HomeMy WebLinkAboutBldg Permit 04-0024
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
JJ-- J,- () 3
I. White File
2 Pink City
3. Yellow Applicant
I PERMIT NO. 04-. () 0 Z4-1
(Please ~e or print and sign at bottom)
ADDRESS
~qJ7 6;"'0'" "A.Jl.
ZONING (office use)
Jft 5Jj
LEGAL DESCRIPTION (office use only) .
I I ..,-k- "'Ill,. ;I"",/L
LOT BLOCK ADDITION
PIDd5- L/~L/' 00/-0
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name) 1J'J"b,v,d- AM~.J,
IJ1 i t/LII~
(Contact Name)
(Address) /d2.~:J
tJ. ;/, ~
(Phone)
(Phone)
/
tJS;}-!'<ib'J'7J.}
O/S;/-'/;o - n.z.?
Al,'LC/!e.J Av?t1"'C-
~'dH5I1//t
hWSS337
,
TYPE OF WORK
;g.New Construction
DLower Level Finish
DDeck
DPorch
DRe.Roofing
DRe.Siding
DUtil~nneCtion
o Fireplace
OAddition
DAlteration
o Misc.
PROJECTCOST/VALUE (excluding land) S :2so av
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 ~m 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 ~ccordance 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 pr ~pe:p)o perform needed inspections.
X c LZ, W~. Hd/J01.5"YI<l /"lIdtJ3
Signature Contractor's License No. Date
I Permit Valuation r.Ffs'htJ.OOO,081 Park Support Fee # $ I
I Permit Fee $ I 9S~.5&.. SAC # $ \ ':<\'SO ,0() I
I Plan Check Fee $ /2-~<},7i Water Meter Size 5/8"{ J:) $ 300.00 1
I State Surcharge $ /2S,()o I Pressure Reducer $ 7(J,oo I
I Penalty $ - I City SAC and WAC # $ 1'U)o.ool
I Plumbing Permit Fee $ 1110,00 I Water Tower Fee # $ 700,DoI
I Mechanical Permit Fee $ !O(),OO I Builder's Deposit $ Is-oo, () 0 I
I Sewer & Water Permit Fee $ 3'5.5a lather $ I
I Gas Fireplace Permit Fee $ ""10. () 0 I TOTAL DUE CAn\jUJ I. /5dJ---$ fl,743.18 1
This Application Becomes Your Building Permit When Approved
~~
, Building Official
1/IS~Oq
ate
I Paid ,.f114-J:7r
I Date . /.~IJ9---
I Receipt MS.
By ~_.
U
4WN--'
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
~~nin~ J/I~~L( ~ ~nditi~f~~
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
~1
C-::White . Build~
. Canary . I:ngme"imng
Pink . Planning
Th~ (-..n't'. nr Ih.. I.ak.. ("ounlr,-
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLlCANT-'m~ Lf)~ /~
APPLICATION RECEIVED J;;. - d- -() ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for constru:; 9c;; Wh(J ;;;;~ fJ~
Accepted
Accepted With Corrections , /'
Denied
~""'</J , .A , n' -f) (/1
~Y'-"-Z ~ Date: 05~~
~ ~ ~.!J~,
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."
~~
White - Building
~ering
...--Pink - Planni~
The Crnter of the L.kf ('oun.".
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
, ..'/
~.' .'1 -, I ..
NAME OF APPLICANT F... / ,
APPLICATION RECEIVED
-~
,
/ '",-.J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.I
Accepted
Accepted With Corrections ......----
Denied
q . J "/1.
Reviewed By: UV.-R~ ~ Date:
Comments: A, (2.. U<r, 'I-:c .-k -t...e...., ~
~.~~dY--~
/ /1 c;;- /0 <f
/
o-v-:t- a;j ~ e. .. ...::X;-
~ -a.J1r'~.
t7
"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,"
~~
White . Building
c:::l.<l'nJ'rv . e'J1pineeniia:>
Pink -=-l5Ia"nln9
Tht ("tnln of Iht I..kt COllntry
IDm.DlNG PERMIT APPLICATION D!;EARTMENT CHECKUSI
NAME OF APPLlCANT-1l/" /l
/f
!
APPLICATION RECEIVED
/0<,
i '-:.;..".'-
/'; -;--:t,
:_--," """..-'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
./ ,',;--}
I' .1
Accepted
)(
,
Accepted With Corrections
Denied
Reviewed By:
IW/o
Date:
/- /6-0'1
Comments: See Reverse Side for Additional Information!
""D~ ~ ~ tf~ ~.
See Attachments: 1) Grading Plan, 2) RTOsion Control Measnres
"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."
03/01/04 MON 14:21 FAX 6128902753
STOCKER EXCAVATING
~001
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
q?leoUe:J'(ge orOr1nC a..c.d sim a[ borroml
ADDRESS
Ie"," Fil, I PERMIT NO
1 Y~IQW ellr .
}, Gall A.ppliulll
04-0024
ZONING (office",)
2917 Cougar Path
LEGAL DESCRIPTION (off"e use only)
LOT 1 BLOCK 1 ADDITION
The Wilds North
PID
OWNER
(Name)
(Phone)
952/890-8722
r:
McDevitt Homes
(Address)
12252 Nicolle. Ave, Burnsv11le, MN 55337
(Add.ress)
(City) (Zip Code)
APPLICANT
(Name) STOCKER EXCAVATING COMPANY, INC.
(phonc) 952/890-4241
(Address) 12336 ll.~c:lne .!':':.".~!':~...__. . Savage, MN 55378
(AdZ,",,) (City)
Curt ~.~II
(Contact Person)
APPI..ICANTSIGNATURE vZ.'" .. .~... bv
(Zip Code)
(phone)
DATE _3~ Iv oJ
I
same
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 pve
Estimated length of sewer I ine feet.
Clean our (ifrequired) located at feet from structure.
feel.
o Cast iron
Residential sewer and water line connection
Sewer connection on ly
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi.family 1% of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
T01'AL PERMIT FEE
$
$
$
.50 .... i.e,!.,
''';~';i r;'4o;) ~1IrIri-- ..
.'.'~,":li"?'IIt vlf/J!I!:.,n
'i,"~/?'fl,li""""
. ....'~,~
... '"::'r(~~
(Of(ice Use:: Only)
This Applicalion Becomes Your Building Permil When Approved
Building: Official
lPa1<l
I pate
L--MAR-'-'^~ LUU~
24 hour nOI;.< for 311 ;n'poctions (952) 447-9j8!;'Q. fox (952) 4474245
R~ceip[ No.
By
cr.
OM 1('
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I,Pink
2. Green
3. Yellow
File
City
Applicant
I PERMIT NOD+. o Oaf-
(Please type or trrint and sim at bottom)
ADDRESS
ZONING (office ">0)
2917 COUGAR PATH
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Namp Mr:1]l'VTTT HOMES
(Phone)
(Address)
APPLICANT
(Name)-----1'- T.T ,T'PD PT'R'PSTTlF DRA FTRFSTDF HF.ARTl-f & HOME
(Phone)
/\51-/\33-25/\ 1
(Address)
noo NORTH F AIRVIEW AVENUE
(Address)
ROSEVIT T F
(City)
55113_
(Zip Code)
(Contact Person)
RRENDA HUSTON
(Phone) _651-633.2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
3/2n/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent System
D Steam
D Hot Water
D Radiation
D 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-750TR-C
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 & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
2/:'[c) {'ljf<rr:. ._'
~'".'- \;. '.. . I
-'of' r"'.~ ("'l:I.1'l',\r.~ ~:'JB_" ,._,
,"'" .,.,[..." \ ,1:1 !"':-~~I~'.>:':V I
.50
(Office Use Only)
Buildine Official
Date
I Paid
I Da.lfPR 0 1. 2004
Receipt No.
This Application Becomes Your Building Permit When Approved
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
s~~~
~ <<.""
:r"'NESO
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
L Pink
2. Green
3. Yellow
File
City
Applicant
I PERMIT NODf-. ooar-
(Please type or orint and si2D at bottom)
ADDRESS
ZONING (office use)
2917 FOX TRAIL NW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name JOHN BUTT.ER CONSTRUCTTON
(Phone)
(Address)
APPLICANT
(Name) AT.T .TED FTRESTDR DRA FTRRSTDR REA RTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
(Contact Person)
RRENDA HUSTON
p"OSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
3/.,0/04
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
OWarm Air Plants
OGravity
D Mechanical
DAir Conditioning
OVent System
HEATING OR POWER PLANT
o Steam
o Hot Water
D Radiation
o Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
REA TN GLO 6000TR-OAK & 8000TRD
Industrial, Commercial & Multi.Pamily
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
"Mrc'I)1'^^""'""' "
L-,~"';i'J';I,fl';!'-:,
,,",,~ ,,:.'.J.".
~'C co, "",. ''''' ""...~, _
.5tt"":'.,~t~:.",~'!'.:lI'o":"?I':"'!'4~-I'
(Office Use Only)
Buildine Official
Date
I Paid
I DA1f'R 0 1 2004
Receipt No.
This Application Becomes Your Building Permit When Approved
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
-.
'f/::Jy......
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
CPlutc"!1'I!f if'" _taP .tbaaDml
I ADDRESS
I d,Q/7
( (l U 3 Q {
I LEGAL DI!SCJl... ..v.J (ollkr......")
Lor BLOCK ADDITION
OWNER
(Name)
(Acid....)
. APPUCANT
(N""",' I.l?.
p.
(Addreos)
(Contact Person)
m ~ ().e v J"f 1-
cJ.
p}"",o
6v~ ;;) ~ 17(;J...
(Addless)
tn \ i,,6
APR 0 1 2004
;:= ~~ I PERMIT NO~ '. _",A-
I V~n ~ ~ ClIl.".....-
p.... ,. ~ I ZONING (oIIl...",
PID
(Phone) <1 s 2 - g '} cI- .~? ;;;)-4
/JA.
(phone) t. ,/-(" 8/- gz.-s: z
5S.12-~
(Zip Code)
(0 /2 - Co I 9, 7 IN",
DATE ~- <,J . ~ '(,-/, <J!<t
S-I'. r,,;c.w'
\"\'l-10lV"
APPLICANT SIGNATURE
/?/d.
QIIa11rity
.:),
I
~
""
I
/
I
d.
2..""kO-"
~/V
(CiIy)
(Pho1W)
b--
APPLICANT PLEASE COMPLETE BELOW
I Type or Fb:t.....
Both Tub with or without sho-.
I Diohwosh..
Floor Drain
Lavatorv (Bathroom Sink)
Launell"iTiaV (lor 2 com~nment .ink
Shower STall
Sinks
Bar Sink
I W...... Closd (Toilet)
Q..1I1i1y
~
I
I
I
Type ofFil:tut<:
Rouj!h-ins
Water Healer
W1lIer Softner
Steel Pipe (Wasllllll Machine)
Sewage Eiector
Bocktiow Asso:mbly
B.ckflow Assembly Test
Lawn Sprinkler
1000er
I
FEE S~....._.ULE
Indb.strial, ComI1Iercial &. Multi-fllmily l%oftab CQlit wilh It S39.SQ miftimum R.aidmlial, New One a. Two-family S99.:50
kc::lidcnli.l. Additions 6; Alteraliom SJ9..50
Eoli..-d Cost S
Bwildins Permit N
~DWJni
~JWNG~nr
.50
PUlMBINO rBRMIT fEE 5
STATE SURCHARGE $
TOTALPERMlTFEE $
(omrr Uk 001,)
This AI, :.." .:,. Beo..v...... vo.. Bulk1i11IlPtl'1llit Whe. A.",
t . 01
-..-
.....
i'
.. ~:
hid.
Receipt No.
!
Date
APR 0 1 2004
By
ZUn._faroll..., ..;. ,(J52)~.i~-'fult5Z)"7""Z45
tallO EoJIe C.... ....,~ 11-..... Pttot.""", _ _1110
'L_-'>.____
L.------
SOEBtBStSS
Z~I tL.j:>S a>tHj
e6S:60 ~O to ~0I~
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS JfL7 Cf;,,~ PATt(
NATURE OF WORK ~ "lMJcr/ll,Jt:n.~
USE OF BUILDING S#F:" D#
PERMIT NO. 04, 002.-4- DATE ISSUED IllIg ~
CONTRACTOR JI<.cfJEI//~ J-/~WfCS PHONE -894 -9"1z.:z...
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~OR
I Jf1P
, FOUNDATION (Prior to Backfill) I // /5 I $'-</
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - tNS
!tf5 - '1-:s
~; ~!l3/b I{
R> V7"~
!?JJ
I't:h. _
//:1;t7
~ I,~ t{/l~/fJt/
.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I _ I
FINALS ~ uJ~
IV~ 7/2,05"
, FOOTING
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
GRADING (Prior to Sodding)
BUILDING I_y l-. 10-1-0<-1
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
DEPARTMENT OF
BUILDING AND INSPECTION
DATE
I -:z~:z?
1
l
,
IJ,J/e
I
sr.~
t/ 113/oV
t/ /1:i14./
. r
We. h ~'d""">
(~/l
~
UNTIL ABOVE HAS BEEN
NOTICE
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 shall be placed near main entrance.
F"" ':' ~.! J. iNSpr.:~~'ONS (952) 447-q8~"
_.n.. "'-...
C1lrrfifiratr of <IDrrnpanrl!
CITY OF PRIOR LAKE
~rpartmrnf of '!JiuilMng J}nsprdion
Y-Final Permitted 0 Conditional e.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.
04-0074
Occupancy Type
R3
Type Construction VN
_ Fire Zone
N/A
_ Zoning District
R1SD
Legal Description
Ll. Bl. THE WILDS NORTH
Owner of Building
Site Address
OQ17 ml1r:;AR PATH
Contractor's Name & Address _ MCDEVITT ~S~
ROBERT D. HUTCHINS i .1/---
1'/ I a I Building Official V
Date: -+t{O~
Po':; NICOLLET AVE.. Rl1RNSVnr,F.. !-IN '>'>337
_ City Planner_
nON RVE
Date:
-~
,:.'
"
DATE TIME
CITY OF PRIOR LAKE "'I
INSPECTION NOTICE SCHEDULED 7 '" 1-0 ~
ADDRESS ";2.'1 /7 Qd~ c:?"'~<l
OWNER CONTR.
~~otJ
PHONE NO.
PERMIT NO.
t..J - 0021:1-
I
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
;-~SULATION
NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
I. "'-lQ,......a. iw:.~"<rvt f'\J.ljJ&b.. 't<:,,"J.-qI.(7-~n.1
bJ'....... 9..1l
~. """,......I-.....:"'-~- (\~
ct3- So.A.~Tt:UU ~ ~.J-~
t./. 10 Cb..... ?.~I{'"k In-Q \,.~""'^ G<.o..-o; ~
1tJ-1- (') Y
~~~~
Ot;l\D..J- I1g....4 ~ {
~
I~o
~ I
~
L,..... S' 4"tiJ:: ~ at:
.
o WORK SATISFACTORY, PROCEED
o CORRECT ION P OCEED
~ORRE OR REINSPECTION BEFORE COVERING
Inspector.
OWner/Contr:
FOR THE NEXT INSPF-CTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
I/fSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7-20
OWNER
,;ft n 0~ J-
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
'/-
"2... Lf
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
. 0 ~R HOOKUP
;S::PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: ~ . 1\
~ ~"t ~
'2. D"'f a.Lt t?JtI.J~
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORR~K' CALL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contr:
CA 7- 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
./
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
umwn
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
1'1l
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
HAL
o SITE INSPECTION
COMMENTS:
SCHEnll ~ nME
()NXA) \hYh
(]
CONTR.
PERMIT NO.
tl _ OOZy.
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLINE AIR TST
o
A
I. t:",~ rot-r~ \'~ ~'
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRr\~ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecte: .r /l Owner/Centr:
CA ~lj 9SS/FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 7.717 (19~<r ./J6vA
OWNER
DATE nile
=
PHONE NO.
CONTR.
PERMIT NO. '" 1I - txJ) Sf
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(;f'a/fb-ryf
.
~~ING
D~ INT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
~+/-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
C CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:~1.~'~ ~l -wner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'....n
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETYI