HomeMy WebLinkAboutBldg Permit 01-0593
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please o/Pe or print and siJUl at bottom)
ADDRESS
~J-1
m/-M &4AlJ-l
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK & ADDITION~~
Date Rec'd
&.&-01
I. White
2. Pink
3_ Yellow
File
City
Applicant
I PERMIT NOQ/.-()5q3
ZONING (office use)
;e/
I?I
PID z;5-37fr079- 0
OWNER
(Name)
WlNDWOOD HOMES
14811 EwingA~'J. G., ~roa
Bumsville, MN 55306
(Phone)
Cj{;t.- -f}"}~ -~4-4J3
I he celt that I have furnished informa~n this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
auth .ze eot the above-menrio \H'~r~"J and that all constrUction will conform to all existing state and loca11aws and will proceed in accordance with
submitt 1 I a aware e buddIng officIal can revoke th1S permIt for Just cause Furthermore, I hereby agree that the City official or ,a 7ee may
en'erupon ope .. ..-< 'd, _H" h97 C//flPI
Stgnpe Contractor's LIcense No Date
I Permit FeeU I $ 1.301 - 7S-
I Plan Check Fee I $84~. ''-I
I State Surcharge $ 1/ ~()
I Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
(Address)
BUILDER
(Name)
(Address)
TYPE OF WORK
I
~ New Construction
ODeck
OLower Level Finish
o Fireplace
o Misc.
I Gas Fireplace Permit Fee
100 .0()
I[)O.OO
:5S'. SO
4() .00
(tJrfon B:O) Your Buildm~~7~ ~;;:oved
B~cial Date
(Phone)
OPorch
ORe-Roofing
ORe-Siding
OAddition
OAlteration
OUtility Connection
PROJECT COST/VALUE (excluding land) $ /55 PRO
I Park Support Fee
I SAC
I Water Meter
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Aso.ool
IJI,sn.Cl6I
1~.s,~1
$ LiS. 00 I
$ Il~OO.QJ I
I $ trClO _ CO I
$ fl'~tX) .611
$ I
$ 8.070. '09 I
#
$
$
$
#
Size~ 1";
#
#
~J}
1..I.,.fJ I
I Paid f3. o70.e c;! I R.ec~iP .3t:-?&",q
I Date ..:..:>i . ell By /.
I - ,--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and ma'f 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
"'"~J^ . ~__~ tlt~/lPl ~~~f'w.T.('k.k~~
t....- A -~or Date SpeCIal Co~i.fany AI ,,,_
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ~~\~-;
~1
White - Building
Canary - Engineering
Pink - Planning
Th~ ('fnlt'r of lhf l.ak.. ('Ollnll')'
mm,.DING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WI NDINOOO HOMES
{IJ - (p- 01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for consfruction activity which is proposed at:
/532./ WI L-DS PARK-WAV
I
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
fLIfH3
Date: c.-/3-0 I
Comments:
See Reverse Side for Additional Information!
::;ee Attachments: 1) Grading Plan, 2) ErosIon t;ontrol 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."
----'---~_._"------_.
I
...
f
I-
~
C.I.~X PR10,s> (
!::: ~
u rn
White - Building
Canary - Engineering
Pink - Planning
Tht' ('"nl... of IhO' ".lIt' ('OUl1lry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI!;T
NAME OF APPLICANT
APPLICATION RECEIVED
WJNDWOOO HOM55
&-tc- 01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/532./ WIL--OS PAR%JNAV
)--
Accepted Accepted With Corrections
Denied /-:J
Reviewed ~
Date: 6 -/5=-;bo(
~ent:r( o~~ +r.J~
v
"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."
ThrCf'nllrroflhf L.bC."oUnlry
White - Building
Canary - Engineering
Pink - Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NlAME OF APPLICANT
ApPLICATION RECEIVED
\\J J tv /) ~VOU) HCfvl S S
(/ - (J - C I
The Building, Engineering, and Planning Departments have reviewed the building permit
alPplication for construction activity which is proposed at:
! =.:.2/ \\1 L DS j)!\Kr:-'v\AV
I
Mcepted Accepted With Corrections ~
Denied
Reviewed By: 4Gb.- ~_,_ ~--/.-L--?.--.
