HomeMy WebLinkAboutBldg Permit 01-1421
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
ADDRESS
'J1~()0\
~('))( \~: \
\c-. NlA)
Date Rec' d
1z.-6 -01
//
I PERMIT NO. () l1/(4kL
I. White File
2. Pink City
3 . Yellow Applicant
LEGAL DESCRIPTION (office use only)
LOT \0 BLOCK ::l ADDITION(~~~~~CA~
OWNER(. \ \ \
(Name) AJ ~~~QD."" vr(1""C)~, I "-C.~
(Address) l ~5 ell'll? 'l\ Or \''I'f>_ *aDd
t9>+
PID 2S-37h-O /4--0
ZONING (office use)
../ Je../
(Phone)C05I- ~... t...t..:LCO
P_ ~ I rY'\ l"\. c;=s F) \ '2.?
\ l'.f ~ .
BUILDER. l \
(Name) (. ~ .p~ c;,. ~ o..Ar--.. f'N'1\ l'.s. I
(Contact Name) ~ ;( .K \4. ~ i \ tv""'-..au-....
- .. - '" - .
(Address) ~
~~~
(Phone) k51-4.QL- 44[i)
(Phone) 10.1), .. '1~q -lb~~
..){New Construction ODeck o Porch ORe-Roofing ORe-Siding
DLower Level Finish 0 Fireplace DAddition DAlteration DUtility Connection
o Misc. ~_ \-\r-r<'\.e PROJECTCOST/VALUE (excluding land) $ ~~JO{,)()
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.
x(~P.D~\l.LJ'4>~ ~
Signatur~ *- \
- -
TYPE OF WORK
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
''''0 . CJ l!J
IcJO ,r1t"J
'Z~, 60
tltJ.t:Jn
.
ecomes Your Building Permit When Approved
/2 -II-Dt/>
Date
$ A. c::;() ~lJ
$ l,#P,oCL
$
12<;".00
$ . ~.n/'J
,;
$ ~! 2t::JD .on
$ 7QO. dO
$ '1G'Oc).~
$
$ P>, PJ30. &7 I
i
Receipt No. 41 (2-'3
By (4)~
l4~9:
Contractor's License No.
I Park Support Fee
SAC
#
#
I~-~-(j 1
Date
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 I
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
issue
Water Meter Size@'; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTALDUE
#
#
Janning Director
~2/r?t&t ~~ JA.'\J - ~4l c:~~~~
Date . - ~~ditions, ifany -
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
'16200 Eagle Creek Avenue Prior Lake, MN 55372
I Paid
I Date
8~ 30. .(,{
'2.-1t.-"7 / c# ;
,
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3. Yellow Applicant
Deck 0~
I PERMIT NO. ol- (<<.{2(.
(Please type or print and si~ at bottom)
ADDRESS
-;SC;o l)
0Xc,<l,(;
ZONING (office use)
, f.A,',
N, \,V.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER~___
(Name) ..=-::S- I r.1"f) J.J -c "- )
. r
'--rR-tPWJetL
(Phone) -1.2z.... 'L...(/O
>hZ~
(Address)
:~~~~R lJJ ~. jV\,VWV
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
llI6eck
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 are that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;terupon operty t pem ~:~ ~ / I 'f /0'7_
Signa~ -. -- Contractor's License No. Date
C> Park Support Fee # $
$ SAC # $
$ Water Meter Size 5/8"; I"; $
$ Pressure Reducer $
$ Sewer/Water Connection Fee # $
$ Water Tower Fee # $
$ Builder's Deposit $
$ Other $
$ TOTAL DUE $
/J
Building Permit When Approved I Paid Receipt No.
I Date Bv
ng Cl / Date
. This is to certifY that the r'est 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
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
I
~.
I
I
I
i
i
~---
.
White - Building
Canary - Engineering
Pink - Planning
Th. Ctn'er ollh. t.k. Counlry
'J
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\\ E r<'~ tl /~ 1\ (\
J Z.- {c - (),
. .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
35l~ q .:: (, 'I --17\ I L-- T/<-
I ,.
1/
(\j' j V
Accepted
Accepted With Corrections
Denied /-19----11 ^
Reviewed By: ~- ~,....~"';?
Comments:
tic ~iuJ
~-".~~ to
'"--"
Date: ---t 1.-./ Ild/rh
#Q. 1~;J;--
~Y'PI( ~~
IJo ~~ tl() ~~ ~~;tkks
~. ~O h>_ ~~~.d<_ ,e,':; ---_ ~- <) pr---
~~ ~. [t~ ~ ~1:e r-t.~~ ~ )p
'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
Canary - Engineering
Pink - Planning
Thr C"rn'f'f of thr l..kr ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
W5NSnANf\
!Z-(o- Of
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
350Q fax ~ T1e- N\A/
I ~
Accepted Accepted With Corrections
Denied /~
Reviewed B~
Date: j.2 -./(.-00
e::/~l cJk,cked
~~
f,
"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."
C9 ( - /'-/ ~ /
White - Building
Canary - Engineering
Pink - Planning
Th. ('.nl., of Ih. tlb ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WE-NS ~IANf\
! l- (& - 0 (
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
350 q .I~() X --rt\ (G I 7~ (\) \IV
I
Accepted X
Accepted With Corrections
Denied
Reviewed By:
A#J8
Date: /2- /7-01
Comments: See Reverse Side for Additional Information!
Dr ,'VtWo..f /I1v.~ 1- he; "t.
u,/ll-I/.om/l
I
~ee Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
liThe 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 : 59PM
GENZ RVAN PLUMBING AND HEATING
No.7996 P, 3/21
Date Rec'd
ell ~ OF PRIOR LAKE PLUMBING PERl\t.llJ.
1 BIu. Pil.
1. Ck>Id CitY
J. YolIo. AppU....1
I PERMlTNO'OI-ftfZ U
(Please type or])1mt and S1.21l at bottom.)
ADDRESS
Qtf11 ~I L- I ~L-
Mw
. ZONING (~lJSC)
LEGAL DEsrli' I "'uON (otfic:e use only)
LOT I D BLOCK 2- ADDmON~ JI\.Jf\ \~,
PID
OWNER
(Name) Wensmann Homes
(phone) 651-905-3709
. (Address) 1895 Plaza Dr
Eagan~ MN 55122
APPLICANT
(Name) Genz-Ryan Plumbing & Heating
(Address) i4745 So Robert. Trl
(Address)
(phone) 651-423-1144
Roselllount. MN
(City)
55068
(Zip Code)
Quantity
z.
\
I
LJ
J
\
I
Mary Olson
\ ~ DATE _ '7.....:,JD l.oJ
:,~~ EASE COMPLETE BELOW
I Type of Quantity Type of Fixture
I Bath Tub with or without shower I ~ Rough-ins
I Dishwasher I J Water Heater
I Floor DrainJ2::.1, I Water Softner
La'Vatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I .Shower Stall I Bac;:kflow Assembly
I Sinks I Ba.ckflow Assembly Test
I Bat Sink Lawn Sprinkler
I Water Closet (Toilet) Other
(Phone)
651-423-1144
(Contact Person)
APPLICANT SIGNA'I1..JRE
~
.l".I!..I!; S\;J1Jl,DULE
Industrial, Cottu:liex:cial & Multl-farmly 1 ~ of job !;lost with a $39..50 minimum
Residential, Nc'fl' One & TwQ-Farnlly .$9950
Residential, Additions &:. Alterations $3950
Estimated Cost $
Builc:IiDg Pcrnlit #
PLUMBING PERMIT FEE $
STAlE SURCHARGE $
TOTAL PERMIT FEE $
rr"ort" ~A~D WrrH"~~T
50 \' ....\,.\. F'....:i1".~.~dF.i, \PERbQ~U"
,: ~\~.'t.J > :'\.,,)..
(orner: U,r: Only)
Thill Application Becomes Your Buildiag Permit When Approved
Paid
Receipt No.
Date
By
Building Official
l)~tr:
24 bour nQtice fOI" aU inspectiQn' (.952) 447~!l8S0, fax (.95~) "7-4245
1:59PM GENZ RVAN PLUMBING AND HEATING No.7996 P.2/21
elTr OF PRIOR LAKE Date Ree'd
11.EA~li~G/AIR CONDl'lJONlNGI.141.l<EPLACE PERM.1l
(PIwc: type: OJ wiat md si~ . bottoJD.)
ADD.RESS
t~ j~,- ~PERMITNO.O 1-14--2 f .
'.;',\ '~',. '"
~~r9\
~,~IL- -TrLL-
~jlU
I ZONlNG(ofIke......, I
LEGAL DESCRu-uON (ottic!: use OI21y)
LOT \0 BLOCK '2-ADDITION uJ~.~ f~, PID
OWNER
(Nwn~ WA~A"n Rn=AQ
(phone) fi 51-9n ,,- 'n...llil
Eagan; MN
55122
(Address) 1895 Plaza Dr Ste 200
APPLICANT
(Name) Genz-R.yaro 1'1 tUDh.iI1.Q' & V'".",HT1g:
(Adch'ess) 14745 So Robert:
~honc) -p~1-4?~-1144
(Contact Person) M~T'V 01 "'nn I
APPLICANT SIGNATURE . ( A
Rosemount. "MN
(City)
55068
(Zip Codl::)
(Phoo.::)
. DATE
.6.~ 1_lI.7~_11/1/1
l,=-1DlD {
" ~ AP LICANT P E COMPLETE BELOW
- ~WCONSTROSDPN --" o REPLACEMENT o ALTERATIONS
FURNACE MAKE AND MODEL W J1(J'( (}.,'2loGlU l~... I~C;- FUEL ----1J.&TG73_
FLUE SIZE -.. RETURN OPENINGS q INFOT J 2$', ODD QUTPUT JILP: rr7JL
TYPE OF SYSTEM HEA'I'll'IG ORPOVVERPLANT
~ann A.1r Plants 0 Stellm
DGmvity 0 Hot Waret
o Mcch.anica.l 0 RaclJation
DAir Conditioning 0 Special Devlces _
DVCIlt System 0 -Othc:r Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Eucroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
InrJustnaJ, Comm~a.l &: Multi-Family
FEES"D..IloDULE
1 % of job cost Residmtial, Gas F irepJacc
$39.50 minimUOl
$9950 . Residential, AddjuoQS &. Altuaiions
$64.50 Residential, AC D.lly
$39-50
Residential, Heating &: Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #.
HEATING PERMIT r'eJ::.
STATE SURCHARGE
TOTAL~~FEE
$
$
$
PA%\i) WlTH.."
S~%W~NG \P~_
.50 ~_
((''''' -~ U,cQl.Ily)
. ~ _JIS ApplIcation Becomes Y 01U' Building Po..mit When ApprO'Yed
I Paid
Date
Receipt No..
By -
Building Offic:j~
Date
24 bour Dotice for all inspec:tloDIl (952) 447-'850, fax (951) 447-4245
OB:OB 651 633 BBB4 FIRESIDE CORNER #121B P.001/002
. LJ:II ur CKJ.UL"\. ....n.,l~
HEA III iGI AIR CONDITIONINGI f udPLACE PERMII
t~ =ltA"! \ r'Ji,~TNO'OJ-JLfZ /
(Ptelt6e goe or T1rict lIJ1d. si"", III b...... ,....)
ADDRESS ZONING (olfic:r_)
3soer ~~t:~~
LEGAL DESC1lJ.K' llON (offl.ce use o,lIy)
LOT
BLOCK
ADomON
OWNER L J . )
(Nam.e}} ~AuJ-?_Jl4I6I: ~.s
(phone)
(Address)
APPLICANT
(Nam.e) ALLIED FIRESIDE DBA FIRESIDE CORNER
PlO
. (phone) _ ~51-633-25Q.l
(Address) 2700 N. F~ Avmwf.
