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HomeMy WebLinkAboutBldg Permit 01-0609 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d (Please type or print and sign at bottom) ADDRESS I. White File 2. Pink City 3. Yellow Applicant j I t.f ;2/q / , I ~ Iy AlE 0/., 0'01 I ZONING (office use) ~I LEGAL DESCRIPTION (office use only) LOT 10 BLOCK ;2 ADDITION k n/1 ~ H / / / 'I7h PID~'3t;z.:- O~5-J, OWNER (Name) 1< ; r 1:. .;.. /< 17,/1 r (Address) /J ~/ .~ j, 4.;- (Phone) -.bL:J ....~, 1 "/ -87'qo BUILDER-r (Name) 7 d~ .~/~ ~ r"/J;,ff: (Contact Name) Tt:fIA--7 (Address) '-/Lf7 TAe /( Dr ,~'~~e (Phone) Cj'l;",J.. -1196'- ;109 '3 (Phone) <7 C::2 .....J..'7:J.....t..!t$Y r<;,l,) 9 4Lf TYPE OF WORK lB'New Construction ODeck o Porch OAddition ORe-Roofing ORe-Siding OLower Level Finish o Fireplace OAlteration OUtility Connection o Misc. PROJECT COST IV ALUE (excluding land) $ 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 enter upon the property to perform needed inspections. ~~ , Signature 7~ Contractor's License No. s- ~\-ol Date x I Permit Valuation 1 13,0X) rOO I Park Support Fee # $ ~. 6}, I I Permit Fee $ I . S'll(.s'\ I SAC # $ (I I~ /XJ I Plan Check Fee $ Cfeit. c{(4 I Water Meter Size f1iJJ I'" $ 1?b,tJO ' , I State Surcharge $ '1 (Po c::;-O I Pressure Reducer $ 4C<2CJ I Penalty $ I Sewer/Water Connection Fee # $ II r2(X) . txJ I Plumbing Permit Fee $ 1a:!J. tge> I Water Tower Fee # $ . ~ .I9f!!1 I Mechanical Permit Fee $ IOC). c977 I Builder's Deposit $ 11'70a...~rJ I Sewer & Water Permit Fee $ b~,~j;) I Other $' I G~lace Permit Fe~ $ l.{O. (?I) I TOTAL DUE 0I/Jj..RilJ '-:..1.$' () ! $a~ 0/ j01 A , - I :5 qk'~) ( ;' p 'Mn-r;;~d I Paid st'44/"' U Receipt No. I Date o --:)...j -0 ) By ~ U . ng Offici)( Date I 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 ~~.m~_,~ a ("'n.~ /".->L ~';;:l~~ 1... ~Ls 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ~~ White - Building Canary - Engineering Pink - Planning The Center of the takt Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED -.-;@! f/o-fAJU> ~ _ ~- :::;>C;-o / The Building, Engineering, and Planning Departments have reviewed the building permit application for constri~a~;ty w&;:m -4..-0 Accepted Accepted With Corrections ~ " Denied /J ~1 ReViewed~~~ (J:;J& t1~~ Date: ?-l/-32d1 "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." -'---~--'-'-~~'~"-"""""~'~~~"-'-'~-'--"""'---'._- ----,.,--......,_._.".,.._,..~,,',-""---~~_._.._,,~...."....-.._~'._~..,.,~-'~.,,"~.-,.~.'._-,...,----_.~._---,.__..-"._-~~--~--,._..,-,..~_..~-".,.,-~-'" Tht Ctnlt, of Iht Lakt Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST .../"~ .--, NAME OF APPLICANT / /j'7 I ) "1'i ;-1-,1 ::... /' f.. CL/ APPLICATION RECEIVED /'-::-~ ) (-;--() / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: / if} <; / ;: /~<i' (/',;0' /' d - /./c~ Accepted ~ Accepted With Corrections Denied ti /~ It Reviewed By: ~ \~C)~ V' ~ Date: ~4 /& ( Comments: ~~ 2-t.f F\ ~~ ~ F'ii'eUt.- \ )riflW'1 {;;v., ..J-- '\( VtvlJ rQ, D~ t:-..1 ~ 0 G-v-kl. --AU .-1/k~ f2t · ~,i_~< _~IU- _tyvJ ~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." Thf ("f'n'''' of 'h~ l~.kf Coun.ry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED f:rnn .~ ~ ,~- ::JS-O / The Building, Engineering, and Planning Departments have reviewed the building permit application for constr~ij;;~~ WB; Zd -4-v Accepted X Denied Accepted With Corrections Reviewed By: 1IftJ3 Date: t-/8-o1 Comments: See Reverse Side for Additional Information! IY/us f- h411( ~ % M ,on S I<:J(U 4l.t/"'-," ('vf!)m h(1v5~,- ~ee Attacnments: 1) Grading Plan, 2) Erosion Control Measures 3) Erosion Control Plan "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." Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT ~. ~~ ~:;y I PERMIT NO../)/_ / 4' 1 Yellow Applicant U (t:JU f (Please type or print and si~ at bottom) ADDRESS ZONING (office use) Wiler I 'BI ve $~,D +r- R I LEGAL DESCRIPTION (office use only) LOTI/) BLOCK ?- _ADDITION OWNER (Name) APPLICAtll2 ---:A (Name) O~\~ ..rlu..u.~~ (Address) !3{51/S t'cJ~~ -cr (Address) (Contact Person) &"6 if. ~. APPLICANT SIGNATURE A_ AA... "'d V- I APPLICANT PLEASE COMPLETE BELOW Type of Fixture Quantity Bath Tub with or without shower -:3 Dishwasher I Floor Drain Lavatory (Bathroom Sink) Laundry Tray (1 or 2 compartment sink Shower Stall Sinks Bar Sink Water Closet (Toilet) (Address) Quantity .d-. ) A/ '" 1-/ ." . , 34i1 ~ob 01 IJdi? tftA v PIW?S-J~;;t - ()d-S-<,,) (Phone) (Phone) 9s~-J:13"> -6l9"~(P ~((\~v('{le. SS33? (City) (Zip Code) ...... (Phone) bl ~ ~ "3~~ 3/ 7 J DATE Y/~I 0 I Type of Fixture J Rough-ins Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly Backflow Assembly Test Lawn Sprinkler Other , FEE SCHEDULE Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Estimated Cost $ Building Permit # t"./IID I~" t'JU 1"'\. ',: . Tq D lLDING [. .1:,. ,_ .50 L.;I "'"111 r PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid I Receipt No. Building Official Dat~ -&-0 ) / 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 B~ U Date FROM : KLINGBERG COMPANY -:f\" tf PR~ .f: 1\\ \~\ ""'l l:II:: ~ tr1. ~NE~ PHONE NO, : ..I\. J!l. v' R w.of-; a.,' 0 () ~\f!A./ uJdi:L ~ '01ftJ/ ~~ .);,~t~~~~~~~[;.~:;',c,;:'. ',' t' :.' GIllE. . FILII; 'rIR.LOW . .....Lle..' eoLD - C'TY Jul, 11 2001 06:50AM P1 ,'v':, ."" Q <, ,i.....,_/ 0-' '. NO.. ~ . '. '\" ::.>> ... . "'-, Jl{QTE: Se~er and Water " ";;' :"~:;,,:' ct1:nt'ractors must . '.<(._.,:(),.'..,.,;",';'. :,':.,.. .' b~..: .'r.9'ist~reQ . < ". . . (:<\,}, '~::';;;;i' ,:,;.:::~,j., ~.,~~:y~><:>.:;:: ;.;':,L::'J.;/,,<:.t . . ~t~~ .,,:2:~e.. ~\7:~ . " '" '..:~~~ ~..,. .:~~t."':-,"" .'