Comments: _
MflItlW11JM. 01="'\ V':vL~ ~o-d< 1D
<;f&o ~~ I~! 4~ I/We1Jt9~ :~Fr-+ c
. ~J /.IL1M.MI :2- Lj r-:r- ('y~)Jt'-~1 fA) r~ A-<{"'
~~ {dr~ ~ .J- ThV0 vQ .O~ to
~Pd~ ~+
Date:
r; /t L{dJ (
"The issuance or granting of a permit or approval of plans, specifications ancj
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
SEWER AND WATER PERMIT
1 Gco," "I. I PERMIT NO
2. Yellow City . J- -r-c1-;;Z
3. Gold Applicant ') "-.J
(Please tvQ~ or orint and sim at bottom)
ADDRESS
JS3:L/ Cu.l: L 0
1'.4/l It' W /f Y
ZONING (office use)
R\
PID;;I fJ - 31L,-079-J
LEGAL DESCRIPTION (office use only)
LOT2> BLOCK" ADDITION! J }~Wrt/YU Is+--
OWNER
(Name) W J:-vJ/)w 0010
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANT
(Name) !J4-LnU..,1 E.. XC
(Address) " 1/ ,f J OI'L l:'.-J
(Address)
lL""c H
(Phonel95l..) grp. -t; 9t>1~
tv .4'1
L/L (lL _
(City)
(Phone)
DATE
-S~? 'I V
(Zip Code)
(Contact Person)
") /;ok)
APPLICANT SIGNATURE (' L ..-t. D~ 'l.1 L
<1
APPLICANT PLEASE COMPLETE BELOW
Size of water service 1/'; inches.
Location of any couplings from structure - feet.
Type of sewer pipe. 0 ABC 0 pvc 0 Cast Iron
Estimated length of sewer line If 0 I feet.
Clean out (if required) located at - feet from structure.
Residential sewer and water line connection
Sewer connection only
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
0>0.>
Estimated Cost $ <; 00 .
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID WITH
BUILDINt':> PE'c' .'-
~ IUoll1
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
r Paid _
I Da!y;_ (0-0 J
I Receipt No.
IBY~
L/
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
08-08-2001 07:46AM
MATTHEW DANIELS. INC.
423 3017 P.02
1. ala. fi:Ic
1. Gold c.,
J. Y..... _.....
PPNo__)-SQ3
Applicant: Mn+/,},Pu) 7);,,,;,./.'5. /n/1_. Phone: ~SIJ -1.:1-'1- ."''l''l't.--
A~dress: 11:; ~h~ .w~, .P"'~rnL>lUJf - hllV -S:.;?Ji-Y
Signature: h_ ~._-:.II1.--_L~~f~ . ,
Legal De~criPtion. Lot '. Block d (~." Sub / j)0rILYrrv;/'I/1J (Sf
SiteAddress:~l (-H..."..lAiJ diAl.
Building PermiU ' - PIO # ,;{j -::::; 'lb-07C;'-Q
NOTE: This permit WIll not be precessed without complete information.
FIXTURE UNrrs
CITY OF PRIOR LAKE
PLUMBING PERMIT
'nil c....... I" ulw e-.r,.,
Ouantity
Type of Fu.ture
Ouantity
Z-
I
I
.s-
I
I
I
Bath Tub with or without shower
Dishwasher
Flcor Drain
..&
I
I~
/
-..3
Lavatory (bathroom sink)
Laundry Tray (1 or 2 CQmpi!ll'lmem sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
I~
FEE SCHEDULE
Induslrial. Commercial & Multi-Family
(1% of job cost. 539.50 minimum)
Residential. New One & Two Family
Residential, Additions & Alterations
Slate Surcharge
$99_50
$39.50
GRAND TOTAl.
TYlle of FlXlUre
Rough-ins
Water Healer
Water Sollner
S<and Pipe (washing machine)
Sewage EleCtor
BaclG'low Assembly (l'Ipz. Oouble Chedc, PVE
Backflow Assembly Tesl
Lawn Sprinkler
Other
This penni! is ;ruued upon lbe espress condition thae ...id
conCl'Ol:U>r. .hall comply in all resJ*lS ..;tlIlhc: onlIIWlC"
or the S..... P1umblnf Code ....<111I. ,"", _",J__"",~ men:of.
. - Il.ECEIPTNo.~7-OJ DATE
- ATTEST
Call for all iDspectiOJl& 24 II in lldvance.
5
S 99.~
S
s
.50
5 /tuu,Q....~ ~
, (J<4~/()
~G tt/1';
~to-/,.'
'I'-' .
I,y I
'I/,
162C 0 Eagle Creek Av. S.E., Prior Lake. Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-424:5
. An Equ~ OppolNnicy Employer
TOTAL P.02
08/28/01 TIlE 15.
.23 FAX 7635530887
_ GUYER. S BUILDER.LEXPRESS
@002
Date Ree'd
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONINGIFIREPLACE PERMIT
(PleiUC tVi,l: or cr;,nl and. si5Dl at bcnom.)
I ADDRESS
\ >') 3~ \ u_..,\\A,.c::;, --:Y\{~n\ J tJ-t=; "? r.,o1'" ~k.e...
I
::~.':.. ~:,. , PERMIT NO. f- S /i-?
