HomeMy WebLinkAboutBuilding Permit 03-1463
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
Date Rec 'd
10 .Z-1. 05
1, While
2 Pink
3. Yellow
File
City
Applicant
I PERMIT NO. OJ-It.f~3
(Please ~e or orint and silm at bottom)
ADDRESS
/.5 35'/ kl-f'ae5: fk S-S.
ZONING (office use)
12-(
LEGAL DESCRIPTION (office use only)
LOT,;?VBLOCK -2 ADDITION R t"Q.aA eV l's-l-
(j
PID Z. r. s8fc ,cA--f.. C
OWNER
(Name)
(Phone)
(Address)
BUILDER,rl II /I
(Name)---L)) lIef e L, 'h-,
(Contact Name) !;rlr! -' r--J
(Address) 7'/;2D La/(f>tJ./(e
/IOm1!"6
Blud,
(Phone) f5.2-~4,,9- ~7CJQ
(Phone)fi,/,.2.~..fS' - 3.<tJ 9
LaK'f'cJ .// e IrvJ 55tJVQ
I TYPE OF WORK
It New Construction
DLower Level Finish
DDeck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
DAlteration
DUtility Conn~tion
o Misc.
PROJECT COST IV ALUE (excluding land) $
..2"3 7 r /6'
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
exnter uP9"Jl'J~rty to ~ef=,n:d:d ;n~ections
IJ~ fiv~ /02cJ'T /tJ -.;2/cOJ~
{/ Signature Contractor's License No. Date "1
I Permit Valuation {fd?3S.ooo. Oil I Park Support Fee # $ I
I Permit Fee $ /r;t6.~5 I SAC # $ 12-7<:; .00 I
I Plan Check Fee $ Ii '-JR. Z& I Water Meter <fz"e5~ 1"; $ Z-5tJ{ 00 I
I State Surcharge $ 1/"1.00 I Pressure Reducer $ Lf.'S .00 ,.1
I Penalty $ 1 City SAC and WAC # $ l2..Ca ,-CV I
I Plumbing Permit Fee $ 100.00 I Water Tower Fee # $ ;00, 00 I
\ Mechanical Permit Fee $ (00.00 I Builder's Deposit $ I
I Sewer & Water Permit Fee $ 35,5'0 I Other r~ $ I
I Gas Fireplace Permit Fee $ "1tJ,OO I TOTAL DUE $~. 719.3 I I
This Application Becomes Yow Building Permit When Approved Paid t.; 77~ :r I I ~~ceiP~ 4''' rJt:- /
~ ~ /O/?-h"./aJ Date /1. c. .<n
!
Building Official Date
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
~~::(~ /(J/2-8/07 SeeMaID FUp
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
/'
See Main File
White . Building
c ~::I~arv - cnQln~!~
Pink - Planning
Th.. (...nIP. nr lllp I..kr <-'Ollnlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(~c.'G(Eqs CI1\/
I
/(). 2( CD
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ S3 S / \..77:;;::';-:-Ck..':5 PI-iS.S
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
m9-8
~p
Date: h..... 30-03
Comments:
rY1 fA /Y'
~/(~
"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."
s~\
See Main File
<:1lb;te - BuildinQ)
Canary - Engineering
Pink - Planning
-
Tll.. C..nl..r nf th.. I...... Countr,.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
toU.-6Gtb ~/ 7lI
, /
10. '2-/. a3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
/530/
/
VEFr:6~S PASS
Accepted With Corrections
Denied
Reviewed By:
-~
-f~ !--
Date:
loj~;:7
Comments:
SeeMain-Eile
"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."
~~
ue~
See Main File
White - Building
Canary - E:ngineering
C...mK ~ - ..,an"'"9)
Th~ Cpnln of Ihp 1.akt ('ounll"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(L U':: C) !-., C I IV
I
/0, Z/. (,,3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/~~,~~ /jE.J~-r-r:I.....'::; l./-1~
Accepted
,/
Accepted With Corrections
t
Denied
.
.
