HomeMy WebLinkAboutBuilding Permit 03-1451
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
q-cJ-03
l ":1:::' ~::, I PERMIT NO.O'? _lA-51
3. Yellow Applicant ..:> 7,
(Please ~ or Print and sian at bottom)
ADDRESS c5lt?Lf'i ZONING (offic,u.,)
JUX c.-..fllv' B..I{ ,J, I<J , j{f /5.fJ
LEGAL DESCRIPTION (office use only)
, ,;l --r/.., Mid" 5 /1".41,
LOT BLOCK ADDITION PI~-'1"4'- 0;).,0-0
OWNER
(Name)
(Phone)
(Address)
.
BUILDER & ~
(Name) me. :JIlIJ. ~
(Contact Name) rrh,,~II(. wdj~
. (Address) 7373 I '17 !!. ,S!ru;. W.
(Phone)~ -..yril AI \;"101 QO-l1tJ-1'7n
(Phone)
sic. No -'11,,1l. ~/g/k~ M/l/ -SS"/;lt!
TYPE OF WORK
ilNew Construction
OLower Level Finish
DDeck
DPorch
ORe-Roofing
ORe-Siding
o Misc.
o Fireplace DAddition DAlteration
PROffiCTCOST/VALUE (exc1udingland) $ .:25l2 (W
DUtility Connection
I hereby certify that I have furnisbed 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 y....y....~J 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
enter upon the yro;e"'j}'}Ierform needed inspections.
X Y/('-~ I,,),./L.r ~~""/I/ 9hhll
Signature Contractor's License No. Date
I PermitVal~on ,..;}SOIOOO I I Park Support Fee # .$
I Permit Fee $ lit 33- 7S'1 I SAC Size 5/8"<9 # $ /:;.--75.-
I Pl~n Check Fee $ IJq/. qq. I Water Meter $ 300.-
I Slilte Surcharge $ OS-. I Pressure Reducer $ 70.--
I Penalty $ I City SAC and WAC # $ J ri-OO ,..-
I Plumbing Permit Fee $ 100.:-- I Water Tower Fee # $ '7 t>> ;0-
I Mechanical Permit Fee $ 106.- I Builder's Deposit $ ltJOO,"-
I Sewer & Water Permit Fee $ L~'SV I lather $ I
I Gas Fireplace Permit Fee $ L1o.-1 I TOTAL DUE ~ 10. '14,83 $ ld"rJl' I q I
This Application ~'"'W~__.;,., Your Building Permit When Approved I Paid /("1:""7/./7 '~7O' ~(!.f
~' ;&;R;-fJp7};7 I Date /ILJA. 0"7
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina.nce 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
~~~
Planning Director
/1P ~~j
Date Special Conditions, if any
24 bour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Tht'("t'nlt'rnflht'l.ab('ounlry
C White - Buildiii9'::>
l:ai'iiry - Engln....nng
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
/JJ~~ fcJh~
APPLICATION RECEIVED q-~- 3
NAME OF APPLICANT
The Building, Engineering, and Planning Departments have reviewed the building permit
application f~:r19tion a~roPf?~ _
. L/
Accepted
Accepted With Corrections
,KI
Denied
,
~,~ L; ::/fl--Jlj)
~~~,
Date:
'7 /2- z~ '!
f
Reviewed By:
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,"
,po
..1"
Th~ (""nln of lht' L.kt' ('ountry
White - Building
CanarY - E:l'aineering
('"t>ink - Plannln~
BUILDING PERMIT APPLICATION DEPARTMeNT CIiECKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
:1
" I /
/ I
,7 ,,;{ - 3
If
1; /,_/
Ii ,~' t.
/
...;..--'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'J O--L/Q /". ,.+t
,: (/It! I I'~ ',I /". / 1;..._
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
~-t..., .,;
r.:1~ Date:~"3
p~~ ~/.:~
A ..tJ P ,
~ ~ tr?- ./L'/lD ~
t/ '
.....
