HomeMy WebLinkAboutBuilding Permit 01-0057
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MIE..flFr.FIVFn CITY OF PRIOR LAKE
j- /~-O/ BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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 ?)/ q q J.LI J:. e. I!:J uI-f' (IN V-e.
3. LEGAL DESCRIPTION
dl BLOCK I
tlbrMtVad frlks
1. DATE
/
1. White
2. Pink
3. Yellow
,
/-/0-0/
f?/~D
(Depth)
(Tel. No.)
12. NO. ~TORIES
13JIJe";; C/Jor;::.'ON
14. FLOOR AREA APPORTIONMENT USE
ADDITION
2/1d
PID z.&j,37/- oz.7-0
It ddi./-;Uh
4. OWNER Ji L ~Name) ~
{)/VI f .....;U(
15ARCHITE~>;anifJ $35 /))d91i~A;~)f)r (acttl/i 1~?-e'!f'.5)-01J4
6. BUILDER (Name) (liddreSS) V (Tel. No.)
(f/an/tI..j &00. ()11Sf.. 1CJr78A1t:5&Y\ ~/:I6H toS(-L/S\i-4~3;
. I SEATS
7. TYPE OF WOFiK Fireplace CI Septic 0 Deck CI Re-roofing 0 Porch 0
New constructiO~ Alterations 0 Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement)( 16. PlfJECT COSTN ALUE
Chimney 0 Misc. ~ I. (XJIJ
\8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 1'0. CULVERT SIZE 15D17. c~~~;5noJJ,DAr,,-r, j\~ I,
Sq.Ft.aO.()/ ~ Width Depth Yes No I-..l>>f. tnPn 1J71 L1.11C.
I hereby certi~ that I have furnished infonnation 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 ~n Jevoke this pEWDi! fo~ ~~se......Furthermore, I hereby agree that the city official or,_' designee may enter upon the property to pertorm 'leeded inspections.
X '-1'~r,.J r/~ ,}.m"'Jlf3;;l1 /-/(j-Ol
Signature I license No. Date
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT V ALUA TION 3cc.OOC'l.C'O PLOT PLAN 0
LOT
bttr+ly~AddreSS)
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
<,-r:f)
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A 8 E F HIM R S U
0""'00 1 2 3 4 L/5 ~5'
Permit Fee ................................... $ '::2.. .
. I) t/
Plan Check Fee ............................. $..l::'? 3. ~
1.~.tV
State Surcharge ..................... ........ $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
This
By
too. a;
/ tYJ .d'J
35.50
LlIJ . () D
J
Permit When ~e.rovec.h
Dete / -aI,;J. -~t:Jt'J I
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Issued
City:
~3\"OI
1--
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
A., c:;- ("). ~
~ I 60.0(")
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer .....%.~~............ :
Meter Horn ... .... ......... .... .... .... ....... $
Water Meter ................................. L_....1.';lfi. (;)0
Sewer & Water Connecllon Fee ........... $-1, ~f1 tl . ~
WaterTowerFee ........................... $ '700 <' 0
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid T~' ~~J;.:;........~~~~i~;~:~~~
Date 7-7-tll By
t
46.00
1.500.0d
t
/'1-
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
s~~.nner constitutes a temporary Celfi7te 0: Z]lning compliance).'d allows ~7!~;tion to c~mwence. ~~ore occupancy. ,a Certifica
..-- . 3(/b{ ~ i ~ Ull<<JIZ~ \C?.ov
City Planner Date Special Conditions ~ any
24 hour notice for all inspections (952) 447-9850
requested. This document when
of Occupancy must be issued.
~.J.A/Io:.
The eenle. of lhe L.ke Counl!')'
White . Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHEr.KII~T
NAME OF APPLICANT
APPLICATION RECEIVED
~ A N lEV Bl<.-oS -
I
I-(la-O\
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3 (CfQ LA~5 !SLUi="F CIt<..GL5
Accepted
Accepted With Corrections :x:
Denied
Reviewed By.
/
~
--
Date: J - ad. ~d
/:}~ts~o dt'(AcdJ ~ cn.--E
. . -
"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."
Thr <:~rnlrr of thr t....r COllntry
White - Building
Canary . Engineering
Pink - Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
f-U\~l.EU \~Ic.C~~
I
(-I((-GI
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-) I (/' () L 1--\ t.c:. ILL 1_ i. II (" L 1-
-. \......- --~ .- \ ;,- --- '-' '--'
Accepted
Denied
Accepted With Corrections ~
Reviewed By:
4t/IA f4-~~
Date:
I /s I/D/
Comments:
Zt-{r-r&1CJ(~jMiAM V0V1WM~h'A~ "r~
~M l~ ~~V v2!,tJ),l-J (l;; Uurb;
"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."
