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Home My WebLink AboutBldg Permit 01-1012 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT (Please.!VD~ or mint and sign at bottom) ADDRESS c,Joy CU~dL L....n". Se ~('1,\. ~ Date Rec' d I. White File 2. Pink City J. Yellow Applicant ( LEGAL DESCRIPTION (office use only) LO~ 0 BLOCK , ADDITION !Jet:>e{-ll'!f , .J ~I'l ~ OWNER (Name) (Address) BUILDER "n I L_ ,,___ f\ - (Name)------LJI..... I"T(/VTVT I Jl)I\..{... (Contact Name) ~_IJL ZviaU}Y1.. (Address) 2.09 (,,0 k'e.nbn~c... U. ~<- , dVLv"l~ I AJh r ~~ TYPE OF WORK M New Construction DDeck DLower Level Finish o Fireplace PROJECfCOST/VALUE (exc1udingland) $ /I!?~ /r;:)'1 DAlteration DUtility Connection 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 upo e property!o pem needed inspections. c/,,,,O 'D I X " dOtJD sz,(:;7 0 c:>I Ji -J 'DaJ Contractor's License No. u: V I Permit Valuation I Permit Fee $ I Plan Check Fee $ I State Surcharge $ I Penalty $ I Plumbing Permit Fee $ 10 rJ . c:JO I Mechanical Permit Fee $ 1(') () . ()() I Sewer & Water Permit Fee $.$ 5' . 57) I ?firePlace Permir Fee $ <if). (9t"J J (/'5 BecomesYomBUil$:3i(~::~roved ,J'~ Dare o Misc. loFJ .t9QO'~ q,,:g. i~ I (PttS. ~1 I ~_~1)_1 PIDH-S- 0/ ;;-:OJ.O-() (Phone) /00 (Phone) -f9c:;;;}) qe~-1~oB (Phone) ~a~fo-, 8d<./ DPorch DAddition ORe-Roofing ORe-Siding I Park Support Fee I SAC \ Water Meter I Pressure Reducer \ Sewer/Water Connection Fee I Water Tower Fee Builder's Deposit 85C?00 I I, t H:) L::C> " g;.c!JO $ t;6~1 $ I. 2~C) . C90 $ . 'J~c> .e0 . $ I 5Ct?re I $ :SS.$Q I $ 7. 57t). to'! I / I I # $ $ $ # Siz -;;0.. I'" <1tY. . # # Other S ~ CJ I TOTAL DUE ~ , I Paid I Date 7670 17 '1-"1-tJ . I I Rece~J~4tJ5el Bv ~- 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 ~ Plmn~oomtirut~ a "m~my cmill'~O!:~=" mdallOitru~on to~ B:p: oc'rrc:; ~upm~ must~ ----. pi."niOgDire::-- - Date ' ,-,G 1-~pdi~nditi:;'ifmy.J.. 11 ~~ 24 hour notice for an inspections (952) 447-9850, fax (952) 447-4245 Th~ C~nl~. nf th~ L.kt ('onn"", White . Building Canary. Engineering Pink . Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED D J< .y,jeru~ ,>?- :?:J<-() J The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which,is p-roposed at: 5aOL! .LO~~cQ Accepted X Denied ~(L f ~ Reviewed BYWV--y- Comments: -0dtJO ~~ Accepted With Corrections Date: S> - '- ~ 1- ~O ( W~ ''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~ ern I.. nf fhr I.akr Counlry White . Building Canary . Engineering Pink . Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED I- T, 0' , ,.-(:'::/--- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which,is proposed at: /' II /~ Accepted ~ Accepted With Corrections Denied ...., /' !",'(A (/1 Reviewed By: ~ A/"",,~.;(v'~~-:=:' Date: OzI(~(t9 t ~1J~\~ '?J-.p. r'~TI Of I 9 I <'L +- QIA' ~ "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," .' 1//') (Ix RIOii' ..I.~( !::: ~ u '" Of -Io! :( - White - Building Canary - Engineering Pink - Planning Th, {,nlfr flf Ihf Lak, Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT D J< 'll CYLl.tYT'---' APPLICATION RECEIVED y-;.),-}..-() / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which ,is Rroposed at: L~:;" /) if I. ( /ij /l J J 0 (.Ai '--/ L' L " \. '.-\0' ~/^,...,...A.._.', (_.~ . C; X Accepted Accepted With Corrections Denied Reviewed By: NIH3 Date: 1-/). -ol Comments: ~e Reverse Side for Additionallnform::ltinnl See Attachments: 1 }Grading Plan, 2) Erosion Control Measures 1_~ I=r"c:inn r.nntrol 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." (116.(7.111111 3:41PM GENZ RVAN PLUMBING AND HEATING No.1I949 p. IVI5 I. Date Ree'd CITY .OF PRIOR LAKE SEWER AND WATER PERMIT @ease!.yJ:te orpr.fDtand.~:atbalZJ:lm) I ADDRESS ' ~?f) L( ~P/{i(J eo 0-Vl p LEGAL DESCRIPTION (oflkc == only) , LOT20 BLOCK I ADDmON ill fRe? 0 n I OWNER (Name) TIp 1i1'"':::~Q'tJ ,.nr+-...._ u.........""ro (Address) 3459 Wash1ngtoon Dr St:e 204 (A=Sl . APPUCANT (Name) Genz-Ryan Plu1l1b'mg I; Heating (Address) 14745 S<> Robert Trail (Aold='l f (Contact PerSon) Marv Olson 11 T1CANT SIGNATURE eJJ~ ;, ~w ~ I PERMIT NO. 0 {- (0 ( ? 1, Oald ^I'Ii'u.::-t L- ,~ ZONING (o1ti<ewe) R\ '2A)O PID~t;- ~7;;l-OJo-O ~e) '~1-~5~ b~'? Eagan, MN 55122 (City) [Zip Code) (Phone) 651-423-1144 . R08e1l10unt. MN 55068 t<;:liy) (Zip Co<k) (Phone) 651-423-1144 ~ DATE 7?: /2-r II') / APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings 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 oonneotion Sewer connection only FEE SCHEDULE S35.50 Industrial, Com'l & Multi-family 1% of job oootwith ,,$39.50 minimUlll $17.50 WateroonnectiononIy $17.50 Estimated Cost $ Building Pelmit # SEWER AND WATER PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEl!: (Office: Use: Only) I This Application Beeomes Y ou~ Building Permit When Appmved SEP I 9 '2iY:i lInildlng Olllcial I).,. i L.. $ $ $ ~"'P~~t) t~t.." .~,~Q,N t ; ! I P::---- IDate - lJ~/q~ {) / I ReoeiptNo;______ .-----1,. I By /J/tL--- /. I I ~4 bo... .otioo fo. all ia.pootio... C/SZ) 447.9850, fax (95%) 447-4%45 ALgL7. 2001 :j:42PM GENZ RVAN PLUMBING AND HEATING No.0949 p. IR/15 Date Re,,'d LU 'L OF PRIOR LAKE PLUMBING PERMIT ( f?lea.se tvrJe orpnDtaJ;1dsis at'bCJtDJtD-) ADDRESS - r-,2Du 'lY~rqoO n i ~ ~i~ rPERMlT NO. (J 1_ 10 12-1 l, V~lgW AppMuit !- [(') lil. D . ZONING (O_....J ~E Rl > LEGAL DESCRIPTION (olfil%"'..",Jy) LOT 2D BLOCK I APDITION 1V tlY-.Q t7 0 [) 7 to.. ,f'\ prod. c;-37d -O~O-(j OWNER (Name' DR Horton C;ust:om _ Homes (phone) 651-454-4663 (Address) 3459 Washingt:on Dr Ste 204 Eagan, MN 55122 APPLICANT (Name:) (p,,"T"I'7_li'yan 'Pl,iM'h.i:Rg 1\. "R""....~..f....: (Phon~ ~~'_b?~_"~h (Address) 14745 So Rober!! Trail (Address) Rose.w.ount MN 55068 (Zip Code) (City) (Contact per.son) Mary Olson APPLICA.NT ~IGNATURE \ l ~ Cl'I>6ne) 651-423-1144 I =-- ~ __. DAT.E --.2J r;C1!D I APPLI ASE COMPLETE BELOW Quantity Type of Fixture I Quantity I Rough-ins Type of Fixture I f Bath Tub with or without shower I I I Dishwasher j I Water Heater J Floor Drain I t I Water Softner I ~- 1 Lavatory (Batlu-oom Sink) J I Stand Pipe (Washing Machine) I I Laundry Tray (1 or 2 compar1ment sink I I Sewage Ejector I a- Shower Stall I Bacldlow Assembly I I Sinks I Bacldlow Assembly Test I I Bar Sink I I Lawn Sprinkler I ?, Water Closet (Toilet) I I Other ~ FEE S<';1:U!,uu.LE Indus""aI, Commcrciallk Mulll-famdy 1% of job cost Wllh. $3950 minimum ~d<:nhal, Now One & Two-Family $9950 Residential, Addition. &: Alterations $39..50 Estunated Cost $ Building P<ro1it # PLUMBING PERMIT FEE $ STATE S'URCHARGE $ TOTAL PERlWT FEE S ~ l?MO \N\~t L50 . .'"'. .'NG p.,,' ~l'\'_v' F (Offie!: Use: Caly) Buildidg Omclal D... IP~ i Daq.~/1_0 / I~i Tbi. Application Beco...e.)' our :BuIlding Permit When Appro..ed SEP \ 9 20UI ~4 hoor notice for an inspection. (952) 447-9850, !as (952) 4474245 CITY OF PRIOR LAKE SEP 2 1 ~le Rec'd HEATING/AIR CONDITIONINGIFIREPLACE PERMIT . J . l / : "- ~I.- _..._~-,-~.- ~". ...'......,......---... I. Pink 2, Green 3. Yellow FiI. I PERMIT NO Clty . I '0 I.' '"\/ Appli,," -II "" (Please .tvDe ororint and sign at bottom) ADDRESS ?1ij)4 /) e.er +1l"'Jrl ZONING (ollkeuse) Rr ~$E. i Q OVifyirJcf 0< pJ ~':e~Ru.'M. Horton {luckm H(Jme~'" (Address)df);{(oO j,(e-flhrictof' (H.. LaKe-vi Iff' M~ .'L J APPLICANTA J /. t M h---- (Name) rlAr1 e<!... ..LiIr'. (Phone)11J51-45:L-~775 (Address).g(PSO '\,ennehee.- Lx-. S+e. #j ,j-~Q_aQn 55/2.~ (Address) V (City) (Zip Code) (Contact Person) .Je.r-Pre.-V Z;mmprrn G!l.n (Phone) (P5/-.i../5:J- bl7'7!:J APPLICANTSIGNATUk. JOJ"-'I'N..A t142_~~ DATE 1/ (/(/ (J . v . APPLICANT PLEASE COMPLETE BELOW !0NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS FURNACE MAKE AND MODEL 'Br'fKL+ 3~A-vtollD" tJ FUEL J\JQ,flAt'n.1 FLUESIZEtjJICIa.S'i. "EL RETURN OPENINGS 1.4- INPUT 10.000 OUTPUT 6iD.OOO TYPE OF SYSTEM HEATING OR POWER PLANT LEGAL DESCRIPTION (office use only) LOT 2b BLOCK I ADDITION PI~ - -37d.-- t1 ;)L; -d (Phone) C(5a - q <??5 -7:l7,z 5 (')Ol.../.L./ DWarm Air Plants DGravity o Mechanical ~r Conditioning QtVent. System 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 I FIREPLACE MAKE AND MODEL Industrial. Commercial & Multi-Family FEE SCHEDULE t% of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential. Additions & Alterations $64.50 Residential, Ac Only $39.50 $39.50 $39.50 Residential. Heating & AIC (New Construction) Residential. Heating Only (New Construction) Estimated Cost $ Building Permit # HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ .50 Building Official Date [ Paid I Dateq__;n_ I ""'D CUILr';:.~ WI I&! ~;r (Office lIse Only) This Application Becomes Your Building Permit When Approved 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 BY~ DEC.14'2001 07:29 651 633 8884 FIRESIDE CORNER #6301 P.003/01l5 CITY OF PRIOR LAKE Date ~'d HEATING/AIR CONDmONlNGIFIREPJ...ACE PERMIT DEe I 3 2001 \: ~ Z~,,,,, I PERMIT NO. 0 1-10/2-1 (Pl."", l.'JP.e ornrim ",.6:0"" O1ba1:tom) ADDIUlSS 5'Jo'..j 7)~fJ./ ~ S'~ ZONING (._...) LEGAL DESCRII'TION (otllco u.. only) f.OT BLOCK ADDITION PIP OWNER (Name) (Address) ~ r;? rdllLa.. (phone) APPLICANT (Nam~.' lILLl:ED FIRES!DE DBA FIRESIDI': CORNER (Phone) 651-633-256J (Address) 2700 N _ FlUR\1'l'F.W AVENU~ (AdIl.....) (C __ p ) BRF..NDA lltJS'I'ON on....., . erson ~ APPLICANT SIGNATlJror /'1A8..IJ~ Rr.JSE\TTr.r.F. M1\1' (Ci<y) 651-633-2561 l;t:.,"":I: (Zip Code) i11~ ( (Phone) DATE -..I~- 1'-1-01 APPLICANT PLEASE COMPLETE BELOW ~W CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS FURNACE MAKE AND MODEL FUEl. FLUE SIZE RETURN OPENINGS rNPUT OUTPUT TYPE OF SYSTEM OW""" AlrPlalJ!S OGr"OVl1l- o Mtch""jettl OAir Conditioning X.;z OVen!. System FIREPLACE MAKE AND MODEL ~ (;6- HEATING OR POWER PLANT J Stell1Jl J Hot Water J fuldilllion J Speej.