HomeMy WebLinkAboutBuilding Permit 04-0074
(Please ~e or print and sign at bottom)
ADDRESS
J71/'/~Vu'I}f_
LEGAL DESCRIPTION (office use onty)
LO'M~ BLOCK I ADDITIO~ q-ft:::
OWNER
(Name)
(Address)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
Date Rec'd
2.2.04-
I. White File I PERMIT NO 74+
2. Piok C"y . 04-. 0 0
3. Yellow Applicant
ZONING (office use)
I!z...
PIDz,5 +00. OZ.S_ 0
(Phone)
(Phone{9'~) 78'5 - 7c'3a3
(Phone)(9~JMb - </73:'<"
BUILD~ ri) L L-l --r-:_
(Name) LJ.1C 'f"UI.{DY).-L1. IG.... .
(Contact NamefTYi; k~ ~L.u4:~
~5 CD( J<. ~ hA d.q,.,.. Qj: ~ "I> 10 U
(Address) ~~ ):rlt.~ ~l\ICJ SSJ~(I
TYPE OF WORK
)z! New Construction
OLower Level Finish
DDeck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace DAddition DAlteration
PROJECT COST IV ALUE (excluding land) S 1:2...-)
OUtility Connection
) (p5 [,
DMiscI.B.c..~. (2.-3 ~-f-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 aU 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
,~oP~':r~ections d('ry€j~7 //?/O Lv/
I d Signature ._ Contractor's License No. ~
I Permit Valuation 'J~/. bOO,aO I Park Support Fee # $ ~SO, 00
I Permit Fee $ 1z.'1~.so'l SAC # $ 13'50.00
Plan Check Fee $ EN 4 .t,,~~ Water Meter ~';"'l"; $ d'5IJ.OO
State Surcharge $ 7 5 Pressure Reducer $ J'
0, O. ..,<;;;'.00
$ I City SAC and WAC # $ \ 'ZdO. 00
$ 100. DO I Water Tower Fee # $ 700.00
$ 100. 00 I Builder's Deposit $ /5'00.0'0
$ 3 '5'", S'o I Other $
$ <fo, 00 I TOTAL DUE ,,$
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
j Gas Fireplace Permit Fee
_f
B,38S./8
II
I ReceuA No. 4f't..J.i"' 7
Brl
o
This Application Becomes Your Building Permit When Approved
Paid
Date
V,3r./ 'Iff
, '2-. ,""f.. () 4--
~
~~
Building Official
:ljq /0';
~
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
~'. ~ ~11/0"; f?~ aL( ~
Planning Director , l Date Special Conditill'ns, 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 /7IT/1 ~r ~dt/
Heating Contractor d/l.~ ~CH
;la1-PJ"l~
7/z..';w
7.'=t ?"
-{f~
'17J~
Name ofTester
.
Date
Percent 02
Percent CO
Percent C02
Stack Temp
Combustion air is adequately suppiied per
UMC Sec. 606 U;J'S
input ~tfI/lI $'w
..
',<
~
Main File
White - ~uildin!t
r' . "anSlIrV - t::n.9lneerl~
Pink - Planning
Thr (rnlrr of thO' I..k.. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APP~ICANT
APPLICATION RECEIVED
D
--...,
'(~.. .
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l,_
II c k~:rD t.,,)
-7 () /1_
c- .,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/-74/1 DEE p/Fr Ct. i..-J D ic.1 \JC-
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
m18
Date:
;). - J(J -0'(
Comments: .BAA Rev.er!;A Side for Additinn;:Jllnformalion!
1Ilc,/11 r:,t (.
Spp A ttachmellt~. 1) GrHoing Plan, 2) Erosion rOlltro] Mpa~]1TPO
"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."
t~1
Main File
-
lh~ Crnlr...f lhr L.kt COUnlrl
While - Building
Canary ~ F-nClineering
r Pink- - Planninil)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
!
I L I ( : '.? .1
,- . I ,,_;,- 1,,-' '
APPLICATION RECEIVED
/
i-- .
7
~
( .?;.-
. I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i .L- f I I I I I I
i , , . (- , ',,-, '_' '__ ' j i.....__ ; \i t:....
Accepted
Accepted With Corrections /'
Denied
~
Reviewed By: ~
Comments: '1'JIl4,' "c:1.-.....;)
'\jd ,./J f-J
~~-:- .>Qtn.~~
~ t). H. ';;j L. J?~ a.J
~
Date: d{/IL/lo 'I
I '
.
~
~' .a.d-~
/
"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."