..
-;,..'
~.
~
U I - !:::, II
'the C..nl... of th.. L.k.. Count!')'
White - Building
Canary . Engineering
Pink - Planning
I
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
tvl/--\ N l/EV 6e..os.
I
l-I(U-OI
The Building, Engineering; and <Planning Departments have reviewed the building permit
application fo/ construction activity which is proposed at:
31 qq LAt:..c lSLU r:-F CI t2-ClE
V
Accepted
Accepted With Corrections
Denied
Reviewed By:
LII
Date: I ~ 2'1-0/
Comments:
See Reverse Side for Additional Information!
x
JJzv:- -: mf1j;;/::SI1&E.....-rD 0/?AP€ I{I) nR.)tI/JlJI}rm::. 5W/'/J = :W Borfl
SlOE LflT U/IJE.5/
See Attachments: 1:) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
. '
<>
"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."
02/07/01 WED 12:58 FAX 6128902753
STOCKER EXCAVATING
~001
...... - .......
TEU.OW. ~
GO\.D . ClT1
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. 0/- 0057
NOTE: Sewer and Water
contractors must
be re~istered
with the City.
APPLICANT:. DD Mechanic:al/St:oc:ker Exc:avat:ing
PHONE:
890-4241
2/ 5101
ADDRESS:
SIGNATURE:
SITE ADDRESS:
West 125th ,sr.)' s~
.'/~,
~~'ULDATE :
":t.1QQ--L.rlr... 'R1~.~": ('t..;-....:a..-
BLDG. PERMIT # 01- ()()$7
PID# 25-37/- 02.7- 0
FILL IN THE BLANKS
1. Estimated length of water service
feet..
2. Size of water service
inch(es) .
J. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC-x-- Cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
This
-----====~~_~_~~~====~~~_~~_==e=s_===:=====
s your permit
when approved.
2-7- 0/
DATE:
BY
~~=~_=~===~~= ==~====~==~=a===~~c~_=~==:=========~5~asa~____~~
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
~ ree for either seWer or water individually is $20.00 plus
$ .50 surchar<;Je.
~
Sewer and water permits issued for new construction must be
recorded on the buildin~ permit card at the time of issuance
to insure that no dUpl~cate sewer and water permits are
issued. "
DATE PAID
RECEIPT #
AMOUNT PAID
REC'D BY
16200 Eagle Creek; Av. S.E., Prior Lake. Minnesota 55372/ Ph. (612) 447-4230 1 FAX (612) 447-424.5
An EqUal Opponunhy Employer
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HEATING APPUCATlON / PERMIT
Datil ?vlq~()/ PID,25...37/- OZ-7....Q
SI. Addresa ;3 J q q cJ r, 1> O.~.. FeeSd1edu1e
Lat Zt BIock-LAcldftlon N'a Ooortt:::S tsm7ES 2J;f!i1lnduslrial,Commercial&MUIIi-Family
'::!l2 .a IJ Residential, Healing & AC
Ownefl Name CU'rI. J.1/. t'J nl).}) Residentia., Healing Only
tf Residential, Gas FIreplaCe
Residential, Additions & Alterations
Residential. AC Only
.--.-
CITY OF PRIOR LAKE MC
18200 Eagle Ci"eekAv. S.E. Pennft NO.
PrIor Lake, "'55372.
.......
1 Ore.
1Yo11ow
PiIc
a."
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tyPE OF STRUCTURE
01-0057
.J
I -
SlngIa Family
Commercial
Two-Family
Mull-Family
Industrial
Public
O1he,
Ie
F(vvm.l~dJ
1'" 01 job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Conn. Load
Fuel
Supply Openings
Retum Openings
I"put
Edr.
elm.
Remember to. add the Stale Surcharge on the bottom oflhis application.
Flue Size
~)
/1)
~/I
TYPE OF SVsraa
Warm N.r P1anls
Grllllity
. Machanlc;al
Air Condft/onillll
Vent System
HEATING OR POWER PLANT
. Steam
Hot Wal8r
Radialion
Splcial Dlvlces
The price 01 your heating permit Includes one rouiJIi.ln and one final inspec1ion.
Additional inspections wiI be blled at $35.00 8ach.
House Healing Test Record must be submifted with I!lll!IIng RmmillllllDllll: before build-
ing ce.rtirlcall 01 occupancy wiD be i8l!ued.