I
Reviewed By:
~-7~
Date:
/0/'1-6 /a '7
I
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."
No v' [ 0 .
,!~~
i,\\:~\,~", .""'''''ESO''it-
\;:~~'::;>~;()
,,:';,G",,~''''
~w~,l,
2003 6: I 3PM
GENZ RVAN PLUMBING AND HEATING
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONlNG/FIREPLACE PERMIT :.
".,r
No,9708
P [2 [3
Date Reed
. -
A",'
l.Pinl:
2, "-
,. Y,IJow
<
~ ""'>:.... l
--!~.':~i; !J''''
~: I PER.M:{TNOC~ A---/d I.h ~
ApplicW ~ ' ""-~5~; J ,:/lp' v
.... :~
,.,
Cfl~ase ~ or orjl)t and si~ at bottOD11
ADDRESS
1~15 I i. Je+-fel?~
11?~
ZONING (o!lie':';') ,:
, ,
LEGAL DESCRJl'TION (office we only)
LOTlJj BLOC:!;: J.. ADDITION
r2.M a1 CIQgS+-
J
~~e~R rim (lift fil.1A l-trrrYi!J. I Y) ('.
(Address) 14 W I aJt:.oj ill p/ j11~d" LJ JLt III! t
- '.
~~~T (1fYll- ff u a 111 !
(Address) ) Lj 145 j, 'f&; 0r rd-ftd
f'I t . f"'ddm,) ,
(Contact Person) ~~liIKJ&h ~t1 s
r J J.5:4B ~f 1/\
PID
(phone)
qt1'J-- 4I1Q-(ct!W
09J1-fr.-f
thY!
I
(Phone) (6/-48-3- (IL/L/
1eDVJr1,(ilJvII1;f . r}1 n ~ZJkf/5
(City) , (Zip Code)
(phone) (tiS I - L/ ;;}-i3- I ( L/CJ
!I-J{)-().~
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
"'"
. ~W CONS1RUCTION . J~J REPLACE1YlENT 0 ALTERATIONS ,
FURNACEMAKEANDMODEL Ib1)1fJY 6..l!Lf)}~-'76 FUEL Y!J9T-6~
FLUE SIZE RETURN OP~GS ' .f INPUT 7<::;, eRr) OUTPUT ~q (J1}{)
TYPE OF SYSTEM KEATING OR POWER PLANT
~ann AIr Plmts 0 Ste2ll1l
-QGravity 0 Hat W:uor
o Mech.mcal 0 RMiation
,~IT Conditiomng 0 Special Devices
DV<Ilt, Sy,t<m 0 .other DCYlce'
PLEASE NOTE;
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setback'
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industn,.], CommereJal & Multl-Fanllly I % of Job eo,t Residential, Gas Fireplace
$3950 rnlll;rnulll
Resldennal, Ho.iJng &. AlC (New COnSlrUttlOn) $9950 Res,dential, Addition' & Alterations
Residential. Heating Only (New Construction) $6450 Residential, AC Only
$3950
Estimated COst $ Buildmg Permit #
$39 50
~fYW;n,'
'iNG:>ERMIT
:1.
HEATING PERN.aT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
-e UStOnly)
Building Official
i~4, '-;~-,c, ~I-"ejpt No
!Rf~ NQV 1 2 2003 ,.4'" if
24 hour notice for ,II inspection' (952) 44'.9Sk,fax (9S~) 447-4245 I V
~-_.,. _._-=--=:==---------.~---I
D...
..is ApplicatioD 'Becomes Your Building Permit When Approved
2003 6 1 2PM
GENZ RVAN PLUMBING AND HEATING
No 9708 P 8 i3
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERlVllT _.\
"'(1'
r
.~
'f
;:;~?;j/j
! ~jL E~"...t I PERMI'f.l'i~..v25 -/~ tt 3
ZONlNG (O~""u..,)..
11'1easc: ~~ or print and sW:J at boaom)
ADDRESS
'6~Y) 1 ,,-~€-f-fJlKlc\ ~S
-~-"'l
Pill
(Address)
(phone) q C) ~,4 (i1- &::Cf 00
t11 n qx;JeF
APPLIC.ANT i},PiI\:' _ II) 'I i'A /"
(Name) r." L' t'. r<-1A ./LU.f I /
,- I
(Address) IYlLis ,S;. ~()bcl0f T~.
(Address)
(Contact Person) 0JI1 ~ J ~tJ tttr (1
. "'?UCANT SIGNATURE r ~ '-4rJv.luJ
(phone) 1i0/- 42-3- I/~L.I
J4JUVYltTlAyb!, m VI '-JS,L;(f::/g
(City) (Zip Code)
(phone) (tPJ f ~ Ll2.-3-1 j Y l{
l( I/ol~
DATE
Quantity
f)
(
I
z./
;
I
(
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture I Quantity I
Bath Tub with or witbout shower I I Rough-ins
I Dishwasher I Water Heater
Floor Drain t2T Water Softner
Lavatory (l3atbroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (l or 2 compartment sink Sewage Ejector
Shower Stall BackflQw Assembly
I Sipks I BacJd]ow Assembly Test
'I Bar Sink I La"'1J Sprinkler
Water Closet (Toilet) I Oth.er
Type of Fixture
I
I
I
I
I
I
I
I
I
\.::(
FEE SCHEDULE
lnduStTlaJ, Commercial &. MuJl1.f3111l1y 1% of Job cost with a $3950 minimum ReSldennal. New On. & Two-FamIly $99 SO
Resjdential, Additions & AJtetatioos $39 SO
Estimated COSt $
BUlldmg permIt #
PL~llfGPERNITTFEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
-
.50
. . PAID,Ah .
t1U11...i)IN O",n-,
G ,':;'1::,..,..
.ry,,,,IT
'Office: U~t Only)
....
'Building OUieisl
,/ ~Ceipt No
,lay
if. ,!
Lj,
24 hour notic_ for oil Inspections (952) 447-~, fa" (952) 447.4245 I
-----. - ----,c:c=c;J
Dau
f Paul
l~teNoV I 2 2003
I
vr---I
[)
~"is AppUc2tion Became. Your Building Permit When Approved
. _ _ . n. . _ ,,'"' '^.' II. ......,......"
,-" . I vI [(,~,...n .....'\1\1;.
~VV.
~
I~~~
/: <.,.
,- ~
,'-' '"
~'I<('/f"O~~
Date Rec'd
CITY OF' PRlOR LAKE
SEWER AND WATER PERMIT
r1'1<a..n rroe or orint.md ,.it.o it bocrom)
i ADDRESS
! /5') 5" {
p~
.---c-
~~~
II v
! LEGAL DESCR.lP110N (otll<<"Ie only)
I LOT;;).~ BLOCK ~ ADDITION
,
~ -e ,Ci cJL
~
i OWNER
, (Name)
~QL ~ \\~
79).0 i~~ ~(U,g
(Add,....)
: (MdleS')
I
, APPLlCAN+---.
(Nam'\ .lSc. r\'1.'A_ ;:- XC u u~
(Address) '6~7S' W (efT'^.. S-ty~
(Add,....)
(Conta", Pwon) S ~.lct s: ( "'<::/]A,
APPLICANTSrONATVRE_ ~<-!.h -d<.~
(
; ~=" ~:~ I PERMIT NOg.. /f~/ .3 I
,. 0GI4 A.p,l1OW -, !pI.....
-..--..,
ZON!J'lG (ollie. "'I ,
I
I
PID
(PhOl1e)
L cJ::..e ~
(City)
q S' }.- '-fie y-? 900
,fl\;J ~ '::,oYi{
(Zip Co..)
(Phone) 5D7-(YY'~ .s~~,--~
L~" cJJp .s-WYc:..
(City) (ZlpCo<l<)
(phone) ~C)7- {YC(- So -.s<;; S......,
ElATE ~:::- '-(-03
APPLICANT PLEASE COMPLETE BELOW
Size of water service I inches.
Location of any couplings from structure ~
Type of sewer pipe. 0 ABC [2!PVC
Estimated length of sewer line _@feet.
Clean out (if required) located at _ feet from structure,
feet.
o Cast Iron
FEE SCHEDULE
R"idential..wer and wiler JiM COMeOllon $lUO Industrial, Com'[ &. Mvlti.family 1% of job cost with. $J9.l0 minimum
Stwer connection only $17.50 Wit" connection only $17.50
Estimated COSt S
Bulldiog Permit N. ,...
SEWER AND WATER PERMlT FEE
STATB SURCHARGE
TOTAL PERMIT FEE
{omett't Onl)')
\'
Tills Applleltion Become. Yo"r Bulldlnl Permit When Apprond
Bulldill;OmClt.1
Date
$
$
$
P.41D IA_ ,
I::$UILD!NG";;' Ii
. .rERMrr
.'50
I. ,P,!jd:j
I
1.;l2;' ~~ I [':lttceipt No.
, '
I
r
" !! i.DIUOV 1 2 Z003 iI 1"-
U~ Nil,;
24 hour notleo ror IlIlnsptclion. (95%) H~ 'J,850, rn (~2) 4'7~145
0'/ nmn__
;
,/ "
Nov.10.2003 611PM ,. GENZ RVAN PLUMBING AND HEATING
N0.9708 P. 4/13 '
CITY OF PRIOR LAKE
SEWER AND WATER PERJ.\fiT
,
, -;.t
~q'
Date Rec'd
tfo
.?'-.
.;
~ '
j_.:4i',~7
--~"':l
~';"l ..
'--<:;',.-9 .-
I Green Pi,Jc: _:<
:. y.~w c"," I PERMIT NO. "J_{LI' :)
,>. Cold AppbC<,Ult _ ~ Ct>
Il'll!a.so=: !7<P~ or nnnt ;:md sil7.ll at bottom)
ADDRESS
163m ~ le#.eTZ-J f:o.s6
ZONlNG (ofOe< u~~: I
LEGAL DESCRll'TION (ollieo we only)
LOT ZJ/ BLOCK t ADDITION
VJ 1101 ~tV(\+-
1
PID
OWNE.RC I L~A' r . . I
(J'.'ame) D, l'Cb1e. .d1j H1JYV\es" I VlO . , (phone) qC:;Z-L4(cq- (aCJDD
(Address) "F12D Lake-Vi!/{, 'Blvd, I UJJu~J\fi11{; if}1V1 - C:)<:'D4l{
(AddI=) (Ciwj (Zip Cod,)
APPLICANT I?. - III - I r l/ {
(Name) cflVlL - ~::JA tLYL (phone) L.P0/- <-..(2...'3 -II U
. . J
(Address) ILiILlS' S. lI'ffl Yulct lid., k!tJUYVJIJ)),rll V'fln ~t-Xf18
(Addtes') . (City) (lip Cod,)
(C:pDtactP~on) m~l(\t1 ~ / IS - (phone) .1 ,01 ;,I~r 1'-IcJ
.. 'LICANTSIGNATURE 0--< ~j-;} M fc/'1 DATE ' (fh
'"
.....D'.
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
FEE SCHEDULE
ResIdentIal sewer and water line connectIon $35.50 Industrial, Com'1 & MuJti-faJmly 1% of job cOst WIth a $39.50 mfnunum
,ewer connection only $1750 Water connection C>Illy $17.50
Estimated Cost $
Building Penlllt #
SEWER AND W ATE.R PER.lVIIT FEE
STATE SURCHARGE
TOTAL PERl)fiT FEE
$
.$
$
.50
K).. PAID WITH
.--lJtLD!NG ';:)::'~~"T
Receipt No.
Office Use Only)
Th.. Application Decom.. Your Building Permit When Approved : ~-l ~~Id ...,. ;' .
I Date
Building Offici.l Dolo tlI0V 1 'l 7003 i.,
.. Ojl
24 bOUT notice rOT .11 i"pe<!lonS (952) 417:~8So, fax (9~2);47-'12:5::..::...J
,------
By
~
o
.,
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2. Green
J. Yellow
~::, I PERMIT No.^2 ,,AL....
