HomeMy WebLinkAboutBuilding Permit 01-0155
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
. ~
(Please n:o~ or onnt and siJUl at bottom)
ADDRESS
li?J'?:JS
6u () ro... y ~ i re,I e,
I. White
2 Pink
J Yellow
rile
City
Applicant
LEGAL DESCRIPTION (office use only)
LOT4-BLOCK k-ADDITION lfla:rlvleuJ
OWNER
(Name)
m w uCn()~n
\ 7h4o "'Jun{ peV
W-='eJ hnSo (j
(Address)
BUILDER I J
(Name) JVl
(Address)
TYPE OF WORK )i!i(New Construction
DLower Level Finish
DDeck
D Fireplace
DMisc.
Date Rec'd
12-1~.OO
NO. 0/-0/551
ZONING (office use)
1<.2.5D
B3-l-Q ieS PID 2S -2.30- (J 11,,- ()
(Phone)Q'5 ~ ~qd. -,7.;)0
~\ 1-) LnKJLU; {/('_
(Phone)
Dporch
DRe-Roofing
DRe-Siding
DAddition DAlteration DUtility Connection
PROJECT COST IV ALUE (excluding land) $ Bo, 00(')
":l..'";;).C5!
Contractor's License No.
Park Support Fee
SAC
#
#
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 wilt 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
enter upon the property to perform needed inspections.
x~~CL'Ul OJ.A/
Signature A
Permit Fee $ 85Rf
Plan Check Fee $ 55 . 'Ii
I State Surcharge $ I..fO.OO I
I Pendlty $ I
I Plumbing Permit Fee $ I t)() . 0 CJ
I Mechanical Permit Fee $ I fY). (Jf)
Sewer & Water Permit Fee $ -
3s-.SQ
Gas Fireplace Permit Fee $
T~JJtiomes Yr Budding PennIt When Approved
~~ ~k- J~-~(Q-~
BuddmgC5fficlal ~ Date
~
Water Meter ~ze S!JJ";
Pressure Reducer
1'"
,
1'd//5/D(j
I Datl
$ A~~
$ I l So. l?0]
$ 4!).tJQ
$ t U.oo
$ " ~I'J~.M
$ ~()(J.oo I
$ '; ,5"1')') oa
$
$"7, ZSt/-; 19
/
I ~~c~-vt-
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
i'~U. ~
~../..".
or- ~
- Planning Director
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
lather
I TOTAL DUE
Paid ?z.54--,Jq
Date
-o/qL~' ~- ~;e~~~~'
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
612-452-0367
(TUE) 02.20' 01 17:42/8T. 17:41/NO. 3561851084 P
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: M/cfn'2,::A. II!~~
A~dress: --L-1-S:" .yr~ An
Signature; ~~ -
Legal Oe.<:rip"on: Lot Block
Site Address; '" J J';- or u,./IIfAJ/ I!!:4A
Building Permit' D 1- 0/55 PIO It
NOTE: This permit will not be proces.ed without <:omple19 information.
1'IIr C."'n' ., ... t..b C..II.'"
FIXTURE UNITS
I
I quantity Type of Fildure Quantity
I I Bath Tub with or without shower J
I I Dishwasher I
I , Roor Drain
I I Lavatory (bathroom sink)
I I Laundry Tray (1 or 2 oompartment sink)
Shower Slall
I Sinks
Bar Sink
/ Water Closel (toilet)
FEE SCHE:OUL.E
"
Industrial, Commercial & Mulli'Family
(1% of job cost. $39.50 minimum)
Aesidentlal, New One & Two Family
Resloential, Addllions & Alterations
Stale Suroharge
$99.50
S39,50
GRAND TOTAL.
I. .1.
%- ClaW
,.V_
PlIo
Cl.,.
^"u_ I
PPN", 01- 0155
Phon..: &6"/ . JJ-U. ./.r~
Sub
Type of Fixture
Rough-Ins
Waler Healer
Water Softner
Sland Pipe (washing machine)
Sewage EjeCtor
Elaclcllow ....embly (RPl, Double Ch~ PVS)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
S
S ,50
$ ~~~~'tRi~.rr
TIus permil IS granled upon (he upreis condinon th..[ ,.id
c:onu,:u::ror, shall comply in :111 r'Qpec15 \lri:m the ordinances
nf[h. Sial. Plumblnr Code iItld ",.'~men+l/liRlS.hi-cl!\lOI
~ RECEJr- NO." OI\'Th
1:</.' , .. ,'. {. AlnST
Call fllfalrinspedttlnf 24,hoiHSiIhd>oancc.
16200 Eagle Creek Av. S.E.. Prior Lake, MinnesotaS5372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
FROM : SABER Heating and A/C
PHONE NO. 6124738565
5ep. 27 2001 12:29PM P4
ern OF PRIOR LAKE '
BEATING/AIR CONDmONINGIF'IREPLACE PERMIT
I
Date ""d
lJ'II!!.."'lIf .....1', !lP .. ""-l
,ADD~' .
/7335 ~/m-I CuJch ,..pfU~ ~
."
i=. S.....lpERMlTNO' {-/55' ,
I I z..E;~-1
UGAL DilSQUI' rION (- _llIlln r . :b
LOT L/ BLOdJ.;J! A..........,.l/;)iJa! i))OWr~ ~-d~ -()/(,
, '
OWNBll '
(Name) vnU/;~rtc7crr.v , . . . lPlloMl CJ5.:?/81.:?-5.:?tJO
CAdd:caa) /7~ '1-? c)~ '-ParJu4FIOO; L/;,j(R. vd/.; .
~,~ 'II~~q t A:k tpbau) 7~2/'113-~:<b 7
(AIIda:lislJ!i50.5--,7/) 6J:; aJ.J(- N,4fjqlij ...{JtJ!.-u'YJ~ '-1i7/V .55.i.f"l,
. ~I . . ,~). (j (CIIy) (2If (lode)
(~Pmt>rl.j,:-~1ojH 7iU{M,~ lPboJIe) "f(,.:3/'1-73-:<:?(p7
APPL1c:ANT~'l:NATU1lB V}d Cfj*,~f'__ _=- DATE <J-.f?7-0/'
; APPUCANT PLEASE COMPLETJ. BELOW
.. I ~wc..""'...JCTIC!N OIUlPLACDIBNt OALlDAnONS
F\OOIlACIMA}Il"fDMOIa ~ MIilJ70 _ fUfTJ. Y"}o} 1ia.a
fLUE SIZS '~ ' RBTlJN{ OPi)lDlos.if IMPU1' "70, tJO{} OIJl1'UT 5c.. O(j()
. ,
ImA.11NGOJlIOWD-PLANT
3~~
3 SpIooiIl Dw_
.J 060r Pova.
TYPE OF ~~., .....1
..,..... Air P\udI
, ClmI\W
i -......,
, It CDndilloAIIII
tl\t.~
~KOD!
.wec.,,;;.,. t1niII
c-."".."j"iInJo,
.....1ilM 1r_
S~ ;lCf
l'lJlEPi.ACB hi .n ~ MOnlll.:
""--
,
la4uaiol. Cetnri ..ialA M111U-l'onallY
JIBE ...-:I.~''''.&
\"''''Jc>ll_ ~ol.ClooPl"""
S39.5O...,-
1laId..1ial. HIlII ...,t: Ale 0'1'" ~OII) nUll
ICeoidondal. Hor!- .. Only (New ~ S6oI-'O
EoIi_CoatS 4/;;.50. M
.~ Mdhl- 01: AltonIIiaaa
~AeOldy
, 519.50
SiUO
S39.50
Bullil..~ II
ImATlNOPEJQ.UTFR S
STATBSuacKA:lG2 S .5q
TOTAL PDM1T lEE Ii
r--
IS" P4/D .
vlLOlly l1JT'-,
G r-'.-
(om.. lilt Old:!:
Tilt. Appll' IIIOIIIIcc:ell\eo YOIIr ..iId", P_it Wh."'"., .. I
I
I
aoq. loll QIIkI.. 11_
i'OI"'Cj
lJtIe r~cfr /' i
-.0"'..
,. bolW _.... au ....... \'52) M'".., ru (lI5Z) "7043"
By~
U
-------- - - ~ ~- -
,-.-.. ~_.._._----_._----
FROM WENZEL MECHANICAL 612-452-0367
(MON) 11. 05'01 11:39jST.ll:35/NO.3561851656 P 6
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_~t./::.,.",.,. .... 1159 -Sh/{"IIVW 'Es:L 551"-~ p~_.~.r:'~:"'\,,;.', ':",:".:'";,,,~ ....
:i.'...':' "., s.tGl;Ji'\.'I'OR~: f/ /.l . ';,.",,,",_ _ SLPG~ ...~'J! 'If . .
~~C'F"'"'' " . / /"73"?-r:; .:\' ., " ,..-V........
,'.', .:' :"S.~'I'r:: .AIilDRESS: . / l~:"; <",,-I,ZA-f ,.."C_ ~IC# Jl5-j:3G1"6"t:{;;-~",J"
~"'1:"':".' .. . ,..."
.. , . ' ;. ....,.' "\..:: ,.\<...;,:.: .'
:', ~,:,~','-.-:,:. >:.~. FILL IN THE BLANKS -. ,,: '::"'~"":'~'. .~
~r:t;'.':' ~;:,E~:':.i'lllatad length of ....ater se:rvice feet-.;.. . .,,"<';':;j;;ifIJ.JIiJ!
~""f" f~" . J.~' " ;1' ' 'I >.,"." (~;,,:,.:...:':~
. ~i:.' ...2~:'$ize.qf water s...:vice inch(e:sl'. :.' .:;:::.:~/:~:- ';~>i'>":,'
: L " :,' __, .3.;,': .-Location of any couplings from struc::~ure f-ee~,: .;' :,/: ."., ,,:.,,;,''il~a,...
_~>lf: I,., '.'; l',',. , " \', "p.' ',:, ".. ': 1 .
,'.,' .1:: '''::.''4 "" '. '~rpe of sewer pipe. ABS ,/ pvc: 'cast :rian' '. ' '.' ,.'1;" -^""j'll'iII".-....
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~,..,:j.;.,..s,':,:.':E:.;t~mated length of sewer line feet... ...." ".", ,'T~"':\.'.",',
. , -e""';-ed), locat--" at 'fe::~:...,;:_,;~;a;..;:';.~:,\i!~..
w..' '. ;1:'>' ":, '1$;":. C:Le~'n out ( if. .,.-.. OCQ .... ..~....~.
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~r' ;:,( ':"'-'rb:~,'.$$ 35.00 Sewer and water li~e 'con;"'ecti~~::::t.~~~it::I';-"','~~",,~
.,...:.,r,".',',,-"'.:, .50 St>rchar"e ' "';'., -....,'."'.,..,"'....
II - ~,' '.. S ~ 5 . 50 TOTAL . .... ,,\,.., "'" .,
... "l ,\.," j ."", ,.i'';'o'~
~' ':;-.' ;:.", ':. .-.'~t.. ree,'far either sewer o.r \orater indi;v~d, ual~y is ;.;'d./~~i:~\fi:~.'\:.".. ..... ,
~~~~ ~)'" I:;"" ' '$", .. 50 surchar'"'e.
. - . ,.;1;1-,..,,'" .:. ,I I ~ oj :,",;I,.~'<;'~'::~
...I'''T' .':,' , ' "''';':~'l'~~'~~
,,' ....!:,.", "',:..., S~weJ:' and wat:.er perm.i1;:s issued. for ne~. ponstJ:'UCt;LIil'n:'::". ,..:.~
,"'. i.' ':.' - .~cord.~d on the buildJ.n~ pe:rmi~ cari;l. at ,the tiill$~" ~~!S1;a.rtee': "." '.
~!\/, "1" ~o' i.ns'\l.re that no dupl~ca~e lOQWe;r' and wat6ti,,'f.- ~ts '. ar~ ,. :-
,"" ." l.ssued. 'I(, ,-,." ...,,:~.~
.. .~ '~"'. 6)1.n: PAID /I-f.:,-I AI'.lOtn/TPAID - ~:~~.,c~~:d;;.i:.~
: ,. 'II: 1 -': '. ; . .. . " .," <" ~ I; "'" ,
:...): .~tcZJ:P'l."'# REe'!) Sy ~ . .;'" , .",', , :".:....,...
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;-J, .;- ;:-!:!6,2pO bgj&; Cn:#c Av. S.E_. Prier Lake:, MinneSOlA 55?n/'~b. (61'2) 4474230 ~ f~'(61, '.,
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" ..,. _ "",'''(';''''':'0-''.
While . Building
Canary . Engineering
Pink . Planning
Thr erolf. of thr Lab Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CH~CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
K \N JO!-\NSorJ
12-IQ..-OO
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17335 SUN MV ~l ecU:=;
I
Accepted
Accepted With Corrections X
Denied r) () (;) J
Reviewed BY:\dY_ l/\- r ~ Date: / r") - 2re. - Uvxs
Comments:
L R~ I'l.\\. o..~~ tJ.c.-&~",
-z. ''a t( {()+ I.- """--L ~{..ec~'O"Y\.. ~o; .
c.;
"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."
_..,~.=--
rn AlrJ Fi t..t
/7335
17'3"3'1 >ut1rau Or:
1733q ,.
113"1
White - Building
Canary - Engineering
Pink - Planning
Tht Ct'nttr of Iht' L.kr Countf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1--'1 \J\l JDt1 NSON
\2-ICl-()()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
11335 SUN r<AV CJ r2..CLS
f
Accepted
v
Accepted With Corrections
Denied
Reviewed By:
Comments:
Date:
3 - B -01
LLL
See Reverse Side for Additional Information!
~ee Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Ero!';ion Control..E/<ln
"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."
'~O~1i PRIO",,,
r: "
_ '1'-
" u en
ThO' C..nlt'r of thO' L.kt' (:ounIO'
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
fc 1\0 Jl+\ N -=-Cr\ )
\ 2. - I (I - () ()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i -7 __->'::-'::,=./ {\J I,,-~A \j ,~\~ I k:J' LL
{
Accepted
Accepted With Corrections
~
Denied
~'" /-A
Reviewed By: -t.?' "h...~/--/--?->
_ Date:
_~/.8b (
Comments:
_2~ (<r- ~~J.AM ~'~~ ~\~~
<F--v~~~~ (~ +-~.YLJ ~Lc9 I tJ
~ ~~~~"
~Pb~~""b2, c::;~~~
,
~e-e _A--N~ ~qAP_ -J-Ve-p ~~ ~Yie~
~&1J>>Q ~TT.ti UwP."kl>tS fW ~
~~ ~ \/few ll't\~
"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,"
PRIOR LAKE
INSPECTION RECORD
(1....
DEPARTMENT OF
BUilDING AND INSPECTION
SITE ADDRESS fl3~~ Q !II"~
NATURE OF WORK ~
USE OF BUILDING _SFA
PERMIT NO. 01- n/55 DATE ISSUED _ I'J. -':2 G. . ~
CONTRACTOR _M t.J ~^ PHONE-B-q 2 - 7.!Z2./")
( NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I ffr:r I 7/3/ If) J
I FOUNDATION (Prior to Backfill) I ff;J::;--.,' I <(I 't /0 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS"
%
I~ ~ t11,~ 71",
"
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/VI)
~ I/IM/I)I
I
I SEWER I WATER I SEPTIC
I FRAMING
I INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
';ml:.~
GAS LINE AIR TEST
"
GRADING (Prior to Sodding)
BUILDING"\.C,O ~ 6/ }/O2.
ELECTRICAL . I
PLUMBING
HEATING
DO NOT OCCUpy
INSPECTOR
DATE
I
J
/I/~/ol
1t1-1{D I
IN! /~ I
. . (
/A.Gt .
f?r., f(j J 7/~ I
~
'"
&.J1.?7!tJl 1m/l/ 6n
9~1 .
(
8PI. d Z---
115# z.,
,
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 (952) 447-9850
~,,:,_..-,.,
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
~
/7PS- SVNeA-Y {!,/~.
TIME
SCHEDULED
)r.T-
ADDRESS
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o I - OISr
COMMENTS:
o PLUMBING Rl
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
ScJ~/17lOf? ~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
I! FINAL
o SITE INSPECTION
.
C;foV
d-~
.
~
1Sc.(;; Jl.. . ,,}
#a- . //" A~..JJ
~---r-'
)l WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RE1NSPECT10N BEFORE COVERING
Inspector: 4. Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
n 333'" su tJ R.AV
/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING Rl
o FOUNDATION 0 MECH Rl
o FRAMING @ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~INAL .tAlI 0 PLUMBING FINAL
o SITE INSPECTION ~;s. MECH FINAL
DATE TIME
tl-30.() I 31 cro
/ -I fi'j
o EXIGRAD/F1LL1NG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS@) ~: ) ~ -16 ~
~. ~.f.o .4dZU J A-- ,,-...../. 'I-t
~.;,.,'~~~
3. p~ ~~.~ frY"-' "/~
.f-."., ~a7~ r U 0
T; <2.., 0 . --I:.zJ-P R' ( J 1 0"2-
o WORK SATISFACTORY. PROCEED
)oCORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RE1NSPECT10N BEFORE COVERING
Inspector: h Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE_
IHSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
l;pdol jtJ::sO
ADDRESS
/73.~ -S- ..j~/ &.
CONTR.
OWNER
PHONE NO.
PERMIT NO.
tJI ~ /~S
o PLUMBING Rl
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
j1! MECH FINAL
COMMENTS;fj1 p^~ P~Y1~ r'h--
r - J v
~O~. -~t
. ~~~0-F~'
Pf-l,J:i.L ~ ~ f", ~
~~~____~. t)
(5') ~.f. -hoa_V ~ ~
(@l"15 I( ~ ;11 ~ _. -"--- '
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
Jil..F1NAL
o SITE INSPECTION
~ ,,:Jp-,,~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASL1NE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
'I CORRECT WORK, CALL FOR RE1NSPECT10N BEFORE COVERING
Inspector: ~ Owner/Contr:
(
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE_
lliSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
ADDRESS
/733'5
DATE
SCHEDULED ~
~~.
J
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ja:'j'o
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJr - 1~4
o FOOTING 0 PLUMBING Rl
o FOUNDATION 0 MECH Rl
o FRAMING 0 WATER HOOKUP
o INSULATION @ 0 SEWER HOOKUP
o FINAL ~ PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EXIGRAD/F1LL1NG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASL1NE AIR TST
o
COMMENTS:fii) t2e-n~ '.'5,4l1 -r1/J 0 Y ..J~
~Jk T ^"-1'".'1 ~'I ~.
~ p; I\L. ~_ ,a)1Jto-dJ-r
@ ~"J:' V-J, ~ (frO ~ O-a
~ <L:...-.- ,M-~.4)
~ e.- \lJ~' ,'I ~
--....-
~ ~
~~~
o WORK SATISFACTORY, PROCEED
(J CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RE1NSPECT10N BEFORE COVERING
'R:v,
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
ORSAT TEST
JobAddrpoo / /jJJ 0lvt/h", c,J~
O Heating Contractor ~'h/\J2- ,r
Date-1!..!6!c") ( Pressure 5)
. -
o
Percent 02 -:;
Percent CO? fj'
Percentcn
Stock Temp
'< (')h -
'"
-