HomeMy WebLinkAboutBldg Permit 01-1204
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
~~()q \
0Q kt l-- -a lH fl
f~w('t
Date Rec' d
9- II-I
I PERMIT NO. ()/~:'04-
1. White File
2. Pink City
3. Yellow Applicant
LEGAL DESCRIPTION (office use only)
LOT D BLOCK / ADDITION N()tM J1)IJOtl Oak s c2} A,
OWNERi'./' 1/ <:. .
(Name)/ fAU; d ~ IV'(:,\+i ,-)a.mUt/~h
(Address)
ZONING (office use)
KlsD
PID ,;75'- 3-'7/- 6O~J
(Phone)
Ci0;) - LJ 40 ~ {y 17~
BUILDER ( hll I 11 (). \
(Name) -, Y ~an pj ~ L-'3r n~ tJr'S L,iYn0+r/;{<2.-,tUln
(Contact Name) J.\.( l) 1/\ rvlo./,I-<<r
(Address) ~ jt-]Cf Sfhr1f\Or; lff,
(Phone) (of'J!-lJ9-1 - L/ q~ ~
(Phone) lP J J- - J.., ~- g '1 Jd.
65/),3
f Oc;(JUl ,
J
TYPE OF WORK
~ew Construction
OLower Level Finish
MIJ
ODeck
o Porch
ORe-Roofing
o Fireplace
OAddition
OAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $ fA 8 (). 6(JJ-
ORe-Siding
OUtiIity 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
:ter:fj;;y;rty,jJrf/y;:;;;::Ctions. .~()n~ 43J-7 4/1/ le)'
- - Signature f .., Contractor's License No. Date
Permit Valuation 280,~~Q:)
Permit Fee $ 200[ . 7~
Plan Check Fee $ " ~() I .I t/
I State Surcharge $ . /40.06
I Penalty $
Plumbing Permit Fee $ /C;O.00
Mechanical Permit Fee $ 100 ~ oCJ
Sewer & Water Permit Fee $ 35"" .0-0
Gas Fireplace Permit Fee $ 40 , OJ
I Park Support Fee
SAC
#
#
$ esO.. c:>o
$ 1.160.00
$ , IOS CJt5
$ 4.1::) .00
$ I. ~DD.CXJ
$ . , t'-J 0'9 .a5
$ 1,,&:;0 0 .ct::)
$ ,
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE WA~ /fJ-Z 1-tJ !..$ ~ tg!3.37
Paid Z 2,88..;3 &if R.ec~e' t . ~ 7.sv
Date . ID... 2-4 -"() J By
- . ,
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
iSSU~d.
_ '. . y~-<'<,,~ ~)..Jl..ol ~(' .41 ~l(-<~/v"l<flev~
~ing Director; Date . ~al Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Water Meter
Siz@) I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
11/05/01 MaN 11:53 FAX 6128902753
STOCKER EXCAVATING
141001
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
~. ~:::. ~i~. rPERMIT NOV/1204
J Gohl ^pplIC,anl I
(Please type or print a.o.d sien lit bottOm)
ADDRESS ZONING (olfu:e use)
3091 Lake Haven Court A 150
LEGAL DESCRIPTION (office use only)
LOT 5 BLOCK 1 ADDITION Northwood Oaks Est. 2nd
PID ~r; -cf7/- L)05 -C)
,
OWNER
(Name)
Manl~y Brothers Construction
(Phone)
651/454-493)
(Address)
4179 Ethan Drive. Eagan. MN
(Adc1ress)
55123
(City)
(Zip Code)
APPLICANT
(Name) Stocker Excava.ting: Co.. Inc..
(Phone) q'i? IR90-4241
(Address) 8247 W. 125't~-
(Address)
(Conlact Person) _" Curt /l
~"'2P. M.IL 'i'i7l.7R..
(City)
(Phone)
DATE
(Zip Code)
I
APPLICANT PLEASE COMPLETE BELOW
Size uf water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at _~_ feet from structure.
same
11/5/01
APPLICANT SIGNATURE
. .d
"'I
Residential sewer and water line connection
Scwer connection only
FEE SCHEDULE
$35.50 fndustrial, Com'l & Multi-famil)'
$17.50 Water connection only
1 % of job cost with a $39.50 minimum
$17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.so
,..
:>
(Office U$c Only)
This Application Becomes Your J'Juilding Permit When Approved
~ ISUIt'riiWG WIT~. .
PEl' ,'-.
ll"jj I
Paid
Receipt No.
Building Officilll
Olllt
Date//_ b ../
B~
()
24liour notice for all inspections (9S:l) 447-9850, fa" (951) 447..4245
651 633 8884
FIRESIDE CORNER
#6302 p.00lilJ02
Date Ret'd
CITY OF PRIOR l,AKE
Jj.~A TINGI AIR CONDITIONINGIFIREPLACE PERMITOEC , 3 2001
(Please !Yl?e or TJrint IlI1d si\1IlLU bm:mm)
ADDRESS
~. ~ ~~I~n', I PERMIT NO. 01- /Z04-.
- ZONlNG (off= u~)
~cJq I
~-
r/)-a)t.rl .
LEGAJ~ DESCRIPTION (Dffice USI! QIl.!Y)
LOT
BLOCK
ADDI.TION
PID
OWNER
(Nam.e)
~~
()
hL
. (Phone)
(Address)
APPLICANT
~ame) ALLIED FIRESIDE DBA FIRESIDE CORNER
,(Phone) 651-633-~1
(Address) 2700 N. FAIRVUK.,.AVENr,m
(Address)
(C P ) BRENDA h1JSTON
ontact . erson
APPLICANT SIGNATURE (' .t3a.R/vr.IL-
mSEVTT,T...E MN
{City)
65]_-633-256].
_ (Phone)
c;.5.l 1 ':l
(Zip Code)
..JJ~
{
DATE
I ~~ {l{-Ol
APPLICANT PLEASE COMPLETE BELOW
~NJ:,WCONSTRJJCTJON 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL ' FUEL
FtfJE Sr.ZE RETURN OPENINGS INPUT OU~UT
TYPE OF SYSTEM HEArING OR POWER pr~A'NT
DWPmJ Air PllII\~ 0 Stcnm
OOravity 0 Hot. WD.IB
o MeclumiElRI , 0 Radhlljort
OAir Cc:mdlUoning 0 Specrlll Devices -
OVertt. Systr:m 0 Other Devicc$
FlREPJ~ACE MAKE AND MODEL . ~Io q IJ {J.. l,o~rn-
PLEASE NOTE;
Air Conditioner Units
ClmnDt Encroach into
Required Side Yard
Se[Packs
Indu:>T.rial. CDmme!'l:iaJ &; Multi-PamHy
FEE SCHEDUJ..E
1% "f job C05t Re,jdClltiQ,l. GllS Firepl.l\ce
$39.50 minimum
$99.50 Re,identlal. Additions It.. Alr.flTatiolis
$64.50 Residential, AC Only
$39.50
Residential, Hear.iog &. AtC (New Constnu:tion)
Residential, Heati.ng Only (New Construction)
$39.50
$39.50
Estlmat.ed Cost $
Building Permit #
HEA UNO PERMIT FEE
STATE SURCHARGE
TOTAl... PERMIT FEE
$
$
$
IE \?A~D WfD:..
J~ij%W~~~6 Fe.--
\,...
(om/:/: Hie Only)
Thj~ APPIiCQUjplltiOJ1 BecQ e! Your BuUdtn2 Permit When Approved
JIEC I 4 2001
. '
BIIUdlng ornclol Dlte
Paid.
Receipt No.
Date
By
24110'" "otlce fpr Itlllnspedions (952) 447.9850, fnll: (952) 447-4245
Friday, December 14, 2001 10:03 AM
__~14/01 FRI 10:4Z fAX OlZ4474Z4S
Lofgren Htg & A/C 651-4601208
CITY OF PRIOR LAKE
p.02
III 001
~11 i OF PRIOR LAKE
BEATING/AIR CONDmONINGJIlud:PLACE PERMIT
Date R.ec'd
(please l1Ip! or arim and sitD ill bOIIOlD)
. ADDRESS j J-/.o
30Q J r'ir-J P /J!f/YI' r)-
t ~i ~:- 11 '~AM1T NO. QJ -- , Z04:t
, ZONING lolller IIIC) .
LEGAL DESCRlr A10N (oftler lJR only)
LOT
BLOCK
ADDITION
PID
=~'Ilh /J?~J3 /) d05
(Addrcu) -v. .
· w.:;,~ IY\ ~ +- A) r , (PhDnel p" C-;) - LIto I; , >( ~ 0 .
(...,,;,~.; d....Lc-~ ()'1:,:;j I.J) #!-/ (O.J) /)?'/" rffJ , fYJ)1 <. {/XJ!r-
(A~) , ("/ (Zip Code) .J
(COata<<........) .Lk...J'\ ~ (] rI. ~ (P.....l
APPLlCANr SIGNATURE V1 '/Y? J'1~ I'~ tJ') /) IlL/; DATE .-1.rl- : J ':i -()~
_ ' I ~PPIl.~; PLEASE COMPLE~E BELO,!-
~ ~ON 0 REPLACEME!<r U AUERA nONS
FURNACE MA"'; AND MODEL 0 ()r~ qdl() R:LJ . fIlEL jJt );;1t>}.2Jdp
FLUE SlZE ~ ' 19f~? lNPUT _ OUiFUT
TYPE OF SYSTEM HEATING OR. POWER PLANT
05tcam
8 Hot Wllet
Radillian
8 SpEci81 Deyi~
OIhcr ecwic.&S _
(phone)
Bwarm Air PIlnU.
Gra"ity
~dwsjgl
iifAlr Conditio"inC
:JV1nl Systan
PLEASE NOTE;
Air Conditioner Units
Cannot Encroach into
R.cquired Side YlII'd
Setbaclcs
FIREPLACE MAKE AND MODEL
IndllSU'ial. Comm~,il1lk Multi-Family
F'lJ: SCHEDULE
I % of job con Jl&sidmtia', Gld Fireplace
539.50 minimum
$99.'0 Rutdential, Additions & Altntiol\l
564.'0 Residential, AC OnLy
539.50
$.39.50
539.50
Rcsidc.nial. HeatinSI. AlC (New Construction)
Residential. HCatin, Only (New Construction)
Estimated Cost S
Buildin& Pc:rmil ~
IlEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PEllMIT FEE
s
S
5
-,i" \?[::%I\U
.SO\\]I!]~lglN~G
th
(Olllet UK aely)
This AppJicatiOD BecOIDU YourB.tlding Permit WileD Approved
Paid
lleceipt No.
Date
By
BoItldi,. omci-'
I
z. hour llodee lor all iftSpectiollll (95%) 44'-9ISO. fu (951) 447..4145
Date
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
I. Blue f;l.
1, Go.. CilJ
J. YoIlo.. "11I'I10..,
I PERMIT NO. (J 1-/204-
(Please: ~t:' or I'rint llnd si~ at l . ~. ,.,)
ADDRESS 30Q \ La. ~ \-\a'JQ,~ ~""*_
LOT
LEGAL DESCRIPTION (office use: only)
ADDmON
BLOCK
~~e~R {\\Qf\\~ ~r~_ c..~-s\v.
(Address)
APPLICANT c... 1'\ \_.... . ~ (') \ \-. .
(Name) .JU~C2..Y''' U~V,~
(Address) Y'1>oo Ad r lOn Q i rdti 'Sf.
(Addrc:S$)
(ConractPc:rson) 'SQ.~"" Sc. ~QY
APPLICANT SIGNATURE ~""" ~d.(l_
~ vv
Quantity
J...
\
I
Y
\
\
\
~
ZONING (olnee II~C) 1
PID
(Phone)
. (Phone:) 9 -S d. - Y 41- (oJ 34
Pr l"or LaJUL Ss 37 J..
- -
(City) (Zip Code)
(Phone) ~ l""2. - (~,- 30& 3
I CV/7/o I
DATE
APPLICANT PLEASE COMPLETE BELOW
I Quantity
,:3
I l
I
I
I
I
I Type of Fixture
I Rough-ins
I Water Heater
I Water Softner
I-Stand Pipe (Was-hing Machine)
1- Sewage Ejector
I Backflow Assembly
, Backflow Assembly Test
,rawn Sprinkler --
I Other
I Type of Fixture
I Bath Tub with or ~jthouf shower
I Oishwasher-
I Floor Drain
I Lavatory (Bathroorn Sink)
I Laundry Tray (lor :fcornpattment sink
I Shower Stall
I Sinks
I Bat Sink
I Water Closet (Toilet)
'\
FEESCBEDULE
Industrial. Commcr~illl & Multi-family 1% of job cost with a S39-50 minimum
Residential, New One: & Two-Family $99.50
Residential, Additions & Alterations S39.$0
Estimated Cost $
PLUMBING PE
STAlE SUR
TOTAL
.~
It.' "".I\'Ou~rn-'.. '"'-.
~ r"""\ \'" C"' ~
.5~\J\U)\NG pE.. .'
1:. ---
E $
$
$
(Office Use Only)
This A.pplication Becomes Your BQildlng Permit When Approved
Bulldlnc Ornelllll
Daft
24 hour notke ror allln.pectlonl (9!Z) C47-98~m, ru (!JSZ) 447-4Z4!
--'.'
I Paid
I Date
Receipt No.
By
~~
White - Building
Canary - Engineering
Pink - Planning
The Crnler of Ihe Lab Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/ //'-~ J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
"
/-
.-r--
Accepted
/
Accepted With Corrections
Denied
........-..
{ ;{~IA-~~~
v - .
Date:
10/2--2,/81
Reviewed By:
Com'J :nts:
A~O t~ . .' c:m S:-9yf~
Y6?~ w;, .~-V ~~
YP-4.Jt5{~c~ 1] IDIt3ftJL-
~ - :2-/C')r~ (--I~ 'S~fsV\.'~
C[7eg., . ~\ 1/ e.4ftV..R<,J I '( 1-1 FV ~
~I'ef:~ ~'f;f.-Jf2 d> ~ ~ r0~
~-< trL 1!clt.-11o (/,<- Vi ~ · 0-4 " &..kL1 '*
"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."
The ('enler of .he t.kt Coun.r);
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Cf11t//I1~ f!n~
APPLICATION RECEIVED 9- //- 0 J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
309!~ i.~ 1J~@j-
Accepted
Accepted With Corrections X
Denied ~
Reviewed BY~
Comments:
Date:
9 -16-.)~/
f
-~_ ~ \l
~
a.:--6-ck~_
fu,J' ~() (.r_~
"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 ('tnlt. of Iht lib Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPI..ICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
L-f/J1c/A1JlL} t3n n-a-J
9-1/-0/0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
309/~ ~~ 1-10~~~
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
/l11J B
I
Date:
IO-ItJ-D!!
Comments:
.. -
See Reverse'Side for Additional Information!
Drr'"t'-v"",,' wl'd+~ m~:,f 10<<- ) 4' Cf,f {'11"(kr.J.r 1/1'1('
~ee Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion CantrnL.E.J.an
"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 10 give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE
INSPECTION RECORD
Q).
I)EP~.RTMENT OF
dUILDING AND INSPECTION
SITE ADDRESS 30 V ~~ I~
NATURE OF WORK -lJ.ew
USE OF BUILDING SF'D _
PERMIT NO. ()j" I.ZfJd-- DATE ISSUED 9.../'5.. ~/
CONTRACTOR ~\~~.~. PHONE_~-t{S'l.~133
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECT9R
, FOOTING t ~.~ I f,; ~ or
FOUNDATION (Prior to Backfill) I ~~ Ill)'" I -g~ u. (,
PLACE NO CONCRETE UNTIL ABOVE HAs BEENI SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC 15(/~ / J-J-z- ())
FRAMING ~...~~ l;L...;;z.~",O{
INSULATION 1--,')41&/ 4r~).I
ELECTRICAL l
PLUMBING ~b ,\'~\C\
HEATING (if required) ~ 1;l. -~p.-Dr
FIREPLACE 't I~ !.:) ...;t~...O (
GAS LINE AIR TEST b \)~ fd.. ""'DLe...l?(
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
I1IIf
fa, 11~6V ~.~ 1
~ ,\ ~1 ~-~t;;; "'D~
~\ ~ 1 t410'l..
OCCUPY UNTIL ABOVE HAS EEN SIGNED
NOTICE
DATE
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
P;;y -f-
~JJf(~
.
"
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.
Call between 8:00 and 9:00A.M~ for all inspections
FOR ALL INSPECTIONS (952) 447-9850
b
$J<tft....~_ ~
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO. -tJ!.....- ,L2.a,q
o FOOTING 0 PLUMBING RI
o FOUNDA TIO(i)N 0 MECH RI
o FRAMING 0 WATER HOOKUP
J INSULA TIO 0 SEWER HOOKUP
It FINAL 0 PLUMBING FINAL
I] SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ ~ ~ - ~
~ (1l~ ~
~~~
- v
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~.
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~?J Lc, kr fK;//tVl L or
/J1o,n/c./ Bro.>.
01 -12C),/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
I?rr.-~- ole
SCHEDULED
CONTR.
PERMIT NO,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/0/'16 E(.9J'--oIL
DATE TIME
'811 CJl
~RLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
)('WORK SATISFACTORY, PROCEED
.". 0 ~RRECT ACTION AND 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!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
3O~l
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS: C. O.
DATE TIME
SCHEDULED 3k1f Ol.. '}.: 80
LA lU: ,.,(AJEl\J CI,
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
{9 I - 1'2. ~ t.(
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
\
~ e-pr .()~
crach~ 1mJeA ~~
~~,
t;A avJ- +ffJPA DC!-r ckv~~~ t-
~ I
G,{u
l
/WORK SATISFACTORY, PROCEED
o CORRECT ACTIO AND PROCEED
o CORRECT WOR ALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~_ Owner/Contr:
CALL 447-9850 FOR n,E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
.:;~~~ 3~~
~~ (}j-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
801/ (jo)f-f!
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
frz 0 SEWER HOOKUP
. ~PLUMBING FINAL
o MECH FINAL
I - /;)()L/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
M fJU).,O w\ ~ ~<<- (Q K-
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTI<(N AND PROCEED
o CORRECT WOR~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ \ Q}.<,t Owner/Contr:
CALL 447-9850 FOR n E NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Job Address .3C1?I L ~_ !ltwnd')]
~
Heating Contractor ~ /L~L .
Name of Tester ' -:t"~.
1-/~-o2
~
0,%
, ~%
//2e:>
" Date
Percent 0
Percent CO2
Percent CO
Stack Temp.
(,..JY>o..
'-_____ __-i