Applicant ~
(Please type or print and sign at bottom)
ADDRESS
15351 JEFFERS PASS
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name COLLEGE CITY HOMES
(Phone)
(Address)
APPLICANT
(Name) AT J.TFD FIR ESTDE DRA FTRFSTDF HRA RTH & HOME
(Phone)
651-6:13-2561
(Address)
_2700 NORTH FAIRVIEW AVENUE
(Address)
(Contact Person)
BRENDA HUSTON
ROSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
. APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/13/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEA TN GLO R-CORNER AND 6000TR
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 #
$
$
$
rAID WITH
i3,WLDING PERMIT
(Office Use Only)
Buildine: Official
Date
I Paid
OI}teI4,04
I Receipt No.
I By
This Application Becomes Your Building Permit When Approved
24 hour uotice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS '~35{ JEr... 1Q.4S. PAs.$'
NATURE OF WORK ~~ . ~
USE OF BUILDING - S,f:':A..
PERMIT NO. m-/4b3 DATE ISSUED
CONTRACTOR ~trv ~CMD- PHONE tJ'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT {.IZ - (,&0- ~5"y.e,
INSPECTOR J-...
DEPARTMENT OF See Main File
BUILDING AND INSPECTION
OATE
, FOOTING
, FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I
SEWER I WATER I SEPTIC
FRAMING
INSULATION ~/I4V.l-').<'
ELECTRICAL
PLUMBING U,c,.6'O J-~ /p 1-2/
HEATING (if required) 1m J' a
FIREPLACE ~'?..,J,LJ fJ.--?-.-
GAS LINE AIR TEST (/ pI;:;' -j. 6Y
-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I
FINALS
-
Vi)
,
~J...-. 'Z-Il'f. ~
2'')..-0l.f
/7 ~ L
'.~~\~~,f
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING f' b 11-/<;;;-
HEATING
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.
FOR ALL INSPECTIONS (952) 447-9850
QIrrfifiratr of @rrnpanru
CITY OF PRIOR LAKE
@.tparfttteuf of ~uilMug JIuspediou
gFinal Permitted D Conditional CO. 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.PennitNo.. 03-1463
Occupancy lYpe
R3
Type Construction
VN
FrreZone N/A
Zoning District _ R 1
Legal Description
1.24. B2, REGAL CREST
ROBERT D. HUTCHIN~ /
/ / Building Official 1./
I " ( .' c:- Date:
I POST IN CONSPICUOUS PLACE
Site Address 15351 JEFFERS PASS
COLLEGE J':1'JIY)HOMES, 7920 LAKEVILLE BLVD., LAKF-VTJ.Tl' <;<;n44
V>
City Planner
DON RYE
Owner of Building
Contractor's Name & Address
Date:
I
J
DATE nME
CITY OF PRIOR LAKE I I. 7:'_~
INSPECTION NOTICE SCHEDULED ~
ADDRESS /.';;'?~ / ~ \fi~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3-1t../~.\
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
X 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 Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
ok ~ c~[;(-e
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRfJ!:RK' CALL FOR REINSPECTlON BEFORE COVERING
lnspeetol Owner/Contr:
CA, 147-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY/
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TillE
SCHEDULED
11-15"-0<(
ADDRESS -1.5.3/,/ Lfths
OWNER
CONTR.
PHONE NO.
PERMIT NO.
.'( - /(J{" '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
~PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRE"~ALL FOR RElNSPECTION BEFORE COVERING
Inspector: <f / Owner/Contr:
CALL'LS50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY/
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JobAddress/:1.l>1 .:s,.t:k-<.
Heating Contractor 6,.....It. - R.... co
....,
Name of Tester ':S~ Q
Date /:1/1/(;1 ~
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1J;O
1':<0 tI
Percent O2
Percent CO
Percent C02
Stack Temp
Combustion air is adequately supplied per
UMC Sec. 606
Input