~~
Main File
~------
n.~ {'~n'..r nf lh.. 1..1<.. ("oun'n-'
.......-:-lfI(l?i~ - Building;>
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
D_g.. Ho~0
Z.' 2,-. 04-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1/4- I I Dt:-t::- J2.,Ff aD D rGl \/5
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
~
"
Date: q/ '-I;:' <j
~.J2~
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."
Feb.IO. 2004 10 18AM
GENZ RVAN PLUMBING AND HEATING
No.1198 p. 3.9
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PER1VIIT
f.Please'!yo€: or m:int a:o.d sum at bottom)
ADDRESS ~ .
/14 f! /~~fJe/d IJJ? (\b
I",~ ru, I PERMIT N004-. OJnf-.
2 Gold City
J. Yello.... "ppliem
I I ZONlNG (Office...,) I
LEGAL DESCRlPTION (offie, uso only)
LOT2)BLOCK i ADDITION j'Jr;..oeheJflJ tf/AJ
PID
OWNER
(Name) DR Horton Custom !lames (phone)
9sz-Q-;.r:; -7BD()
(Address)
2.cSw 0 Ken P;l~. \ D&e.. C, Sre.! DC
/...(LuvdIG /'UN 5!561-j Li
. APPLICANT
(Name) IAn;> PY7- ", "-'-<-g ( "-..at..irl!
(Address) 14745 So
(phone) "'" _I.?'_' Hb
(Contact Person)
_ M(U
J ~
. 'A A.I .<<1)'::;-:)
Rosemount
(Ciry)
MN
55068
(Zip Code)
APPLICANT SIGNATURE
..-, (phone) 651-423-1144. .. /
'--:/:1~ATE. c!} ~(Of)'f
APPLICANT PLEASE COMPLETE BELOW
I Quantity Type ofFixtu.re Quantity I Type of Future I
I h?- Bath Tub with or without shower , .:? I Rough- ins
I ! Dishwasher i . Water Heater I
I I Floor Drain ra- I Water Softner I
I \..~ Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine) I
I Laundry Tray (J or 2 compartment sink Sewage Ejector I
I I I Shower Stall BackfJow Assembly
I I I Sinks Backflow Assembly Test I
I Bar Sink I Lawn Sprinkler I
I. ,;< I Water Closet (Toilet) Other I
FEE SCH.€:OULE
lndu"nal, CommerC1JJ & Multi-family J % of Job oost with. $3950 minimum Re:ndonti.I, New One & r",o-F'.I11l1y $99 50
R."dontiaJ, Additions & Alteration, $39 50
ESllIllated Cost $
BujJdmg Pen:l1It #
PLUNffilNG PERMlT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
PAID WTITH
.iiLJ~i!.D~NG lO~~:;vlIT
I
!.
(Offiu: UU Only)
Tbis Application Becomes Your Building Permit When Approved
Paid
, Receipt No.
I By
"
,
Building Of11ciAl
Dztt
D4tfB 1 8 2004
24 hour oorlce for nit InspecUollS (952) 447-9850, fax (952) 447-4~45
Feb.IO. 2004 10 17AM
GEN2 RYAN PLUMBING AND HEATING
No 1198 p. 2 9
€~~~~
" ,''':d_,...:.,.
~;'\\I\,,:;jjj.:N'~'~:\\
t?i-\'}~~~:->(i"'~.l\h NfIf E 5 0'" '"
""'I";'~'V'
Date Rec'd
CITy.oF PRIOR LAKE
SEWER AND WATER PERMlT
(1'1...,., <1T' ornlint""d';llI1 Athom>m'}
11~t[ bafe-f7e(d tAt C\t7
; ~~,~ g~ I PERMIT NO,I'\"L ^At-'~
3. Gold Appli'-lnt ~...uu IT
ZONlNG (~.Gce""')
LEGAL DESCRIPTION (oflic. use only)
LOTtJ.5 BLOCK ADDITION 'rxwJicl J 4Hv
PID
OWNER
(Name) 1\D U."rOtl <'''.tolll IlOIll--
(phone) _ CfS,2.-Qgs-ii';rv,
(Address)
20&00 jtp;1Bi<...\s:::L-e. C:r- Sn:>./f\r-,
(A<1d<c$,)
LaJI.e,\) I lie..
(City)
- ~,',; 'U'
VJ~J\.-j
(ZipCCldc=) .
APPLICANT
(N~np' Genz-Rvan Plumbing & Heating
(phone)
651-423-1144
(Address) 14745 So Robert Trail Rosemount, }IN
(Contact Person) . QV1I~~~':) W (5-. n ;::~e)
-.rCANI SIGNATURE - 71 j~ ~ J J,/CJ DATE
55068
(Zip Code)
651-423-1144 ,
a. - (0-04
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
ReSIdential sewer and water bne connection
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-fumtly 1% of job cost wIth a $39 50 minimum
$1750 Water cOnDe<:tion only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PER'tvfIT FEE
STA IE SURCHARGE
'tOTAL l'E:RMIT FEE
$
$
$
_ PABD 'WIYti
5L>r "" r'l'~'
. ......'W;...iJ"\"~ D!j:;r;"'"'r
co" :: _ ''''.~,~j\~~
,
I
(Office: Use: Only)
I This Application Becomes Your Building Permit When Appr~ved
Building OfficiaJ
DJ.tt
I Paid
_ ~> DftiB - i II LUU4
I ReceIpt No
I By
I
.-eJ
~
24 hour notice for all in,p.dlons (952) 44~..98'so,.~~9~) 44742<15
CITY OF PRIOR LAKE OU-1~</.t..
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
q'lease Jv.pe or orint and sign at bottom)
ADDRESS """
1'14 II /)eerG~/d
i~::. ~:~ I PERMIT NO. ~ ^'~-
3.Yellow Apphcant ~...~
Dr.
I ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER DR HORTON
(Name) - 20860 KENBRlDGE CT
(Address) LAKEVILLE, MN 55044
(phone)
APPLICANT /J, /. - A
(Name) /-f / EL<< ..,(-~ ..; /' ~4/ r- ./
(Address)~ ~A..IA" ~ /..2-:
~
(Contactperson)A"Vr, . -67-~
APPLICANT SIGNATURE ~ ..-,- "-
(Phone)~5/.. 4~* ,,???.s-
~.o2A~ .1!F".5"/d..?
(~ (Zip Code)
(phone) I"A:F"/ * c;I"~ - dt 77..:2.
DATE
, APPLICANT PLEASE COMPLETE BELOW
j;!lNEW CO~TRUCTION 0 REPLACEMENT 0 AL TERA TI<?NS
FURNACEMAKEANDMOD~fl ""'_',;1 :j/oAA~+"07c) FUEL",( -J, ~~~
FLUE SIZE.y~h...A REn!RNOPENINGS 4 INPUT ~ ~ OUTPUT ~~ ~
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants
OGravity
o Mechanical
~ir Conditioning
~ent. 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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential. Additions & Alleratinns
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
. q..,,~a:::>Buildingpennit #
$~/&u/~'{~cJ
$ 50 ~~ ~~.. -r-ilf . - - '. : - "
-'. L..... _ ~ . \i.~P r-::,::,,,:",,,, "IT
$ /.7 ~"
...,- w_ .' "~.j
Estimated Cost $
(Office Use Only)
This Application Becomes Y our Building Permit When Approved Paid
Building Official
Date
DrE:.8 2 4 2004
By
.
24 hour notice for aU inspections (952) 44~9850. fax (952) 447-4245
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
l :-;,::," ~::, I PERMIT NO.1 J - I #-I,
3_ Yellow Applicant -, "-11
(Please type or Print and sip at bottom)
ADDRESS
17411 DEERFIELD DRIVE SE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER
(Name DR HORTON
(Phone)
(Address)
APPLICANT
(Name) ALLIED FlRE$TDE DRA FtRE$TDE l-lEARTl-l & l-lOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
pnSEVILLE
(City)
(Contact Person)
BRENDA HUSTON
BRENDA HUSTON
(Phone) _651-633-2561
DATE
APPLICANT SIGNATURE
ZONING (office use)
PID
55113
(Zip Code)
4/21/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
HEATNGLO SL-750TR-D
Industrial, Commercial & Multi.Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
S;
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
o\kh 2 i LUU4
HuUdine Official
Date
.,
24 hour notice for all inspections (952) 441A8sQ,fa~ {9521",,7:4245 __ :
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
';'If., ~~!'J. nll~
~. ''''^,\'' t!i0i'y
~. I ~~~__
r; '4'QJiY7!'
Receipt No.
By ~
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS I 'I ~ I \ !:>~2.. F"I e~ bQ.i VE
NATURE OF WORK Ntl.lo..) ~ __~~
USE OF BUILDING S,~A.
