HomeMy WebLinkAboutBldg Permit 04-0815
$-ce. ~ l,M..""'::'" ~,'l.e.
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File IWhi<, Fil,
2 Pink City
3. Yellow Applicant
(Please type or orint and sign at bottom)
ADDRESS
3f'.Po
If ,,~~ )tDrr ,7
LEGAL DESCRIPTION (office use only)
If,,/q t'
V
LOT ? BLOCK /
ADDITION JfFhrJ'
OWNER
(Name)
(Address)
BUILDER J I
(Name) WPNJ/17QA//!/ N6/TJt>S
(Contact Name) GtAr'7 _1/lANS6JV
(Address) /,' DO r /-1/ ,\
" 7 J / /t:1 Z ~ /./ r
I TYPE OF WORK
~ Construction
o Misc.
DLower Level Finish
PROJECT COST IV ALUE (excluding land) $
Date Rec'd
1/lq-L/
I PERMIT NO. o"f .09/51
;{Jd A/w
So I( TJ-
(Phone)
ZONING (office use)
el
PID.,2)- /!9f- 601 ~ ()
(Phone) 65'/- '/pt- "1'/6 ()
(Phone)J,I.2-J'-7 - 7?/:J...
hJA/ S5/;J..,2
F t:l91t'/v'
v
ODeck
DPorch
ORe-Roofing
ORe-Siding
D Fireplace
DAlteration
Dutility Connection
/. di)
'.2..5.0/)0-
I Park Support Fee
I SAC
I Water Meter SiZ@;I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid S;Yc.J"_ 7/
Date J- J l..-. ,,<i-
f
#
#
#
#
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
~terupon/:r;:;::rform7~ / y ~ r 7 -;J.() -0 y
/ fyature Contractor's License No. Date'
$
$
$
$
$
$
$
$
J . "2f:;} 006. t!)" I
i121')L~ I
J~2. 2~ I
(P:) . Q) I
I
I
I
I
I
I Gas Fireplace Permit Fee
/l I
(T/If/ttion ,,"omes Your Building Pennit When Approved
'v~)/(j 1:7' 7 - :,(.:l- 0'-1
. BUucj!',{g Official Date '
! Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
100. dO
I!?C . cJ) ,.
35'". ~~
40. t!lO
DAddition
$ -
$ 1.3so.hD
$ ':L<:;O . CY'l
$ tiS, eX>
$ I ? n D . (')0
$ 7/'J1) . O/')
$ - I
$
II $ 5., 9 f4 ?J.7~
ItNO","""
This is to certify that the request in the above application and accompanying documents is in accordance w~ City zonin~~ce ani may proceed as riuested. This document
~~en signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows cons_~ece"el vIalIT" aptl eccupancy must be
'P. (f , 7/ z. z.-f, </
Planning Director ' I 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
Ii~~
See Main File
~il" - Buildi~
Canary - engineering
Pink - Planning
1 lie {-I'nl<.',nr lhe 1..keC'ountr,'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
11/~~ ~
-1-/9-o~
The Building, Engineering, and Planning Departments have reviewed the bulding permit
application for construction activity which is proposed at:
3 ?[<6CJ -~a..d~~p
- J d
7:+12d.
Accepted
><
Accepted With Corrections
Denied ")
Reviewed B(~
Comments:
Se.e ~
Xy-k-
Date:
7-2'2--01./
MCl-i ""- Q lti
"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."
~~
See Main File
White - Building
Canary - EnQineering
~k - Plai1riln~
Th~ ('''Oln or Ih.. I.Rk. ('ounl~.
-)
I
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/J
/ -<'(
.::,(
j
I
,> I"i
.:.-/
APPLICATION RECEIVED
--(-.I ; -() /J
. 1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'"
I
I" I ~'
/
, /./A_.-
.j,'
I ;
,/ ( ;-",
lJ.
f
.
"
L
Accepted K
::::::.d B,(2 fl {b/lA-
~
Accepted With Corrections
Date:
7- 21.-CJf/
/
Comments:
C? 00
M~QD
..
('.of
"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,"
-~
Th~ C.nl(', ", lhl' I..lilt COUlllr)'
See Main File
w~ . BulldinQ
c::ar.- v. En.1!}neering')
inK - I'lannlng
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
I
I " -', ., ,,-_, )
. 'I I /i "'I"'~ . " .,..,.~ "",~ ."" '.
(,."..~~..//,,~~~,...-- ,""' _.).' J',!" ";;..~_'-' ,1,/.-,- ~'._".,/
, j /
'A/.t:iIH_--I'_
,1 /
".,~,_.."",
APPLICATION RECEIVED
"1- / '1-(} 1../
The Building, Engineering, and Planning Departments have reviewed the buil~ing permit
application for construction activity which is proposed at:
co.') " 1-
,." ----- 1- - "
- ( __ " I) ,,- , .-
-- ,I __ ,lo;- ~.l:l:j
Accepted With Corrections
Accepted
Denied
Reviewed By:
Comments:
x
11/14 8
Sa ~/"
Date:
r:-,'I r
\,
):"( cf0~ 12,,),
I /'
~~3--o'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,"
10/HfOl Woo 11:22 FAX 612H742lS
r.ITY OF PRIOR LAKE
~OOl
CITY OF PRlOR LAKE PLUMBING PERMIT
Date Rec'd
I....' 1il,
I. Gold CilT
, 'I'.f1~... A"',cUlI
IPERMITNO.~
I ZONING rollle< 1lIC) I
q>1t..e ~ or nnnt Illd.;,." 1I bonoml
ADDRESS (J \ \), .1_. \'\ a
3~~~ ~~'()<<'\~ \'\\~~ fuk,
. I
LOT
LEGAL DESCRIPTION (ollice.,",.n1Yl
ADDITION
~~;,R \~ \eJt'\S'('(\~'<\ \\ ~Offies (Phone) GsJ-LfDC, -WOO
,(Addrm) ISqS.'?b.L-D..~. ~\~~DD ~V\ .~t\, ~J;Z~
... '
~;';;~T.ANTLJ~el ~\b~ ~ W\~,~. (Phone) 6S/-'fs)-/5bS
(Address) 17/ D 'f\~D.vJ..e/ '\~J, ~"- tvm < 55'1 c2/
~ (A~,) ....... (City) (Zip CodeJ...-
(Contaa Person) \, eel \-\,0JN:,9Y'}. (Phone) t~/-1s;2.-15bS
APFLlCANTSIGNATUR.E ~ DATE ~J3>)O~
~LICANT PLEASE COMPLETE BELOW
Ty\l'll of Fixture I Q"Dtity I
Bath Tub with or without ,!tower Rough-ins
Dishwasher I I Water Heater
Floor Drain I Water Softner
LavlltQlY (Bathroom Sink) I I Sland Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink I Sewage Ejector
Shower Stall I Backflow Assembly
Sink, Baelct10w Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
Quantity
~
I
i
.')
::J-.
I
I
"-}
BLOCK.
PID
Type or Ylxtlln
FEE S'-n",uULE
Indu",;ar, Commercl.1 a: Multi-fiJ'ruly 1% or job co>! wit!> a SJ9jO minimum Resldentl.l. New Onc & Two-Funily 599,50
R~identi.l. Additions &. Altenuions SJ9.'O
Estimated Cost S Building PenM" --F2\ID WI l.tf
PLl..iMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMUT FEE $
811lhllnC Omtitl
WILDING
11
'.r:\ Ff (0', .1" 0 IJn l~ '
lL~il:: : 1 :~u; t ::eCiP1No.
10fTIt'l tHe O"l1J
Thi. Application Become> Your Buildine Permit When Appro.od
DIl.
S d 9L8ES0098tONltO L '-IS/So-'t lb-r"rl'fiiiioc" LWn=-'7~q~';'t;l;l:'JlI ~ DNI8l'ffi1d 13ZN3M WOlB
,"
Q.l.kr.k . ".....r;.
YtlJ"e....' . A,..1'\Jr,:....IiT
~....D.r:.:r.,'f
F-
:.)
,..-',\.'"
,. ..,-.- .:JIIQaII'"
,.".llf ,
" cl -\.':'"
"<~V"E~~
--......,-
C!~Y OF PRIOR L).KE
SC:.I::P. l>lTD HAT!? ?:::?~I'!'
ilO. 04,00(6"
-'-' '
S e"../e::- ~nd ~rla ~~:-
COlit::-actor:s must
be reS'ist-ered
'''/ith the City.
H'PLICANT: W(:,)i\~t:.\ ~~~t..i>..\ Pr:.ot<E:(JSl..i.I9-~J,>6)""
:::~:~~~ ,3~"'~ ~~~~ ~'__ ::~~ ,~~~~<J
NOT::::
.~~,I;.S_~i!__1'~~ 3~_N"S
30
<t=t:'Io.-'
...--'- .
~s~i~~~e~ l~~gth of wa~er ser/ic~
1-
2,
J ,
Size of water s~~vice
I
Location of any coupli~~5
from
?VC 'K.
inc:.("s). ~
S~=~..lC::-:ure -0, '1\.
feet.
~.
~ype o~ $~~e~ pipe.. Aas
c?.s;t It'"on
5.
~s~l~atad l~ng~h
of sewe~ line 2>CJ
6 _
Clean cut. (if
s't.::-'..lc':.u::-e.
z;-ec:uirec.) ,
loca':.~c
fee~ ;JIlL
at. ~feet
f':'cm
================~===:~~~====~~;~=====~===~=~~=~~~=~~========:===~~
T~~s a?~lica~ion bec~mes ~a~~ pe~it when a?provec.
E.~
OAT:::
=======~===~=======:=~==================~=~==~=========~==~~~==~=~
FI.~S:
s
s
s
J5,OO
.50
J5.50
Sewer and wa~e= line connection pe=~i~.
Surcharge
TOT,>'!"
'1/ :~'2 :c:- ~:.':.h.e::.- 5.2'.';12:- Q.;: o:..r'l":8;.- i:-:ci'/i,:it.:-=.1..1y is S2C.()() ::2..u~
S .50 s'..l:-c~a!:';e.
w SB'("~:. a:J.c IH?-t:e~ ce:::-::tits issuec. :0::- n(.J l_r'T'),~7:'r.JLt.iC')lj ~L.:5":. bB.
=2~~==e~ on the buil~i~c oe~i~ ca~~ 2~~~imw~ ~eeu~~ce
_.... ;-S"-"" ...--:\.......0 .-l"....l;c.a~o s~............ aT'" - J~L,.~l~ :'O~."':.
_.... _.. __<.:.: '-......._.. '-'-~.~ '-- -""--.. - 1-F~ (, '."
.:.~s~e~.
~.'.~,': ~:: ?,-~ :;
- -, ..~._..__.,.,,_._,..-
,\:,~C!':i':' ~gILDrnG
.\~I~ '~dEd ;i~:lli'1.~kMIT
~ L~ l. .. . \.... --
~ AUG 1 1 2004 .')
C.:.'::-::: ?:'..::;
"~ . . .. . ~. "'
.,'.... ":;" :' . ~.'
, , .~
9 d 9LBES009Bv 'ON/vO L lS/9o:L vO.EB (3ill)
By
L9EO-~Sv-IS9 DNllV3H ~ DNlawn1d 13ZN3M WOHd
08/23/04 15:10 FAX 6S18949JSS
~ENZEL HEATING & AC
I€J007
CITY OF PRIOR LAKE
. . HEA TING/Am -CbNDUllJL~d-li/~utE-PL~CE-PERMrr' -- -- -
'.
.J,)~~J~,~c'd
fPle:lsc ~ at orin, aod si...ac bollllm)
ADDREss
~._~ .'~<,';k,peu
, /
LEGAL DESCRIPTION (alticcuseoaly)
,gjr p~!
~::::.: ~;':"'I'rERMIr NO. Ir.:' o;Cr-
"v.... ...,v.w I' d /J 1
ZONING (_...,
J
LOT
BLOCK
ADOI110N
PlD
OWNER.
(Nam~)
(Address)
/Jh"r5hh"f\
~
(phone) (''51-4M-44~
"
d
, APPLICANT / ,/.. /
(N.me) U~/'/7~/ ~.I'(<!":
1 '/
(Address) 4I?/ dc/ 4/&// /Yit>//1
!\ . . I (Addre..) / -
(COrlt.c:tPerson) J '(:)/'---\ (PhuM)
AFPllCA:--OT SIG~ATURE -z::cw #6c- DA~ ~.:L-_-_
APPLICANT PLEASE COMPLETE BELOW
$'E W CONSTRUCTION 0 REPLACEMENT 0 At TERA T10NS
FliR...'1ACE MAKE AND MODEL Pw/l/Il'i h s-I G~ ""l ~ FUEL AbJ-
FLUE SIZE ..;J-::(" RETVRN OPEN!}lOS (", INPUT _)$, (Trj OUTPUT ~ i Sb0
TYPE OF SYSTEM HEATINGORPOWER.PLANr
~""" Air Plants 0 5,,,,,,,,
DGr3vi<y 0 Hot W".r
-!d' ~lcthanieal 0 lUdi"ian
~ir Concli"oning 0 Special Device.
:.ravcn" SYStem 0 Ot/ler Devices
(phone)
h~I-~4~
~p.l'/
~ity)
~1?2....
(Zip Co<l<)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach in,o
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial. Commercial &. M~lti,Family
FEE SCHEDULE
1 % of job ""St R.e.idential. Gas Fireplace
539,50 minimum .
599.50 R.esidential, Additions & Altention.
564,50 Rcsidential, AC Ooly
539,;0
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl'rllT FEE
$
$
S
.50
539,;0
A.,."' 539.50
-uJr""-
,~%()....
.?;;~.."
-:1~
"r
Residential. Heating &. AlC (New ConSlNction)
Residen'iaL Heating Only (New Construction)
Estimated COSt S
Building Permit 1/
(om'e tlse Ooly) " .
. . . _ Jl.llldl4e:Offitiil .
P1~~1 ~ L~ \~ U ill rfPtNO' I
__._._____l!~IL._. ._.___.__D~~l AUG2,4?~O_e'l ._ _..I.
. -''"''---:JO--'''-''~~_,~,_-",,~ ",.,11""":"
24 hour notice for.1I ioop.ction. (951) ~7-9850, fu (9~) 44'1-4245 V
. B~
ihis Application Becotll~s Your Building Penn it When Approved
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2. Green
3. Yellow
File
City
Applicant
I PERMIT NO"!- ~
(Please type or Print and sip at bottom)
ADDRESS
ZONING (office use)
3880 RASPBERRY RIDGE RD
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) AT J JED FTRESTDE DBA FTRESTDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
?700 NORTH F AIRVIEW AVENUE
(Address)
(Contact Person)
BRENDA HUSTON
ROSEVILLE
(City)
(Phone) _651-633-2561
<5113_
(Zip Code)
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
3/2/05
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
DGravity
o Mechanical
DAir Conditioning
OVen!. System
o Stearn
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
HEATN GLO PIER-HV-TPT
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50 8UIL';j;~G WITH
PF2AMrr
(Office Use Only)
BuUdinl! Official
I Paid
It-~"\ !-L (-~'
h.Oale I '
Date '
i i I 6 ZUU;
24 hour notice for all inspections (952) 447-~il!!ll, fax (952) 447-4245
7eceipt No.
,-~ in r J I \
I; I!
I Y
7r
This Application Becomes Your Building Permit When Approved
By_
PRIOR LAKE
INSPECTION RECORD
~ See-Main File
"S~-e ~ \,M.....:IA..~--k
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~P>9,(") Qa"9br-'^t-
NATURE OF WORK Neu0
USE OF BUILDING S FA-
PERMIT NO. 04'. 081S' DATE ISSUED 7-2J-{jc..(
CONTRACTOR l,J.,w:..........u..LL 1=:6~ PHONE I.(~- 3.r47~7t.rz.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
OATE
I FOOTING
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~ ft?#' /)r/os- I I
FINALS
w c... p-'{ZJ %K
p~ ~-/-as-
.I?S :r Ii' /~
~4~",-
/'p~
I GRADING (Prior to Sodding)
I BUILDING
I 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,
ff~
,
,
6" Iii I
,
(Yo
I
17
~/t~
FOR ALL INSPECTIONS (952) 447-9850
~&'/r.j
ADORES. 5 'Fr ()
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work By
TYPE OF HEAT
HOUSE
HEATING TEST RECORD .J..' O~I'?
APT, _FLOOR _CITY RL"'ISUB~R'tI' .
OWNER
uk DATE Ifflj INST,
~, /}C-. INSTALLED BY ~.....
Gas Line By I,
GA _ FA~HW _STEAM _SPACE HTR, _UNIT HTR, _OTHER
L GAS DESIGN
-{ 11", ~ J
(",>'S, ",,-p :>."'~ ~'o
Sqo./I...I'::>hL5
',I "..:JO
-lr
,1<1 CONTROLS
THERMOSTAT H IA./ Heat Plug
Limit _
Limit Se"ing
Fan Setting ~
Pilot Type
Pilot Make
Pilot Model _
Pilot Timing
L, W. Cut Off
Pressur~ 3~
Input CFH ---40"
Stack Temp, II Y
MAkF
Mod.1 _
Serial
INPUT
Valye _
Form 235
,
VI) J
o:"~
,
Jr~1.
'h"",e~
1.5~
,
P.rcent CO2
Peteent 0,
Percent CO
D').
c,
p
y
CONVERSION
_MAKE OF BURNER
_ Model
. Max. BTU Rating
. MAKE OF FURNACE
Model
...3 f1
KIND OF LINER PV C SIZE '::l ~
Draft Hood i "~I"..L.f" Regularor
Filters SiZ8 1f.,,...!1IS,. , Number I
Chimney Location Inside _ "
Ch;mney Con,t,uc.;on lAIC-
Smoke Bomb _N () Wiring
Draft ___~tl",A.U:?.r- .Test Tag i45'"
Door Pressure Lighting In,t. I-Io~
,S- t3-b5
, J/!!",'...?'L
-
Vent Siz-
.NONE
Outside
Dot. Tested
kf J Itl--IfiL
- I-
, ~ ..'
- ---
Company Testing
Name of Tester.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS ~() ce6 ...V '
f2.k.
o
OWNER
CONTR,
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
WINAL
/b SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
o 12S2- ~ D\p
- \.
~nME
Lj - 8t-)
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
/
"","ORK SATISFACTORY, PROCEED
~ ~'~RR ACTION AND PROCEED
o CO ECT RK, CALL FOR REINSPECTION BEFORE COVERING
OwnerlContr:
t!"f47-9 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V--
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIWTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~() Q 'l.q,p\,.,.,,~_
CONTR,
OWNER
PHONE NO.
PERMIT NO.
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
..ef'PLUMBING FINAL
o MECH FINAL
COMMENTS:
11
1fL.~
" /I
~1
<1.-.1
I
DATE
5/4n-
~,(
o
TIME
'-I - IYs
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
......D? RKSATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORREC WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspe or: t I Owner/Contr:
AL 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
c>;;J REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY/
INSNOTl