. '::i:l'i:j,'l~.t17 APPLICANT: ..'~ .t~ -n'iy" rli1 f .J-Jtc:..:;paol:re:"1 :...;. . . I ADDRESS: ftJ 'i1fP1" ,:;PJ1~ J A{M . OA~E: '7-- /tJ-a/ SIGNATURE: ~ __~J..~'~~1:,\ .: .._..':':::Btib~. P~RMIT # JiM- ~D~:d.'iJ Ff!:-::?::"X::~fa~~'irrt'^;~:1157;.:,'i .... IlCL Pr--p- ',(9 '~fe~.~. '. 73:6' '.: 2. 3. .. 4. 5. 6. "" .,.J.... 1. Esti~ated length of water service I" . size of water service inch(es). Location of any couplings from structure feet. Type of sewer pipe. PVC X. 3:') feetr at ~. feet ABS Cast Iron Estimated length of sewer line Clean out (it required), located structure. from ================================~=~=~==;===========:===~========== This application becomes your permit when approved. BY DATE: __.__==*_*____e____~_~___~~a==~~~~~==~~===========~~=~~_~~~~~_~=:= FEES: $ $ $ 35.00 r50 35.50 Sewer and water line connection permit. Surcharge TOTAL * Fee for either sewer or water individually is $20.00 pluS $ .50 surcha:rge. * Sewer and ~ater permits issued for new construction must be recorded on the building permit card at the ~i~ of issuance ~o insure that no duplicate sewer and ~~ter p..~its. are issued. SUILDI'D Win, DATE PAID~! AMOUNT PAI~D . NG PE:F;'"v~JT RECEIPT # REC'O BY',. '. .:: . :'.;;:. : ( , :..: :'", ~ :-:',~~'.,..':..:" :": . . 4629 Dakota $t, S.E., Prior 41<e"Min~~ota 5S372 IPn. (~~?). 447-42$Q I. f11x (6.1.~l 447,4245 . AN EQUAL Of>PORtl:!MTY EN!P~R From-BURNSVILLE HEATING +8128940925 T-l00 P,Ol '-.1..1. .I. V.l' r .l'U.UK LAl\.J!.. HEATING/AIR CONDITIONING,Ill\EPLACE PERMIJ F-250 Date Rectd i;=. SioAn. I PERMIT NO'/_(g 09 (P1C:ll.lIe ~e OUlrint and lien arbottom) ADDRESS' ZONING (office use) I~q 'tS Uf ,')j vrI (/ ~ ~.. ktt. LEGAL DESCRIPTION (oMce we only) LOT /~LOCK _~DDITIONJ::iJob ill yJ!j ~ &=~R\Otn \.-\ h\ M 9-' r () l"\b..4:( {_ rtlrw, (Address) 41..11 ~ D~. W\ bY' l...c;...Y n U.I!..) APPLICAm' . ~ If\ (Name)_bU~ ~\\ \2.. cl.n(r~ (Address) \:l U ~ \ tnDf'lo \ ~\ JL Au . ..s . (Address) P~- 3'J.~dS{-) (Phone) ...""'\~ 379 q6:l- L{7'(g-,!X)9~ (Phone) !1.5;1.- x'i!1:s;:rrf5 ~~Qo/ S537~ (City) (Zip Code) (Contact Person) W('tylj~ (Phone) DATE h-~'/..::Q ( APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BELOW ~W CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS FURNACE MAKE AND MODEL Le..t\l\O)( (1 ~ ~4!1."S"-/S- , FUEL tJa..~. (;,1QS FLUE SIZE - RETURN OPENINGS q INPUT 75. ODD OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT OWlICm Air Plants DOrllvily o Mechanical 13Air Conditioning OVent. System o Steam o Hot Water o Radiation o Special Devices o Other Dl:viccs PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbac:ks FIREPLACE MAKE AND MODEL IndusIrial, Commercial & Multi-Family FEE SCHEDULE 1% of job enSI Residc:ntial, Gas Fireplace ~minjmum ($99.50) Residential, Additions & Alterations )b4.:JU R~sidcntial, AC Only $39.50 Residc:mial, Heating & Ale (New ConstrucIion) Residential. Heating Only (New Construction) $39.50 $39.50 Estimated Cost $ q{}t1J .00 Building Pennit # REA TTNG PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ Cfq. €;;D $ .50 s J D().a-) p,~\n ',' eU\\..D';NG PC-I ",., I (Office: l,!se Only) This Application Becomes Your Building Permit When Approved Paid I Receipt No, Buildillg OJ'tiei.t1 D.te Date ~ /:J;t /0 J 24 h(lllr notice for all inspedionS (952) 4~7-9850, fu (152) 44~-4~45 BYe PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION " SITE ADDRESS JL.Jacl.J ~ Ii.... NATURE OF WORK tJei) USE OF BUILDING S~~ PERMIT NO. () {. OriJCR DATE ISSUED fo-l/"'~I CONTRACTOR ~~ I-\t)\ke~. PHONEq6"2...~,? _/l..f9a NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT JtISPECTOR ~ I FOUNDATION (Prior to Backfill) V~ ~. ter d)-"l /6 J I tf;q.. "7// 0 I 0 I I PLACE NO CONCRETE UNTIL ABOVE HVAS BEEN SIGNED ROUGH - INS SEWER I WATER I SEPTIC _. \.l"~ ~f FRAMING W.c.. . ~~a""'-"'" ~ INSULATION "f?h' ttaJI '~'(Lc ,~c. ELECTRICAL " ~ /? PLUMBING /P9-. - HEATING (if required) " f, ~ . ~t-IiA0f5l, ,.;~ GAS LINE AIR TEST FOOTING ~ /?f1 h , I DATE I 6~/1) / l..J+lP. ( ~(j~1 ib'lID' / I r; 111tJ I , *&/;;./ /~I I . COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS [{)A&/Cfl-~ 4- /,Ja.u.- h- (?--o\ ~. r/~?4J ~t).. ~~Oll()?- h.(6/JZ/rJ) ~ I tfPr A 11;#/), rJk , .J1t- ' Ifr:n 'tb- ~ I" J I OCCUpy UNTIL ABOVE HAS BEEN SIGNED NOTICE GRADING (Prior to Sodding) BUILDING ~c..O, ~ 161(~(lJ' ELECTRICAL PLUMBING HEATING DO NOT 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, ciY.'d sh,~1 be placed near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850 _.- .~ "' ~,_. '- ..,----_.,~",....".. -.- ~ DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS lo/lh{OZ- !y')4.\ {lj~~\It,t V~ SCHEDULED OWNER CONTR. PHONE NO, rYL - &ft1 PERMIT NO, o FOOTING o FOUNDATION o FRAMING 9- INSULATION )Cl FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: ~QlO_ {- ,.\ 1'e..E.-<;. \JWJ, J I)k.. . . - bQ,( _ QtJ lMaJ ~~\A/lJ_ (~(~ ! ) _ / ~RK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING '"""",,"C -4J, Qwne,lCon1c CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! /N8NOTl ADDRESS It/a 9/ DATE TIME SCHEDULED /0- ICK -/ Il T ~ CITY OF PRIOR LAKE INSPECTION NOTICE OWNER CONTR. PHONE NO. PERMIT NO. J -too '1 o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMING 0 WATER HOOKUP o INSULATION 0 SEWER HOOKUP o FINAL 0 PLUMBING FINAL o SITE INSPECTION 0 MECH FINAL \ ~ ~OMMENTS: Tc...o- L~L/I/'6~ /5..e....-r--' OJfb~~ ~ ~ 7 -1! 0>-. (/, IYjL"-~' \.l~~.~~ ," 1A~ ~ v~*e ~ o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o T: Cr d I~ tJ z.... o WORK SATISFACTORY, PROCEED .,.. CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING Inspector: ~~\ Owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI INSNOTI DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ~/ol JJ: Do ADDRESS / ~ ..=J.. 9 / ~ OWNER CONTR. PHONE NO. PERMIT NO. () (- bt)'1 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 TI~ 0 SEWER HOOKUP 0 FIREPLACE FINAL 15il' FINAL ~ PLUMBING FINAL 0 GASLlNE AIR TST /[] SITE INS..'.:... I ON ~ MECH FINAL ,. 0 COMMENTS:(V tJeJ 1;C-\ 0, t11J ~ ~ ~r- tJ~~ l-l~ -~ ~~, (i) ~(?~~ ~~~~ ~-(~J~~~') ~~p~~~ -h'~ (pH. ~ (' ~-A4 /i")o..L r. ~.D ~ o--? A..d-4r, - ~--U~ ~ V , e"...,~ 4- tr>-- ~ I~ ~, ~~~ ~ (E:)~ ~ c~ ~ TC,(). K N~n c rLSA-T ~ lo/~t/o I , B"'- /_ ~....... ~ ~qo~ {(~ "I) o WORK SATISFACTOR ROCEED ~ l CORRECT ACTION PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~ Inspector: Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTJ DATE TIME CITY OF .. ~KE INSPECTION NOTICE SCHEDULED /1-/3-0{ PHONE NO. 14191 B/c.Jch/rI PI /tJ~-. CONTR. --r0M HO/fIII ~ elMS-/. PERMIT NO. -61-W 7 ADDRESS OWNER o FOOTING o FOUNDATION o FRAMING o INSULATION ~NAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL . XEXlGRAD/FILLING " 0 'eOMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o COMMENTS: I'Jjfn &Jf- ..- of.. 6rc,th" 19ft-- ~ORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~~~.~. Inspector: ~~~ -....... . ~ntr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE, CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI ADDRESS / ti ;;-y J DATE TIME SCHEDULED I_II ~/ ~ /) fij)~A_~h-;d r:1 ~ CITY OF PRIOR LAKE INSPECTION NOTICE OWNER CONTR. PHONE NO. PERMIT NO. I r-fp e, o FOOTING ~ 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMING ~TER HOOKUP o INSULATION ...Id-S'EWER HOOKUP o FINAL 0 PLUMBING FINAL o SITE INSPECTION 0 MECH FINAL o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o kOMMENTS(/)) M ~ f1 u..--Jr- @ ~~- ar~~ ~ 1~,J -J b1.~' -j-- - ) 1~<' -; ~ \/'f Ity "l l 0.0'f-f..?-'- PJc : o WORK SATISFACTORY, PROCEED ya! CORRECT ACTION AND PROCEED :S:::ECT WO~,L FOR REINS:~::,::EFORE COVEmNG CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl INSNOTJ CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS 14zCJj ~{,-U65/1eO OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMING (jJ 0 WATER HOOKUP o INSULATION 0 SEWER HOOKUP o FINAL 'fiL PLUMBING FINAL o SITE INSPECTION /[] MECH FINAL DA TE TIME ?-zt.j.o/ tf-:OO /-foOq I o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o rW J COMMENTS{j)j ..J) . , 'f- -01 ~ ~ qu-o ~ ti" rJ {/ -+0 501 if, ~~~ ~ A-~s;J::"iAArc ~ ~ ' _,~/~~~~l'f @~~~ trog~J- ft ~ - f ~ ~ cr1 &s-r:/::-! ~ 1-'-d- J...c-.. '/2. J.-..-, 0 v ~~~ ~ -tit- \ '~IJ () A' - n aA- o WORK SATISFACTORY, PROCEED \tV ~ ~ ~ ~r. ~n. ;V CORRECT ACTION AND PROCEED -, ~ :::CTWO~LL FOR REINS:::,::::FORE COVE~NG CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTI CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!