.!:!fAt CALCULATIONS REQUIRED will number 01 supply and return openings listed per
room with CFM's per opening. . New structures or additions SInd rOOr plan with supply
and reblm Iocallonsshown. HEAT LOSS CALCULATIOI'lS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CiTY OF PRIOR LAKE, 18200 EAGLE
CREEK AVE.. S.E. PRIOR LAKE, MN 55372..
City Hall businesS hours are 8 a.m. - 4:30 p,m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9150 .
Address
Telephone ..kti.J - J.jjJ{()-
FUfJr.'J1~&li~1 ~ 110 ~" 1\
MoCIaI SIze )D'J .0'10
/
Output
Other Dlvices
TYPE OF WORK
Replacement New Construction Y
Est Comp. Date ..
I hereby apply for a mechanical systems permit and I acknowledge that the
informalion above Is complate and accurate; that the work will be in conrormance
with the ordinances and codes of fhe city and wllh the slale building/meclianlcal
codes; that this form does not becoma a permit until signed by the BUILDING
OFFICIAL; that the work wPI be in accordance with the approved plan in the
case Dflall work which re~i).l~approval 01 Plan;_
lature -.... . ~
- 3-/q-() /
clle
A"ations
Repair
Est. Cost $
HEATING PERMT FEE $
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Buldillll P.rm~ t
01-0057
PA\O~
BU\\.D\tlG pEiUJltt'
.50
STATE SURCHARGE $
TOTAl PERMIT FEES $
Receipt t
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CITY OF PRIOR LAKE MC
16200 Eagle CreekAv. S.E. PelmilNo 0 J- 6057
Prior lake, MN 55372: .
HEATING APPUCAnON I PERMIT
Date .3/3.o/{'JJ . . PID. d.5"--;;;jr;(~ ()d.1-()
, , ,tl.
S~e Addless ..3Iqq,;t'~ ~ f1,y."A
Lol 2!l Block I . A~;nion '7J JfrJt {l17(.H (/~.:;2;d.
Owner's t~ame rnn~u1J ~A-fj.~J
Addr.ss
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Healing Conltaclol A.LL lED F IRESlOE dba FIRESIDE CORNER
Address 2.700 N. FA.IRVIEW, ROSEVILLE. MN 55113
relephone' 651-633-2.561
FIREPLACE 1/.
~ Maka & Model ,1JUB,(.jJ c.Co
t.!Y>>OL
Model Size.
TYPE OF 5YStQt
Warm Air Planls
Gravity .
Mechanical
AIr Conditioning
Vent. Syslem
HEATING OR POWER PlANT
Sleam
Hot Waler
RadIation
Spedal Device.
Goon. wad
Fuel~
Flue Si2.&
~
'"
'"
'"
S ""ply Openings
Helurn Openings
Input
Ed.,
Othsr Devices
Oulput .;)7.DfJO
""
""
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Clm"
rl
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TYPE OFWORK
~
a
AIle rali<ms
Aepla='101 Ne., Conslruclion
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Rop.ir
E.t. Comp. Oala
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N
Es\. ('.osl $ 11M I)",
HEATING PERMiT FEE S
STATE SURCHARGE .
TOTAL PERMIT FEES $
Receip. #
. Iluiding Permit .
a
""
PAID WITH
BUILDING ....","..,,'
.50
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1. Gn..
J. \"ellQll/"
Fite
CIl,
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TYPE OF STRUCTURE
Single Family
Two.Famlly
IndllSlfiBI
Commercial,
F... Schedule
IndUSlrial, CDIIlman:lal & Mulli-Famlly
Residenlia~ HeaOng &. AC
Residenlial. HeaOng Only
Residenlial, Gas Rreplace
Re.-1denlial, AddKions & A1tere.tions
Residenlial. AC Only
Public
Mulli-Hunlly
Other
I % of lob cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember 10 add lhe Slate Sureh..g. on Ihe bollom 01 Ihis eppIication.
The price 01 your healing p&rmIllncludes one rough-in lInd one Ilnallnsp1!C\ion.
Additional Inspections wftl ~ billed a\ $35.00 eeell.
Housa Healing Tesl Record must be submIlled wilh.lll!il!!ing Ile!miIlIIlD!Il billo.. build.
ing cellilicale 01 occupancy wiU be issued.
tIf& CA.LCUI Alln~ REOUIRED wilh """,ber of supply end.1IIum openings lisled ""
room with CFM's per opening. Now sltuctures or additions send 11ao. plan with supply
and relurn locations shown. HEAT lOSS CAlGIJI.ATIONS, PAYMENT AND
APPLICATIONS MAY BE MAIlED TO THE CITY OF PRIOR lAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. MN 55372-
CUy Hall businesS hours alft II a.m. .4:3ll p,m.
,
ALL WORK MUST DE INSPECTED (ROUGH-IN AND FINAL) . CAlL CfTY KAlL
441-4130
I hereby apply for a mechanical systems permil and.1 acknowledge thallhe
1-nlormaUon above is complete And acwfafe; 'hal 'he work will be in conformance
wilh Ihe OIdinan"". and codes or the city and wllh Ihe slala bulldinglmewanlcel
codas; Ihallhis lorm does nol bacome a perrnll unlit signed by Iha BUILDING
OFFICIAl,,; Ihat Ihe work will be In 9."""rdrmce wilh Ih.. approved plan in Ills
case ol~1 work 1V~,.reqUlre. review and QPprovaJ 01 plans.
-" -~ ~ ..J/NoI
7 )\l?plicanl's Siynature . , Oala
(k C/~d--I
I:j()il'ding onicars SigrYllw9. Dais
PRIOR LAKE
INSPECTION RECORD
~ 7<J urr () r.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ..s I '7 '7
NATURE OF WORK N.e.w
USE OF BUILDING 5r-:Jj
PERMIT NO. 0 1- (J()5~ D~TE ISSJJED I - ~2' 200 I
CONTRACTOR Ha.V\I~~ \1$k"l~, ~ r PHONE G.s"1-qSl/-~">3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I ~,J~:OR I Q ~r;~
I FOUNDATION (Prior to Backfill) I fte ~ ~aJ()~ I+~ U ~b\ lodb~
PLACE NO CONCRETE UNTil ABOVE HAS BEEN SIG'NED
ROUGH - INS
13.J~
~~
"1..1)r..w \
\
'6 \)~ -{ JJtlJo~
HEATING (if required) 16'B~ 1 4, :<"\01
FIREPLACE ~. A /"b 01
GAS LINE AIR TEST ~~;\ ~ . 4- h DI
COVER NO WORK UNTIL ABOVE ~AS BEEN SIGNED
I I
FINALS
A!/5
'R0~
-g0~ ~/nlol
1.\J~ fI)t7}o/
HAS B~EN 'SIGNED
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
GRADING (Prior to Sodding)
BUILDING-r:c..O. -t.,1.Q lok;/ol
ELECTRICAL
PLUMBING
HEATING
DO NOT
OCCUpy UNTIL ABOVE
NOTICE
'(}... 51' I Cil
4- Olo)or
~;!v;
tJ'. 2 ~.I) '^A,l
P>/t? Je), t u~: p
, .
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 a"d 9:QO A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J(qq
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED (O-(O
LoL. 8( () rr &
CONTR.
PERMIT NO. o I-OOS7
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~d /T/'~c 's
.
.- ~
UOSe t-; Le
o EXlGRAOIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
fir' )
\- . //
'--~
I!' WORK SATISFACTORY, PROCEED
o CORRECT ACTION ANO PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: AF to iO-Ol- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
'i'/!7/a, 9:30
ADDRESS 3/9 tj Ll/4; BluR=' CIa..,
OWNER CONTR.
PHONE NO. PERMIT NO. ()I - 5'7
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
f) o INSULATION ~EWER HOOKUP o FIREPLACE FINAL
~ FINAL PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION fiO MECH FINAL 0
COMMENTS:
J~~(
-tkP.lA
~txl ~ it fA;, ,()~ ~Al clMlJ1Af'AA-t- ~
1I - ,
1&1aY\O.Jt1Aekc/)~' {~t'~ ~to.a.k.eL
~RK SATISFACTORY, PROCEED
o CORRECT ACTl]N AND PROCEED
o CORRECT WOR ,CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ VitA.IJ Owner/Contr:
CALL 447-9850 FOR/THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTt
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 9-;t-o( PlY}
ADDRESS 319 ~ Le, /(t Bluff- L./ 'r-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)(FINAL
o SITE INSPECTION
COMMENTS:
teAt"
/)rr~ f} r1..(
, L
CONTR.
/f?c'T1/~ y t3ms.
01 ~r;; 7
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
K EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
[..,",,,,,,~.,-,c1 $oJ f5)V\. l1e/",/iibJ".""
v ./
o WORK SATISFACTORY, PROCEED
X CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:.#~ ( ~.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
::. .vner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSlVOTJ