HomeMy WebLinkAboutBuilding Permit 01-0276
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
2 Pink
3_ Yellow
File
City
Applicant
I PERMIT NO. 0 1,01..70 I
(Please .!VP~ or print and sign at bottom)
ADDRESS
.5-Y.:?6 ~}q~/v /Y7~a::v CUJf('Y~ ~
LEGAL DESCRIPTION (office use only)
~..y' VN/Y,7'
~ 4-BLOCK I ADDITION
OWNER
(Name)
(Address)
Date Rec'd
3- 2.8-0 I
I I
ZONING (office u,,)
tG2-
~"Q~ >-3"'f()
PID 25- S13-o04- -()
BUILDER
(Name) /l.L. ~L~ ~.
o Misc.
(Phone)
(Phone)
A~'7=61; -7/5b
.k" ~""..v'
ORe.Roofing
5:57.;:r ;:z,
OAlteration
ORe.Siding
OUtility Connection
PROJECT COST/VALUE (excluding land) $ '':>'2./ c70
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 1 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 win 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 ~re~
(Address) ../-Y5"9 ...v~~ .oK ~ p?d,y"
/
TYPE OF WORK ~ New Construction ODeck OPorch
OLower Level Finish 0 Fireplace OAddition
$
$
$ ..
$
$
$
$
$-0 I
$ 5; 480. 2.4-1
I ReceirdJ..59 sVb
Bv/r
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and miY proceed as requested. This document
when si d by the Ci Planner constitutes a temporaty Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issue I '41'4~ t.1 /616' (
Irx) .001
/ t;t? ,001
1
q /'.) DJ I
'\ . I \.
'l/r:;:'7cur BUd~(f.rm~~7:?d
Udd~lal Date
I Permit Fee
I Plan Check Fee
I State Surcharge
1 Penalty
1 Plumbing Permit Fee
1 Mechanical Permit Fee
1 Sewer & Water Permit Fee
1 Gas Fireplace Permit Fee
ning Director
$
$
$
$
$
$
$
$
,9().7'-1
~I~ ,crt
"i5::'.~
=-?~6?!>S7
Contractor's License No.
Park Support Fee
#
SAC
~
SiL.~,"t";
#
Water Meter
I Pressure Reducer ~ J (!) M f'~ ~
I Sewer/Water ConnectIOn Fee #
I Water Tower Fee #
1 Builder's Deposit
1 Other
1 TOTAL DUE
Paid
Date
oS <180. vi-'
~I,~I
Date Special Conditions. if any
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
-..:r-..;(' 7--0/
Date
?!;,<;h .dO
I.II.)O.~
1
i
t-
, ? t':>1J . od
ry eo ,l?cJ
~ _.
The Cenler of the l..ke Count!')'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
. . J 1 -7 I
l/. K. rrL;...:. I v /\)
" .... / 'J
' '. / ~: O' (.
-- '- l.. -
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
': 4- 2.?- /::; / I i, /'v' ji Ifj /fJ,/ tv .iL;!':. [..- S
Accepted
t~
Accepted With Corrections
Denied -"""
Reviewed By: E S
(/
.....
Date:
"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."
i
i
,
-
!i~1
White . Building
Canary . Engineering
Pink - Planning
Thf C.,nl.,r of Ih., 1..1<., Counlry
.BUILDlNG PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. IC.. Ho~f7)rJ
3-zB-OJ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
542-0 FAWN HEAOo/AJ We-1/6
Accepted J<..
Denied
Date: C/-Cn~'
Reviewed B .
Comments:
-
.s~ ~ W1Cu'lA. ~ ~ l~
"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."
@~
61-27"
Th~ C..nl..r of Ihe L.k.. Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. k.. Ho/2---,orJ
.3-25-01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
542(0 FAIl/tV /I'/EJJOiJIN QJJ2.V6
Accepted
5<
Accepted With Corrections
Denied
Reviewed By:
Comments:
,y1JfJ
Date: 3'.h -0 I
See 1YIc..'", F,' I(
"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."
06:56 651 633 BBB4
FI RES IDE CORNER
CITY OF PRIOR LAKI!:
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
#1663 P.003/004
,LUlU" ,lU:\;' U
i ~ ~,_ I PERMIT NO. 0 / ~Oz. tip I
(Please tV.PE. Dr t1rint at.I4 sUm LV. blJttX)m)
ADDRESS
54'..)(.... ~.Ih IhLq;,n~~ 1'-.._
ZONlNG(om",.",)
LEGAL DESCRJPTION (olllo. us. only)
LOT
BLOCK
ADDITION
PIO
O"WNER
(Name)
(Address)
rr::e ~
(phone)
APpr~ICANT
(N~e) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone) 651-63~61
(AdA:lress) 2700 N. FATRVIEW AVENEllf
(AddJ%..)