~l Devices ] Om., Oevie.s Sf '7~-I'_ PI.EASE N01'E: Air Conditioner Unit.~ Connot Encroacb irlto R.equired Side Yard Setbacks InduSlJ'laI. Commercial 1< Multi.F,mlly FEE SCHEDULE J% .fjob cost Re.iden,lal. G,. Firepls"" 539.'0 mini morn $99.'0 Resld.ntittl, Addltio.." IiJ. AI.terllrion. $64,.'0 Reslden.tittl, AC Only 539.50 Residential, Healing & AlC (Now ConOtruelion) Residential, He.tlng Only (New con'IruClion) 539.50 $39.50 Estimated COSt $ Building Pennit II HEATING PERMIT FEE STATE SURCHARGE TOTAL PER.MIT FEE $ $ 5 r l?AiI..P i,f.;' "', .50IB'lJJ~WtNG p~,.. \::..._~" - (om.. I).. Only) This APPIiC.;);~~~ur Buildillll ;itl W~;~IPprOYed Pldld~!'~ Dwrz I Paid I Date I Receipt No. I By ~ hOllr notl"" for allln'pootl.oo (9$2) 447-9850,'''' (95~) 447-424S PRIOR LAKE INSPECTION RECORD SITEADDRESS ,~~4 ~r.c:~cQ. NATURE OF WORK _'" 5pu....,.. USE OF BUILDING SF-A PERMIT NO. 0/- IV! Z- DAT~ ISSUED 8-3f2u:J1 CONTRACTOR D.~ U-~~ (~\ PHONEqs-~-~(,-/33C{ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT I ~(\;\.\ t.\.e.. DEPARTMENT oFl.::: BUILDING AND INSPECTIOrr- - [FOOTING 'NSPiZ;. I 1/;; '5/:~ r FOUNDATION (Prior to Backfill)Y1;;. I ~ 9!;;'7/D/ I ~. /011./ lot PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH . . ft-i..y -g~~ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS /?vI<. SIY!f) '2- fA, , SEWER I WATER} SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING V;" U.C;1., f7:r 10 1/ t../tJ / HEATING (if required) FIREPLACE GAS LINE AIR TEST GRADING (Prior to Sodding) BUILDINGfLD' i;J.P 8{ \ ! 02... .c 4 ELECTRICAL PLUMBING HEATING DO NOT -l~_ IP+- . lo!;;J./o! !/; 0/,(1 L . \ IJ , ~~. 1-7 67 '6~ J/2/(JI / /It)".{i 1'17- tJ'2... 7 &-1/r; L 11. . 'A, r OCCUpy UNTIL ABOVE HAS NOTICE ~ /.;>,5//J ~ 3/X:/M>- . . BEEN 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 $illm be-placed near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850 DATE TIME CITY OF PRIOR LAKE .,/ill L, INSPECTION NOTICE SCHEDULED ~ A-. r; ADDRESS 520:1, (j~. Of; OEEteFIe;.,W LAI. . I OWNER CONTR. PHONE NO. PERMIT NO. /-/0/2., /0/3./0/4- o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MEcH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: .5o'o/77l.66 ~/~ ~ . 15~ 45 o/~. 'I WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPEcTION BEFORE COVERING ~_. . 41 0:..rO' "V 1-1 ~O ..,~ Inspector: Owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.I\ SAFETY! INSftlOTJ DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE lJ!5 S2..O'-f: 5'Z.o(0) SU:.fi<: ~~lrlcL.il L).J CONTR. 0 tZ ~rv. ) PERMIT NO. c2b:-t01c ) IO!\ {Ol4 o PLUMBING RI ~X1G~ILLlNG o MEcH RI 0 COMPLAINT o WATER HOOKUP 0 FIREPLACE RI o SEWER HOOKUP 0 FIREPLACE FINAL o PLUMBING FINAL 0 GAS LINE AIR TST o MEcH FINAL 0 SCHEDULED ADDRESS OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION )Ii{ FINAL o SITE INSPECTION COMMENTS: SW'-i - t:uR..0> ~K. n, II: r; p ~ --1J0 ~R. 1_6C l--.\;HK <(0 P.,E S iNv'll)-w-\fO n-.n C:;?j) (i) ~ LOl-.Jr=iC_ I' _cd2, (2... P--v'iX (,.,Qf+{)? rr'_,) f<i:M? r...(i\ J0ti1:ls <\;'0 ~ .--:- G,t, S~W C:>u \ b"2...6'$( ~ Lo_JJ<. r t )12 (>... Il..rlX #- ~r\ ~PU(f.. ~fO~~<1r~ ) o WORK SATISFACTORY, PROCEED \0 CORRECT ACTION AND PROCEED ~ORRECT WORK, CA FOR REINSPECTION BEFORE COVERING Inspector: l Owner/Contr: E NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl INSNon DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED :Ltrr- OWNER 'S7..0t..J ; ~Lo(o ) 5'l..O<K (jf.C..<Z~1J'.d:::Q l-~ CONTR. _D.._P \:\oR\'r-,Jo.. ) PERMIT NO, 61- 10\1...) IOn. \ 101'1 o PLUMBING RI ')l:; EXI~/FILLING o MEcH RI 0 COMPLAINT o WATER HOOKUP 0 FIREPLACE RI o SEWER HOOKUP 0 FIREPLACE FINAL o PLUMBING FINAL 0 GAS LINE AIR TST o MEcH FINAL 0 ADDRESS PHONE NO, o FOOTING o FOUNDATION o FRAMING o INSULATION "")xFINAL o SITE INSPECTION COMMENTS: 5?n '-I- -f) i/ \ C,?(') (" - 0 II\. c'1 (') S< - l-t., \~{' C", R.. h 6,-) 'x 511'-\ o WORK SATISFACTORY, PROCEED KcORRECT ACTION AND PROCEED o CORRECT W?RK, C ,LL KOR REINSPEcTION BEFORE COVERING Inspector ~ It J? Owner/Contro 850 FO~TH?NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI ''''SHon DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS 5d-/J4 SCHEDULED 3/'?:{O2.-)(): 00 ~~, b CONTR. OWNER PHONE NO. PERMIT NO, 1- /(J/~ o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMINGrif) 0 WATER HOOKUP o INSULATI 0 SEWER HOOKUP '8> FINAL 17:"'\ 0 PLUMBING FINAL o SITE INSPE ION \...!:S,J)Iit MECH FINAL o EX/GRAD/FilLING L.' Vb COMPLAINT o FIREPLACE RI .r.n lit FIREPLACE FINAL VJ 0 GASLlNE AIR TST o COMMENTSrD l<.a....r po:t..,.; A..e-ct /,JL.,..,. W ~ ~~~ [:, ~-(~. ~~.) ~~'~.~"'..M~' ~ '?v.~ -0;1./- A'>-- ~~ [)~ ftfj ~ i.~ n"A~~-r' ~ . '. . l ~ T;f_,D,~ ~/'\/(}2- , , i! I ~_ ~ ~...aJ'-:' ,.w s-k-, o WORK SATISFACTORY, PROCEED :l<OCORREcT ACTION AND PROCEED (~ CORRECT WORK, CAll FOR REINSPECTION BEFORE COVERING Inspector: ~ Owner/Contr: CALL 4470985[ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTJ SCHEDULED ;]- ;;;'6'-;) I~~) 1 ()l!) j A);my CAJ CONTR. U CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS .5aoLf OWNER PHONE NO. PERMIT NO. o FOOTING 0 PLUMBING RI o FOUNDATION 0 MEcH RI o FRAMING ~WATER HOOKUP o INSULATION 0 SEWER HOOKUP o FINAL PLUMBING FINAL o SITE INSPECTION 0 MEcH FINAL COMMENTffl b ~ ('I ~ ~ -.;; 0 -{- ~~~~ ~~'-- ,r0 OA TE liME /-I{)/~ o EXlGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o o WORK SATISFACTORY, PROCEED )!l CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: /'J-.... , Owner/Contr: ~ CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETYI .. ~ APPLIANCE PERFORMANCE TEST Attach to gas line adjacent to regulator Date A.. ,,;..._:>.: M '-<.\.-..... lC.c.'\~'-- ;;> - ;l. ~ _o~ Heating Contractor Name of Tester Job Address $" -'lC)'1 D<-<rlI..<l" l.c..-.o...- Heating Contractor A"\ \i~_->' 1'-\(,-,-- Name atTester K<~~ Date ..2." :>. '") ^ () ~ Percent 02 Percent CO Percent CO, 7.0. - <:l- Stack Temp ~.lc" l..j().).. . Combustion air is adequately supplied per UMC Sec. 606 ~. S input '% ~ ot>O