Comments:
A,e, ~s
~,
"Tl1e 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."
L
j
White - Building
r' ~Anarv . r:naln!HInnq......'
Pink - Planning
Th~ ("..nlll' <I' lite 1..11;, <"011_'"
BUILDING PERMIT APPLICATION DEfARTM~NT CHECKLIST
NAME OF APPLICANT
c
)1/j
}-"('
11--- ..:-i,.,4-_ ,,, "
---; /ty"'- ,:.....J 7'Ji.J',~- -4--/
APPLICATION RECEIVED
,,~ d< -.
'-1-- --<
, ........
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
;(~ i.jC) i.:: d.--Y C c:? {;'.ttL
,../
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
J11} {1.,
Date:
j{)-27-0<.
Comments: See Rever~p ~ide for Additional Information!
See Attachment!'!: 1) Gradinl! Plan. 2) Erosion Control Measures
"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 furisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the furisdiction shall not be valid."
CITY OF PRIOR LAKE
HEATINGJAIR CONDlTIONINGIFIREPLACE PERMIT
Date Rec'd
Ol~l04
(Please tvJ>e or orlnt and si.m at bottoml
AnDRESS -z,.iifq
j..S49COUGARPATH
l;;:, ~::, I PERMIT NOA. I~I
J.Yellow Applicant ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name MCDEVITT HOMES
(Phone)
(Address)
APPLICANT
(Name) A LLIED FIRESIDE DRA FIRESIDE HEA RTH IV HOME
(Phone)
/\,1-/\33-25/\ 1
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
'5113_
(Zip Code)
(Contact Person)
RRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/22/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVen!. System
HEATING OR POWER PLANT
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
HEAT N GLO SL-750TRN-C
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & AlIerations
$64.50 Residential, AC Only
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ P"'D WITH
: IUILDIN@PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
BuUdinl! Omcial
Date
I Paid Receipt No.
l6't'l ~ 104 By
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
Jan 01 04 11:17p Mik~ Schiltz
DI/15/Ul Tllll 14:'U "'A1. 1IJ.;ci.'''''U \o&U ..... ....-.. ____
8518818308
p.l
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
r~lt!w<< car... Mul... It1tacmbll
I ADDIUlSS :;} 8 ~ '}
Co",s,qr
fJ.-4~
LOT BLQCI(
L2GAL u:.c;.,)~ .a.aUI.' (oI&trlilt onl:r)
ADDITION
OWNEll
(N.mt)
(Addtas)
APPUCANT
tN_I
/J1 c tJe-v I H-
HessIan Plumbing Services, Inc.
(A_J ....u. tlOll i!2172
.. Eagan. MN5512Nl172
(ConlKlPmon) r'VI,iII.. S<.l-.; I~
APPUCll.NT SIGNATURl! m ~
(AdcIress)
Quatlly
X-
i
I
5
I
I
I
~
...-"" 'PERMlTNO~- 1
Ja.w c..,
,.Vttn ~
I \ ~~",,'''I_'~1 I
PlD
(i'IloIK)
(Pbcme),c.. $1. c.. 8/. 825"<...
(Cily)
(Zip Code)
(
(}'Iloa) S c ......-\.
DATE J- 1-0"-1
-J
APPUCANT PI.Il"-SE COMPLETE BELOW
.3
I 1')pe'" Jbtllft
Batb Tub with or willliout .
I Dishwuher
I Floor Drain
Lavatoty (Baduoom Si..k)
Launciiv Trav (1 or 2 comDalllPcnI .ink
Shower "'-II '
Siftks
Bar Sink
. W.... Closet (Toilet)
Q.alIly
~
I
\
I
I Typeorn:rture
llouKh-ins
Water Healer
Waler YoiIner
SlmJd f;pe ~uhilll Maehine)
'3#, . It... J::ieclOr
Back/1ow-Au.nbly
Bw:kt1ow Auembly Test
Lawn Sprinkler
. Other -
FEE SCHEDULE
1ndu&via.I. Commutial a. Muhi..r~\l1y l,.,of.lab co_ -illt. S)9.50 ",ini"",,,, Residential, New 0. a. Two.flmily S99.50
llc:sicknti.l. Adctdions. AI1etalianl 139.50
Buil4in&r-it.~
PAID WITH
fjlJWl)ING PERMrr
Eoti_ Co>l S
PLUMBING PERMIT fEE S
STATE SUllCHARGE S
TOTAL PJ:aMlTFEE S
(om.. VI< 00.,.1
Thll Appllcatlon 1lKvm. Year Bu11dlat Pcnail Wloea A, '
.1
....... -.
.....
PaId
RecciplNo. .-.
~;- -d-..
(/
-
.
0.1'1 U I lUUj
14 Mar._.....~ t9SZ) ..~"" ro. (951) ",~Z45
la" ....... C..... Aft, 9.~ Polor Ii oi.I., _ 5D7H7U .~c. ~-
62/16/2664 1a:63
9528947939
ANDERSON AIR INC.
PAGE 62
CITY OF PRIOR LAKE
BEATING/AIR CONDITIONlNGIFIREPLACE PERMIT
>>.te R.ec'd
, .
:,~~
iP..... tYDC at Dl'iat anell" at boffoJft)
ADDRESs
d~'I9 C()~u4'G 1'14 ft,
:. =. :!I:. I PERMIT NO. .n1t" IlUCi .
3, "'11'-' A,.Il'eW ~
ZONING (ollla""'l
LBGAL DESCRIPTION (ollioe ute only)
LOT BLOCK
ADDITION
PIP
g;;;:R 111,- /k/II -IL~>
(Phone) .9s.}. - 'II?() -8?.;J.2.
(Address)
. APPLICANT /J // _ ,--
(Name) H"IJ~/tfMJ I-h-::l~./-vc- (Phone) _9_f";,l- ~?r - 793 9
(Address) ,~3 JJ.4-tlw A.;" I?d L$'lA..l't.vfV;/lt ~<;5"JJ 1
~~ ~~ ~c~
(Contac:l Person) J)l'l11 I . (Flt5 oJ (phone)
APPLICANTSIGNATURE \ 1 rQ /JJ...-- DATE _::J -10-0 'I
, APPLICANT PLEASE COMPLETE BELOW
~IlW CONSTRUCTION 0 RIlPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL ..J}/tYH-'1T :.?S-Ofll1A,)c)'-ffIOO FUBL .J/h;/-'<<If-/
FLUESlZE f)rJ(.. RETURNOPBNINOS f!i INPUT 1{J~JOtJD OUTPUT 9";,d(J()
f mE OF SYSTEM HEAl1NG OR POWER. P~NT
. OWII1lIAirl'llIllS 0 Steam
:JOraviry 0 Rot Wit'"
~ :!"MochBnloal 0 Il.odiation
, ::lAir CondiUoning 0 Spo,i.1 o.vl...
gent. System D Other O.vioes
FlREl'LACB MAKE AND MODEL
FLltASE NOTE:
Air Condltloner Unllll
Cannot Bnctollch Into
Required Side Yll'd
Setbaclc!
FEE SCHEDULE
Indulll'ial, Commeroial &. Multi.FIIl1J1y 1 % or Job cost Residential, Oas Fi"'plBcc
$39.30 minimum
Residontial, Heating & AlC (Now Conmuc:tiOll) 599,'0 Residential, Addltlans It AllOration.
Residential, Hqtjng Only (New CallStruclion) $64.30 Residential, ACOnly
$39.'0
539.'0
$39.50
Estilneted Cost $
Building penni! /I
HEATING PERMIT FEE
STATESURCHARGB
TOTAL PERMIT FEE
$
s
s
PAID WITH
MDING PERMIT
(om.. u.. O.ly)
'.' I
TltlaAppl/..tian 8eco......Voar Balldlllll Plmalt Wb.. Approved I, :) :f:P~ I, " ,
1',11 !fl:!9 1 0 20Dt10.' ay
llall4l..Otllcltl Dale \~U l_J .
%4 bour notice ror allln.pttlloa. (952) 1~19~"'1 (9$2) <447-4145
-
02/17/04 TUE 09:22 FAX 6128902753
STOCKER EXCAVATING
19J001
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(P(ease: Me or orinl lAd sien at bottom)
I ADDRESS
2849 CougaT Path
; ~~':. ~~ I PERMITNO..:;_~I
J, 0014 ApptiCCllI 03-145 L
ZONING (O_U")
LEGAL DESCRlPTION (office .,. only)
1 2 The Wilds NOTth
LOT BLOCK ADDITION
PIO
OWNER
(Name)
(Address)
McDevitt Homes
(Phone) 952/890-8722
12252 Nicollet Ave
(~\
Rurnsville. MN 55337
- .. ,
(City)
(Zip Code)
APPLICANT
(Name) STOCKER EXCAVATING COMPANY. INC.
(Phono) 952/890-4241
(AddICu) 12336 Boone Avenue SaVMe. MN 55378
(Addr.,,) (City)
Cur~ / ~ ~
(ConlaCt Person) ~ ~ 1/ (PhOne)
APPLICANTSIGNATUR.E___~ ~ DATE
(Z;pCod.)
same
2-16-04
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any coupliiigs 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 line connc::.clion
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'[ & Multi-family 1% ofJoh COst with. $39.50 minimum
$17_50 Water connection only $17.50
Estimated Cost $
Building Permit # __..__
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
8(JIL~ "
. .. ~t::IMrr
(Office Use Only)
This Application Becomes Your Building Permit Whe" Approved
Paid
Receipt No.
".Date
By
~~
Buildinr: Official
O.'e ~
, 'j F~R 1 7 70U4
24 hour notice for.n inspections (952) 44 ~~o. t'iir'(952) 44'7-4245
31 n_
.//
" \
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS -<<S I./q I' AU lIItllllL '11 ,J. W.
NATURE OF WORK -AC~
USE OF BUILDING S J=: ".. .
PERMIT NO. 03- /1--. I DATE ISSUED !:J1UlfJ:I_
CONTRACTOR ~ - ...e PHbNE~'C .Z71,Z-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
, FOOTING
.
I
1
_ ~CO ER NO WORK UNTIL ABOVE7 HAS BEEN SIGNED
IUfTM '711~11l.m!JII m;t. -<>1
I
FINALS
GRADING (Prior to Sodding) N'ff
BUILDING-,-....." rJ.a It- ( -#/4-
ELECTRICAL
PLUMBING
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.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (If required)
FIREPLACE
GAS LINE AIR TEST ,..-
~
U t 7 teI-I-
m
f""
\ _\'3-
11./2.01-
..y /~r
-- "'"
~ ~
IA.tf
FOR ALL INSPECTIONS (952) 447-9850
~ntifitntt of mttupnuty
CITY OF PRIOR LAKE
~tpttdmtmf of ~uilMug Jlusptdiou
4Final Permitted 0 Conditional C.O. 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. Permit No.
03-1451
Occupancy Type .
R3
Type Construction VN
Fire Zone
NJA
_ Zoning District
R1SD
Legal Description ,
L1, B2, THE WILDS NORTH
Owner of Building SiteAddress 2849 COUGAR PATH N.W.
Contractor.s Name & Address MCDEVITT H~~~7373 147TH ST. SUITE 140, APPLE VALLEY 55124
ROBERT D. HUTCHINS /~ CityPlanne. DON RYE
/; ~ding Official
Date: ~ 7 / tJ. .- Date:
., ,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4tfq
(01/"'0/ tDCl1'h
,
OWNER
PHONE NO.
CONTR.
PERMIT NO,
o FOOTING
o FOUNDATION
o FRAMING
D..JNSULATION
P; FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TlMI!