BRENDA HUSTON
(Contact Per>on) "
APPLICANT SIGNATURE ~"jJ. ?JfM"=
~r".&EVTT .T~T:' JAT
(City)
(phone) 651-633-2561
51:11<1:
(Zip Code)
DA'I'E
qhlol
APPLICANT PLEASE COMPLETE BELOW
IllNEW CONSTRUCTION 0 REPLACEMENT 0 AL"reR.ATIONS
FURNACE MAlCE AND MODEL FUEL
FLUE SIZE MTIJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air PJenrs
DOra.fly
o M.ehonlcal
OAir Cooditioning
DVon!. S;Y&l"'"
FIREPLACE MAKE AND MODEI.~" J \ Gr,
] St.om
J Hot Wotor
] Ibdiatl.on
] Speolal Pevices
] Otb.r Oovle..
~Q_ 7.('1)111.-
-
PLEASE NOtE:
Air Coo.dit.iooer Uoits
Cannot En=acb into
Reqtlired Side Yard
Selbaw
Industrial. Commercial & Mul~.FlUIlily
FEESCHEDVLE
] % of job oosl Re;ldentlal. Ges FiropJace
$39.50 minimum
599.50 Reside.lloJ, Addition" & Aller.ltions
$64.50 RJosidenllal, AC Only
$39.50
]l.esid<nlial. HCllti.ng 11 Ale (Now Constru<tion)
Residential. HCllting Only (New Conslruetion)
539.50
539.50
Estimated Cost 5
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
:s
$
$
.srt""'" PAtD WITH
IUtLDING PERMIT
I '
(Orne. Uso Only)
This Applicat.ion Beeom.. Your BuildIng Permit When Approved
Bnlldlng Offid.1
BRIe
~
Dale q ~7/(} I
Rec~
~y fJ-
24 bonr nolk. lor .11 Inspection. (95%) "'-!I8SO, fax (952) 44'-4245
~
s~(~
Ar'NNESO't.t-
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFIREPLACE PERMIT
Date Rec'd
I_Pink
2. Green
J. Ylillow
~:~ fPERMIT NOo/"lV_ .. 7'- I
Apphcant L/, /X.
(Please !xpe or Print arid silW at bottom)
ADDRESS
'5~'2lP H,lWYl ffipMblAl tLLY Vf)
ZONING (cifficeuse)
R-d.
LEGAl. DESCRIPTI"'f (office use only)
LOT (.1 BLOCK ,/ <\DDITION
~~R '1) rz. \1DY"-hi1
(Address) '345cf W1l4it~~/r;n fJrv~
~;;~~ANUtllaM YI'ltthtU1/ctU
(Address) ~D ~nfbff..l'l)r ~\{ilk \
(Address) .
(Contact Person) . )pJftetj . (.... 1A1'Yl.I?1P~matV
APPLlCANTSIGNATURE ~h f, 7JmmRYl71tU1 (IfJbJlJDATE
tli U
_ APPLICANT PLEASE COMPLETE BELOW
(9<lttw CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL B"Ijln+- 2>8'?k./WDZ!-Jb1D FUEL ~a.l
FLUE SIZE l..\\\ doss!>, RETURN OPENINGS 4- INPUT 1D, DOO OUTPUT 51c. bbD
TYPE OF SYSTEM HEATING OR POWER PLANT
J0JJlA1A.Q~cR
!)
PID
SlAi.k 2nti
(Phone)
Ea.tf1h MfJ 55/2- 'L
J
(Phone) l1fj{ 452.-lT15'
(Zip Code)
(Phone) _1125 I 45t- 2/76
4-1231D I
(City)
OWarm Air Plants
OGravity
o Mechanical
@.ir Conditioning
GJ'I"ent. System
o Steam
o Bot Waler
o Radiation
o Special Devices
o Other Devices
PLEASE NOT:E:
Air Conditioner tJnits
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential. Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
ResidentiaL Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Penn it #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID WITl
BUILDING PE~~'''ll
(Office Use Drily)
Building Official
Date
[ Paid
I Datu_/;! S ~O /
Receipt No.
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
I BYac..-
U
Apr. 2. 2001 10:15AM
GENZ RVAN PLUMBING AND HEATING
No. 0 9 11
p. 32/41
l.
2 .
3.
.'~'. 4.
5.
6.
~-P1IL.
"lUG.-. ~wr
GOLD - err.,..
CITY OF PRIOR LAKE NO. 01 '{)2.-7&
SEWER AND WATER PERM~T
NOTE: Sewer and Water
contl:'actors must
be registered
with the City.
