rw.,.Fomlly $99.S0
Raidalli.l. Additions 01: A1kn1iOllS S39.50
PLUMBING PERMIT FEE S
STATE SURCHARGE S
TOTAL PERMIT FEE S
(OllIe. v.. 0IIJl
nil Appllcatlollllecom.. YOlr BaUdlll' PtBllt WIlea Approvod
.
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D.,. !: Ii! MAR 2 6 2004
, ;
14 ~eo. .ot\co Ie. olll..pecllou (952) 447-9.~:'r.. (952) 447-4145
1'-'/________ _ _
IoU", 0tIld01
- 'J
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS .sZC?9 4o-x:-Ial.I 7""2A/l., ~,I,IJ,
NATURE OF WORK 1J~ ~S'TI2-u.c:n"~
USE OF BUiLDING S.F: O.
PERMIT NO. 04-. OOz.2- DATE ISSUED l/'L(6'i
CONTRACTOR ~ K~ PHON~5.&.fI?O
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING T"t. ~J F ~ fic... we.. I rWr I :(- u-of
, FOUNDATION (Prior to Backfill)~ ~: ~ I uJli>M
PLACE NO CONCRETE'1j~TIL AB-OVE HAS BEEN SIGNED
ROUGH - INS
~
~ 1:tr
it! 1"-2
il h
~
.~
iJb
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING ,/i<;v& I\D tJ...d.ud.1 f"
HEATING (if required)
FIREPLACE
GAS LINE A~l~ TEST
INSPECTOR
OATE
1- (1'7 /.194.
31 Z:3( 6'(
7111/fl~
31z3/ot.J
'3' I. 2- ) (61j
~/II/[)~
COVER NO WORK UNTIL A~OYE HAS BEEN SIGNED
WIIE/tJU/,TlHlJ STj,JE W" ~-2..
FINALS
GRADING (Prior to Sodding) 11 IV LS:..
BUILDIN~ ~ ~ ~ - L 'e ~ · 7
ELECTRICAL
PLUMBING
HEATING
DO NOT
/.t?-'9-,::;y. ;-
~ /o/~/oy
r'-6 c.-/O
~
OCCUPY UNTIL ABt;J HAS
NOTICE
BEEN 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.
~'-.:, 'l)...-,.~o-~,"",,-~,......~.- !t"l!:''''' 447...01="r.-'"
i ". ~ ......
_,,___,_,,___,"__~_,_,_____,,__"~_'___""u~_<__"'_~__'~_,,_'.u.,.._.__..~"n__ ._._..____,...__...__...____.....__.,....__.'__.___.____.__..__~._.__
... , . ~-
aledifirate of <IDrrnpaut}!
CITY OF PRIOR LAKE
~eflZldtueuf of ~uilMug J1usflediou
~inal Permitted D Conditional CO. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Unifonn 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:
Fire Zone
N!A
Zoning District
04-0012
Rl
Occupancy Type
R3
Type Construction_
SINGLE FA!'HLY
VN
Bldg. Permit No.
Use Classification
Contractor's Name & Address RATZl.AFF HOMES,,,, P. O. BOX 1135,
ROBERT D. HUTCHINS ~ City Planner
/.d7 ~ ..7~OffiCIaI Date:
'/;. I
L4, B1, THE ",;LDS SIXTH ADDITION
SiteAddre" 3299 FOX TAIL TRAIL N.W.
LAKEVILLE, MN 55044
Legal Description
Owner of Buildinp"
DON RYE
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
Y99k~r/
OWNER
CONTR
PHONE NO.
PERMIT NO.
o FOOTING
D FOUNDATION
D FRAMING
D INSULATION
....a"I'1IlAL
D SITE INSPECTION
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
COMMENTS:
/'
L_l /~/
Tlrl"! (/1'---
DATE TIME
/O/0~r
?;/
0'9"-.77,
D EXIGRAD/FILLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GAS LINE AIR TST
D
--..
---- ------ ~
/;:;;- -/ ~/ J
((_ /Cue 1/ /e/
\. ~
~ "- -
WORK SATISFACTORY, PROCEED
D CORRECT ACTION AND PROCEED
D CORRECT WORK. CALL 0 REINSPECTION BEFORE COVERING
--
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"'",,m
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TillE
SCHEDULED iP-) is.-l>{
I
ADDRESS ~2 'l't
Fox ~
OWNER
CONTR.
PHONE NO.
PERMIT NO. _C/ _ 110 21J
. -
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
6 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
Dlv I. ~_ <;OJ:.~ I 'Dh'll-P
2. Jk,,-dL.. <:t---~~ ~"i'~ (""'_,..,:J:-~
,IL =? F.~~ G..~ ~ I~+~ ~hL <;..,d)
~~.9.. ~""..L \f:,~ q...-/1~*- J1~
~ S. SR.c~_ Ilk:,~r--- 4-0 tfe/} {/...q. 1!DT++--
, ,
\~ (I.- cor (') -h,
.
r
8-1. _(jLj
k.~ s.pl"'~ oC-. t(-\;-^ Q...r 1;""-.
o WORK SATISFACTORY. PROCEED
o CORREC TION AND PROCEED
)( COR CT W ~K. CALL FOR REINSPECTION BEFORE COVERING
lnspe or: I /I Owner/Contr:
C ~ i7<:l850 FatTHE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD';i~ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
PHONE NO.
37li fox Jq,/ ~c., (
~",fz.il+ Homd
0'1-22.
CONTR.
ADDRESS
OWNER
PERMIT NO.
o FOOTING
o FOUNOA TlON
o FRAMING
o INSULATION
...cl.f!!lAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
,J(EXI~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
(-nrd!, - I'l I(
(.. /I b /1,/11'- olL_
IV WORK SATISFACTORY, PROCEED
1 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!
uaNCO
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE nME
SCHEDULED
&-(()
ADDRESS ~;('t-=t
h..." ~:\
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Lf - 00 L --z.-
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
;g"'PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: .
..-
-'- ~ll ~_D r,;;. t f l.p~ ~
2. (2A.. ~--.Q C,,,,,,, r~.-,
. j
k.-- C;.n..' ... ,l.:-
I
o WORK SATISFACTORY. PROCEED
')(cORRECT ACTION AND PROCEED
/0 dlRR~ORK' CALL FOR REINSPECTlON BEFORE COVERING
Inspector _ Owner/Contr:
CA -9850 .kR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD~~MENTS ARE FOR YOUR PERSONAL HEALTH 01 SAFETY!
I
..-:>r
---
INSlion
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
M7/0L[ vl~UJ
ADDRESS
2lCtq
~
~~ '\fH..
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t>L{ ~ 2---2-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
i
o PLUMBING Rl
o MECH RJ
~WA TER HOOKUP
')1! SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: \
I I \~ ^/- ,?:.
t '\J L/ '-' ~ '--
- ,
\
....-
(~
\
\
r
C, do-iA'\
"""-
--........
~.
~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!
u"'<<'"