?-J-Li'tJY
3-f'l,r/
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
O.
COMMENTS:
(!) h'1..1 0nJ, a,o~1 r ar~.-- drtlk~
/"'. <4- <)"'1 de IU,/,t! /I
(),.~) ~(k! + 1lr-"~'r ~/ c!~d?)~-tvd-
'--/1) ~-I'fp .tkl-r~ I:IJ",1 /./>1+'-/ II rlt!dc rr
h/ll'/r
~ ibtJ-hl/h. 6l1. 1.$,. 2 e~ (e 'I ~AC"J"
< {o..f' vrt-f:(
Cf-/~
I
o WORK SATISFACTORY. PROCEED
o . C~CT ACTION AND PROCEED
peoRRECT ~~ C.>>"OR REINSPECTION BEFORE COVERING
Inspector: J.J!.ff Owner/Contr:
CALL <147-9880 FOR THE NEXT INSPECTION :u HOURS IN ADVANCE.
uaNOrJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &. SAFETY/
DATI! TIlle
CITY OF PRIOR LAKE 3-1C.' 0"
""SPECTlON NOTICE SCHEDUlED IJ : "!o
.' ........,-
:2849 0003" ... 9..~ ..~
"
ADDRESS -.
OWNER CONTR.
PHONE NO. PERMIT NO. 7~r1.s/ ~
1
o FOOTING o PLUMBING RI o EXlGRADlFIUING .
a FOUNDATION a MECH Rl o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL )Ill( PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
-:i
...
Lllt7-crt;l,;A
1:'-.
..~"'':''-' .
I"; .
...~iot
<it
7.'
.
6RK SATISFACTORY, PROCEED
X:ORRECTACTION AND PROCEED
o CORRE ~ YORK, CALL FOR REINSPECTION BEFORE COVERING
92:
Inspector: OwnerlConlr:
CALI ." 850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE_
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY!
_n
CITY QF PRIOR LAKE
INSPECTION NOTICE
DATE TIllE
SCHEDUlED
J/-/2 '01(
ADDRESS '),$99 Ct:Jt(Je/ !p"...ft1.
OWNER CONTR. I1k./hVJ'f- J./{!)(tI(J
PHONE NO. PERMIT NO. 0 3 -Ill t:; 1
a FOOTING
a FOUNDATION
a FRAMING
o INSULATION
lJ FINAL
lJ SITE INSPECTION
lJ PlUMBING RI
lJ MECH AI
a WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
lJ MECH FINAL
~"""'LING
lJ COMPLAINT
a FIREPLACE AI
lJ FIREPLACE FINAL
lJ GASllNE AIR TST
lJ
COMMENTS:
b.r(l'.I~- r.9L
('.vIA iSn;< - f?/(
')<woRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o ~_,,"-OCT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~
OwnerlConlr:
gALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <1 SAFETY!
IN_m
DATE TIllE
CITY OF PRIOR LAKE P?4;-
INSPeCTION NOTICE SCHEDULED
ADDRESS /<f''Y? ~9~r Ak
./
OWNER - CONTR.
PHONE NO. - peRMIT NO. c:J....? - /9"J-r-
o FOOTING o PLUMBING R. o EXiGRA.DlFILUNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~L o PL.IIMBING FINAL o GASlINE AIR TST
o SITE INSPECTION o MeCH FINAL 0 -
COMMENTS:
,...., I .
~ r- fr.e-es
~,u;t ~~~~'"
/~S*/;;. j-
/.\ &/~..;
-
~f
/
/
er(
~
t L'~Je
~RKSAT/SFA : I>A""1OE8
o CORRECT ACTION AND PRoceeD
o CORRECT ~~OR REINspeCTION BeFORE COVERING
Inspector: / //'7 ~ OwnerlContr: .
~
~ / "\.
/'" / e- )
-
-
CALL 447-8850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTs ARE FOR YOUR PERSONAl HEALTH & 8.4FETYI
_n
.'
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