APPLICANT: P-"n,?-- i2l::f.nPh"'l/T'Ibl~ U>~n.u("." PHONE:.k>6H+f-3-IILRl
ADDRESS: I Lj,i.lE,:::r. r&..:..,12:r -r.:z.L I?rJS.bf"JalJ <(Jr S''''cc.li DATE: L/ /2 It) J
SIGNATURE: Ik h U 0_ _ BLDG. PERMIT 11 0 "oz..7fo
SITE ADDRESS: m~ ~~.......,r"'lI~f st:- PlOt LS-3i3-()olj--O
Estimated length
FILL IN THE BLANKS
. 40'
of water service
~,
feet.
Size of water service
inchees) .
Location of any couplings from s~ructure
feet.
Type ~f'sewer pipe. ABS PVC ~
/' /T"\'
Estimated length of sewer line~_J
Cast ~ron
feet.
Clean out (if required), located at
struct\.lre.
feet
from
=================fWj===========----------===-----=~---============
This application yO\.lr permit when approved.
BY ~ DATE: 4 ---( 0 ~o I
. . .
================f======================~============--===========
FEES:
S
$
$
35.00
.50
35.50
Sewer and water line connection permit.
S\.lrcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge:
* Sewer and water permits issued for new construction must be
recorded on the buildin~ permit card at the time of issuance
to ins\.lre that no dupl~cate sewer and water permit~ are
issued. ~P.\O '-N~~~,\\
DATE PAID AMOUNT PAID ~\.P\~G
RECEIPT 11
REC'D BY
4629 Dakota Sl SE., Prior Lake, Minnesota 55372 I Ph. (612) 447-4230 I Fa" (612) 447-4245
AN EQUAL. OPPORW~fTY EMPlDYER
A Dr, 2, 2001 1 0 : 1 4AM
GENZ RVAN PLUMBING AND HEATING
No. 0911
p. 28/41
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant; ~ 2. - t2.uar\ PIl.c:M. iJ:n~
Address: ILHlLS ~ ~~T '\'<U.j
Signature: \A 1 ~ <
Legal Description: Lot~ Block<:ub
Site Address: ol-J'Z4> FO.tl11-.2 (l('J'rl L!'lf" ~
Building Permit # D / - D 7.7(/) PID # 2~ -373 - 004- -0
NOTE: This permit ~II not be processed without complete Informaticn.
AXTURE UNITS
l"iIc
Cl<y
App.....
# O/-OZ.7~
,Phone: I nR - l.l 7 ~ -II '-/..!::L-
{l1'''-f ~ \0,1 ~l r~
I.. Bb.ac
;< G.1d
3.Y.u-
'J"M. c.,1I~ or ,be l..Pc c~""""'f
&e.4"aD 3.-z-D
::....":J
Quantity
Type otFOOure
Quantity
Type of Fixture
I Bath Tub with or without shower
I Dishwasher
I Floor Drain I
2... Lavatory (bathroom sink) I
Laundry Tray (' or 2 compartment sink) I
Shower Stall J
Sinks
I Bar Sink
2- - I Water Closet (toilet)
Rough-Ins
Water Heater
Water Sottner
\
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ. Double Check, PVB)
BackfJow Assembly Tes!
Lawn Sprinkler
Other
FEE SCHEDULE
> Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$.
$
$
$
.50
GRAND TOTAL
-'$ pAID v.I~p.~\"
SU\\.D\NG p
ThIs permit IS gnmted upon Ute ex~s l;ondition that uid
con=!Or. shall cOll1p'ly in respects with the otdinana;'
of the Slate Plllmbjn tho .'l"",-<lmonlS lIlereof.
. . o. ~1D -01 DATE
A TrEST
lions 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opponuoity Employer
. .. . ~. . ..."."
tjUILDING AND INSPECTION
INSPECTION RECORD
SITEADDRESS 5'/2(, ~ ~ cJ-
NATURE OF WORK 1J2-i.J
USE OF BUILDING SFA- _
PERMIT NO. Q(-b..z:l1i2 DATE ISSUED c.I- (,.z,,,,1
CONTRACTOR DJ ~^ PHONE (;/,/- 25b -il>(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING ~ ~. [gl \1/01 I I
, FOUNDATION (Prior to Backfill) U, ~ ~ ~. Sf., )/0' 1"8 Va., o1@:&)O(
PLACE NO CONCRETE UNTil ABOVE HAS BEEN S~GNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION J;h..... ([..P ~. ftJ /3/0 I
ELECTRICAL .