(AddreSS)
BRENDA HUSTON
(Con.tact person)_
APPLICANT SIGNATURE~
~TTr.1=' MN
(Ci.ty)
(phone) 651-633 -2561
'" 1:;' , ':l
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
[jS'EW CONSTRUCTION 0 REPJ..ACEMENt 0 AI.. TER.A TlONS
FURNACE MAKE AND MODEL . FUEL
FLUE SIZE RE11JRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
JWarm Air Plunt.'1 0 SlClIM
:JGravity :J Hot Water
:l Mechlll1ical . J R.adiKtion
:lAir C.,nditionlng 0 Specill Devices
:JVcnt. Systmn 0 Other Devices
FTREPLACE MAKE AND MODEL 4w- jJ Gte
I
tJLL-.J7L
DATE
{,ooo.11t-
lndustrial. Comme~leJ & Multl'Pllmlly
FEE SCHEDULE
I 'Yo of job cost ll&::Iidcnti..J. Ou Fl:rcplece
$39.50 mill.itnum
599.50 R.esldendal. Additions 8r. Alterations
564.50 Residential, AC Only
Rc:sidentinl, Heating & Ale (New Construction}
REsidential. Heating Only (New Constl'l.lction)
Estimated Co~ $
Bu.lJdlng Pennlt #-
,.)/Jf.(/OL
PLEASE NOTE:
Air Conditfoner Units
Cannot Enc:roGb inro
Required Side Yard
Setbpcks
$39.50
$39.50
$.39.:50
HEATING PERMIT FEE
5T A TE SURCHARGE
TOTAL PERMIT r J!.J!,
$
$
S
.' 'J'J r\'r\ '.' .,-\
.50 ( ~p..\O p~f-~~~\
eU\\'p\~G
~/
(oroce Ulll Only)
Till, Appllc:ation Bec:t1mCII Your Building PCnDit When Approved
I Paid
Date
FEB I UIJl
Bt.lldl"lI!: Omellll
Dat"
~ "our lIotlce for allln.pectiD"! (!IS:!) 4.7-'850, r... ("2) 447..4145
=-j~~!VL
J
PRIOR LA KE DEPARTMENT OF
~ BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 350t!:f Fb~ . Jcu'l ~.
NATURE OF WORK Jle.L.) .
USE OF BUILDING -.S F D
PERMIT NO. 0/- /4,..:) / DATE ISSUED I Z - t/-o1
CONTRACTOR WQM..g.~ ~ . PHONE_t.ltZ-~<OJ-~29
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR . DATE
I FOOTING I gU~ I l{ti/,.....
J FOUNDATION (Prior to Backfill) I /J.r:; /y~ ~l\\ ~1Yt? I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
I "/(> ,
/ \..~ \)~
~ _ 4.103..
r~~ ~ ~ Q..J
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
v.l\CI
~~
1; \fl.af
'~ I
r~ .\\~
~J~
~~'r-
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO' NOT
~ ., ;).,..0 ~
~ - I ....0 i)..
";1-;2.\ ..O~
-;z - g..\ - o~
:> - ~eJ'';t
it/'l4,-v.a.~
4 ;z4- La). ",'1-'1'
- ~ - I
This card must be posted near an electriC".'1I'stil".io;ce 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 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
~ Cfl~
~ T~ f/Z.,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
35"0'
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
Mo SEWER H,QOKUP
.l{ PLUMBING FINAL
, 1:] MECH FINAL
() { - 1c.{,)...1
o EXlGRADfFlLLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: '
M rA/oNJ-~ ur- () c{1_-
rIA P-\-~ <,.f=' P1,\c:rt
. ---
/
/
~RK SATISFA~TORY. PROCEED
o CORRECT ACTI< N AND PROCEED
o CORRE~..\ CALL FOR REINSPECTION BEFORE COVERING
InSpector:-:p \,~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS AfE FOR YOUR PERSONAL HEALTH & SAFETY!
Il'/SNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3t5()'J ~ 1d
/
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
^ _ 0 INSULATION
tr ~ FINAL
o SITE INSPECTION
o PLUMBING RI
~1j,.RI
o WATER HOOKUP
o SEWER HOOKUP
~ PLUMBING FINAL
n ~ MEC~ FINAL
DATE TIME
H- ItJ!br:J
tJl _~t lJ\''l\
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMME"f~~ .
IQs, e fll: j) ~
~ -' s.od- tree>
rV~~/ <!: ~~L +~'tJe,
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK' CALL FOR REINSPECTION BEFORE COVERING
Inspecto;$ 1 iflJJl/ Owner/Contr:
CALL 447-9850 FOR ~E NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/'iOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
35"0=, Fox1oril Tr(
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
COMMENTS:
Sr't'~ ..vOl It- ~
DATE TIME
If-/J-()L.
\Altt15~J111
81-1'1;),,1
~X1~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
kORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector~~ .::..., ,,,,...JContr:
;
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
I/'IS/'IOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
CITY OF PRIOR LAKE
INSPECTION NOTICE
OA TE TIME
SCHEDULED
ADDRESS
3509 HX trt/t-- -rJZn1L-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
tSOO/
,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
f
C ! t1S-t'
J(., / k
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: J11? 1),,-] - 02- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
lNSNOTl