] Ydlo... ...,,,hun, _ .....A-J
I ZO~~ (._~,)
LEGAL DESClUPTION (olliee "'. oaly)
LOT S BLOCK fa ADDITION/j),J/IIAVrV1'/)/ltfl1J
/$--+-
(phone) 6{,;~(B4 ~4J..aI./' <..,
VYlf) 5~t!..(41
(City) (Zip Code)
(Phone) (7~<,lcA4-4h0 '<
:i - ,.;;,?' -0 /
DATE
,
APPLICANT PLEASE COMPLETE BELOW
"t1J.NEW CONSTRUCTION 0 REPLACEMENT [] AL TERA nONS
FURNACE MAJ<E ANI, MODEL~~...... ..... FUEL
FLUE SIZE REnJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR. POWER PLANT
OWann Air Plant. 0 Sr08lJ1
oOra"it)' 0 He. Water
o Mechanica' 0 Radiation
. OAir Conditionin8 0 Spc~ial Devices
oVent. SYStcrt\ 0 Other Devie..
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Requiretl Side Yard
Setback'
fIREPLACE MAKE AND MODEL ~ ' (7o,f 100 'bT-( ~W\~
FEE SCHEDULE
1 % of job con Rtsidcntil.l. Gas Fireplllce
$39.50 minimum
S99.S0 ile:sidGntitLl, AdditiohS &. Alterations
564.50 Residential. AC Only
lndustrial. CQrnmen:illl & MlJ.lti-Family
$39.50
R.e:side;ntio.l Heating & Ale (New Construction)
R.esidential. Heatini Only (N~w Comnruction)
539.50
539.50
Estimated Cost $ \, rl"X~.~
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
tJUfLP':1D l' .r-"
. 0 "" .1
'l\\,.;f r~
...... .-:...
'-0"
.50
(Office Use Only)
Thb Application Be<omes '(our Building Permit When Approved
BuiJding Ollid>>1
D.rc
I Pajd _ Rece!;! No.
I Dat'!i'M--()/ lV'u:: ~
~
14 hour" n9tice for.ll inJp,e:tions (9!2) 447~98S0, r.x (9S2) 447...:a245
_ n__."~__ .._,_.,~.._~
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permi! No. 0 \ -~~~"')
Prior Lake, MN 55372
S~e Address
If>
Pf'I~_ \.t<J<l,.
Telephone f
Furnace Make & Model c......-ro.' 0/
Model Size \'\ '\l P - \ Q~ - :1. 0
Conn. Load (\ () 1.0 q
Fuel N~"" Flue Size '<< V t.
Supply Openings .') Cl
Return Openi ngs \ "
~nput ~\:I~~1:l \'l Output. ~"). 0\\0
iE:dr.
~Zfm. I ~ 'J. ~
TYPE OF SYSTEM
WilIflIAirPlanls X
Gravity
Mechanical \I
At Condilloning Xl
Vent. Sy..am
HEATING OR POWER PlANT
Sleam
Hot Waler
Radiation .
S;>eciaJ Devices
Other DeVices
E
cr ..
9lMera1it>ns
~Repair
TYPE OF WORK
Replacement NilW Co~ruclion X_
Est. Comp_ Dale
\ \ ~~~ 'lI>./ BuDding Perm. f .
;S:E.st. Cost $
ISl
"!HEATlNG PERMIT FEE $
"l
STA'JE SURCHARGE $
iTAlPERMITFEES $
.50
bL ~/"
. ""<q~/jI:-' ttl'J';
'v~ ~ It
~Ji'~l'
Receipt f
TYPE OF STRUCTURE;.
.Xi
Single Family
Commercial
_ Two-Family
I nduslrial
Fee Schedule
Industrial. Commercial & Multi-Family
Residential. Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, AddUiuns & Allerations
R esKlentia!, AC Only
L Pi""
1. Gnooa.
i, YcDaw
Fi~
Cily
CaalnclDt
?ublic
Mulfi-FamUy
01 ner
1% ollnb cosllS39.50 minimum)
$99.50 PLEASE NOTE:
51>4.50 Air Conditioner Units CaMe
S39.50 Encroach Into Required Side
539.5C Yart! Setbacks.
S39.5C
Remember to add the State Surcharge on the bottom of this application.
Tne price 01 your healing permit includes one rough-in and one final inspection.
Additional inspections wDl be billed at $35.00 each.
House Healing Test Record must be submilled with l!IIlJl!i!lg ~ number belore build-
ing certificate 01 occupancy will be issued.
!:IfAI CALCUlATIONS REalllRED w~h number 01 supply and return openings lisled per
room w~h CFM's pel open~ New structures or additions send floor plan with supply
and return location. shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPUCATIONS MAY BE MAILED TO THE CITY Of PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall busin.ss hours are I; a.m. - 4:30 p.m.
All WORK MUST BE INSPECTED (ROUGH-IN ANO FINAL) . CAll CITY HALL
447-!1850 FM 4-4"7. &+2.4-5'
I hareby apply tDr a mechanical syslems permil and I a':.......;8dge Inallhe
inlormalion above is complete and accurale; thallhe work will be in cDnlo""anca
with Ihe ordinances and codes 01 the city and wilh Iha stale buildingfmechanical
codes; Ihallhis lorm does nol become a permit until signad by Ihe BUILDING
OFFlCIAL; that 1he work will be in accordance with the approved plan In the
case of all work whlcn requires review and approval of plans.
~O-~ " ,'k~
App!~ Signalla'e
UC'~
Buildit)t'.omcare SlgJ1alure
~- 3-\
Date
)<'-3-0 "\
Dale
..
PRIOR LAKE
INSPECTION RECORD
tAl' ,t&.s. QJ-L<<. /
/'
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 15""",3~ l
NATURE OF WORK ~ }.J)0
USE OF BUILDING . ,C:;FD
PERMIT NO. OI-05q~'3 DATE ISSUED ('-/5--~/
CONTRACTOR lJ .'1r-J.. ~,,~ ~ /I PHONE ~:2 -f:3"fS -~c(qs
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I <B.\J::CTOR I 715r;~
I FOUNDATION (Prior to Backfill) I <J.-'~ ~ 7 )q)al I 0\1 ~r.zi()/
PLACE NO CONCRETE UNTIL ABOVE HAs BEEN SlbN-ED
ROUGH - lNS r
SEWER I WATER I SEPTIC . 1?_\\/)..(}.I.J 7 /1 ( ,f) (
FRAMING 'R V~ ~q~q(
INSULATION ~_\lll~' c?!;Zll!{}{
ELECTRICAL \ r,l \ I I
PLUMBING ~. q(lr!O\ (
HEATING (if required) Si~Cc i_i':'- ~\14 . g. ~\O(
FIREPLACE - I, I f
GAS LINE AIR TEST Y'9 "\~\~~CI.A.) r~ 5(1/0,01
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
1V.Il
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE
NOTICE
/1-0L-
'€> ~I
~ O~ ItJ AtO!
B. UaJ" II 1+/0/
HAS BEEN C SIGNED
''/'4JnI
, .
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 shal~e pls:>ed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/S3Z-(
uJJJh
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DATE TIME
/(/;~/ /(}~3o
fl~
U
01 ~5'93
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
tyD INSULATION 0 SEWER HOOKUP
rt~FINAL A/D PLUMBING FINAL
o SITE INSPECTION n~MECH FINAL
COMMENTS: ~ ,
J
1s.:s.Vle ~~ CO
ra1~ aff.mv~ Io~ ~~
~
~v
<;t)J n.nd Thc1"~ CPA' deuettJAlM&At---
1 I
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/;:::v..o.
I.--
~ORK SATISFACTORY, PROCEED
o CORRECT ACTIOjAND PROCEED
o CORREC~R~, ALL FOR REINSPECTION BEFORE COVERING
Inspector: L<f)... \ ClJ..)..I)_ Owner/Contr:
CALL 447-9850 FOR TH~NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS _j.~ '? !
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
.......cA TE TIME
1f1
LJ.' LJ,
l-v-O"3
QfL,
)/
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GA.SLlNE AIR TST
;i'f 'S J--r
"
{ t (t~
{W).--l
I /" ~..A:
Of-
~ t'ly
\.
/
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE ORK, CALL FOR REINSPECTION BEFORE COVERING
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
OwnerlContr:
QUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INS/iOTl
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
10.J;-6L
ADDRESS I!;UI lA/de/oS P Kwy
OWNER CONTR. W/ncl"YJlJne/ ~
PHONE NO. PERMIT NO. (;) 1- 5'U
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
llIiCFlNAL
o ~E INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
XEXI~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
G/''1b-f)f
5 ,?It l..h../ ill t) 1<--
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
% CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpeClOr:~fJf(' -
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
16'3.).j
OWNER
CONTR.
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
A..-O SEWER HOOKUP
T' d PLUMBING FINAL
o MECH FINAL
COMMENTS:
- MAl1-14.OiMl"Jpr t9t:::
- lA"ekr -s;:ea tel
0,1. TE TIME
/1-5>-0/ ,~,"eX)
wd-~ jJtf()~
[/
/ -q- 9 "3
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORt, CALL FOR REINSPECTION BEFORE COVERING
Inspector: 'b t ILU.../J OWner/Contr:
CALL~E NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNQTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!