PLUMBING ~ t.{.c.. ~. S/311~J ~ 11/;'. (~ ~(r;161 ~. 't1/7/PJ
HEATING (ifrequired)-f~ ~. '5'1U/OI 1~. 19r-r ~h.f{j/ k. 9~~.1
FIREPLACE ~ 'l/;;J'I/4/ -
GAS LINE AIR TEST ~ b f) 4- . ~V';'~/~)J
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I .Ak. U~ ~ ~//t,j(} I I I
J FINALS
~j, 61
/!A.. 1/ /1 /, I'D / Pro
, .
ffir~
~ h <lIP;
~r >11!b1
GRADING (Prior to Sodding)
BUILDlNG-T,C..o, -tJ1 srI / D 2..-
ELECTRICAL . I
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
IIh /0 I
. q!../J.,-d-
...,
h.
A
/O/3//0J
II /;~/IJ/-
,
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 sha'lI be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
JOB #
~ . l!l~
CITY!:" ,or SUBURB
HOUSE H EA TING TEST RECORD
ADDRESS!)'-/)(., (c,":>f\ fv\Q,q&6..'J eN" ~,J;:. _APT. _FLOOR
DCCUPANT_ nWNER
HEAT LOSL DATE HTG. INST. ~lol
SOLD BY
Electric:al Work By
TYPE OF HEA T
~INSTALLED BY Fr€.d.nc.I:LSo(')l(\
_Gas Line By l \. l \
GA _ FA ~HW _STEAM _ SPACE HTR. _UNIT HTR. _OTHER _
..... GAS DESIGN
MAKE P, rUQ.Vh-
Mod.1 :0~<"i<I\\. \<,:~,\c.:n(')
S.,,01..,1'bOIA {.-b;4JfJ'
INPUT L.& ,c::ct::::> ('iiV\H
\\ ~~~TROLS
THERMOSTAT[_ 0IIll>C(~ IIol.o1 Plug.
Valv.Wl-.-,,~ r~~1 "-
Limit
Limit Setting
Fan Setting ~
Pilot Type
Pilot Make
Pilot Model _
Pilot Timing
L. W. Cut Off
Pressur... 3.15
P.rC:ll!lnt co (,. '1
Percent o~2r. ~
Percent co D
Input CFH
Stock Temp. :<~ ( (D
Form 235
CONVERSION
MAKE OF BURNER.
Model
Mox. BTU Rating
MAKE OF FURNACE
Model
Vent Size
'-/ I;
KIND OF LINER
Draft Hood
Fi Ifefs Siz,""
Chimney Location
Chimney Construction
SIZE NONE
Regulator tv\. C:...l \C, 't'i'QI
__Number
Inside. l.........-:?
. Outside
Smoke Bomb
Draft
Door Pressure_
_Wiring
_Test Tag
lighting Inst.
001. Tested 10 d.4.()\
Company T estin~ A.IJiant M€thjtn.ifjll, 3650 Kennebec
Name of Tester ~.i"-o.. L..\)~"
Dr., Eagan, MN 55122
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
5'fJ)b ....
SCHEDULED 1\( I fa { D ,
~~
/0:80
OWNER
CONTR.
PHONE NO.
PERMIT NO. ~(-~76 __
,
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FilLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING @ 0 WATER HOOKUP @ 0 FIREPLACE RI
o INSULA TIO 0 SEWER HOOKUP p!l FIREPLACE FINAL
~ FINAL ;;/S\ 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION 11.J5)f& MECH FINAL 0 .
COMMENTS: ~,
COT~ ~ ~
;:
,
T(' J) , 1i1..p..,fo 1/4 z.....,.
,.,..,AAt-
,
,too/
~
.
o WORK SATISFACTORY, PROCEED
l! CORRECT ACTION AND PROCEED
o CORRECT WO~CALL FOR REINSPECTION BEFORE COVERING
Inspector: I~ I Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INS/VOTl
ADDRESS
51!?{'
DATE TIME
SCHEDULED /L)- 3/-/ <, l ;00
'\
J:a.-tv Y<--/
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
J-cr7b
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION f#- 0 SEWER HOOKUP
o FINAL . ~LUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS~1'1J-t ~ ~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
)'4WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.{ SAFETY!
INSlVOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
.,51/;;5 ~ J "1
ADDRESS . c-6 ~dL-, - d?
DATE nue
SCHEDULED q -/,;J-Oo-
F:d.l./77 d-f-
ri/A//71 F? l;i(l dnv
OWNER
PHONE NO.
CONTR.
OJ.- :) 75 I ,3 -j(,~
PERMIT NO. S II .3i1t6 ;:;27f?
o FOOTINp
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
c~ir
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/ );(
r.
~I
\ R .../
/[1
;
\
Ij(f/
'-
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~RK. CALL FOR REINSPECTION BEFORE COVERING
6 17.,..-
Inspector: I [/) Owner/Conlr:
1..1 ..--/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
_n