PERMIT NO. 04-.00'74-- DATE ISSUED I.'Gtfo..,
CONTRACTOR ]). R. ~6R.T~N. I t-JC-. PHONE.!SZ -"".. I./'JZ
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
Main File
INSPECTOR ......, DATE
I FOOTING 1/1/;// I ') - t c.- OLj I
, FOUNDATION (Prior to Backfill) I ~/ f'M/ 1J.,.l{.()../ / ..?-,e~l
PLACE NO CONCRETE UNTIL ABO'VE HAS BEEN SIGN"ED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING IrvrJ . /'/-),7 - tJ4
HEATING (if required) //1,$ 5/(~()L1
FIREPLACE L1f/J Sv'I~tftl
GAS LINE AIR TEST tlvo/' s-- ('MIl \
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
1tI.[j ~
lt1Jt
5-1~-VV1
GRADING (Prior to SOddlng),.
BUILDING 1-e~, r~~~?
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
/o/:t"<tJj/
?4~(
.Yf4 //~f'
~ ~J,IG</"
UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prier 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 !~!SPECTlm'<:".-"?) 447-9850
Qltrtifiraft of Ql}r~pauq!
CITY OF PRIOR LAKE
~epadtttruf of ~uilMug Jlusprtfiou
IFinal Permitted D Conditional C.O. 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:
Use Classification
STNGLE FAM'TT.Y
Bldg. Permit No.
04-007[.
Occupancy Type
R1
Type Construction UN
Fire Zone
N/A
Zoning District
1>1
Legal Description
1,2'i. R J. nF.F.RFTF.T,n Q'fH
Owner of Building
Site Address
176.11 nFFlH"TFT_T\ WIH\TL--
Contractor's Name &Addresi)~H()1?'T'()1\I ?()P.
r..p r'T'
<:'TTT'T'l<' 1 00, T .6VPUTT...LE.-55044
nnt\! llVR
Date:
ROBERT n. HDT~HTNS
/ Builpng gfficial .
'//?'// /6.v'
/ ' I'
_ City Planner_
Date:
",,,.,
-
DATE TIME
CITY Of PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
_/ 7'-11 LDrXrC ell
PHONE NO.
PERMIT NO.
Dr.
D" t.. fll'l#vV'
()f.o074--
'l'1 EXIIallAii1l=ILLING
o COMlll:AfNT
o fiREPLACE RI
o fiREPLACE fiNAL
o GASLINE AIR TST
o
OWNER
CONlR.
o fOOTtNG
o FOUNDATION
o FRAMING
o INSULATION
C:l!t.fINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING ftNAL
o MECH FINAL
COMMENTS:
hrrYla../ 0 t..
'\( WORK SATISfACTORY, PROCEED
" CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL fOR REINSPECTION BEfORE COVERING
Inspector: ~ . Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY!
INS/'iOTI
DATE TIME
CITY OF PRIOR LAKE .-L. /
INSPECTION NOTICE SCHEDULED 'f'--ZV~
/79"// A+?~ra// d
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
....en'iNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
..,.JiP1\IECH FINAL
CO~~ENlS: / ~ /./1
~d-'~<r h~9 /Am.e-
//~~Ch." //7-..;/, CJ~
~C-et 'v~d t"5r<S<2 f- 'H& /-
~7~
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
,.l!f-fIREPLACE FINAL
o GAS LINE AIR TST
o
~:y
--- ~ .... ~ -
hke#/.,pc(: ~j.~-/ _a,
b4k~ cP ~/f,,;"j/"'/
@ ;;ed cJ~cI/r n-~eJ ~4~-
..Jill':;'/ ~/t2'dp C7#//d04/
. V '/
..... - /. - / /.
~/P?# ('"./0. Lk~/ 9A-J7'd
/ Y',
o WORK SATISFACTORY, PROCEED
'pORRECT 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.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE _ L;_ L /'
INSPECTION NOTICE SCHEDULED 7.P7"Y
ADDRESS / 7Y// de'p~4c /d .t:/.--
OWNER CONTR.
PHONE NO.
PERMIT NO.
/y.y:7JY
IJ FOOTING
IJ FOUNDATION
IJ FRAMING
IJ INSULATION
IJ FINAL
IJ SITE INSPECTION
IJ PLUMBING RI
IJ MECH RI
IJ WATER HOOKUP
~EWER HOOKUP
. UMBING FINAL
IJ MECH FINAL
IJ EXtGRADIFILLlNG
IJ COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
//&~o/;r~7~r
7;<,/ ~~
/" /
r /P-"'C:;- /
A"J/
G//c
kORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK',~~Lr;.~EINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH of SAFETY!
INSNO"