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Home My WebLink AboutBldg Permit 01-1383 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT MQ~II\. t, k 1. White File 2, Pink City 3 , Yellow Applicant PERMIT NO. O/-/38~ (Please type or print and siltll at bVLLv~) ADDRESS /71!fO fJeu.-he1 J, tn ~ ~~ LEGAL DESCRIPTION (office use only) LOT;~BLOCK I ADDITION ~ Date Rec'd //-Z1-0 / ZONING (office use) /2-1 PID25 -372- 03t./--O OWNER (Name) (Phone) (Address) . BUILDER f\ JJ , 'A 0 (Name) 1.-1. K. +-t'qV~ (Contact Name) -S/r.vL- &- ult:flv') (Address) 2oQ~o K&J?~€.-cJ-. t>+-t... lOD , L,AJ.( tv\ II t-, (\1\(\ 6.... &in ~IJ TYPE OF WORK ts(New Construction ODeck (Phone) ~-qe~ ,.,180(; (Phone)!J5,a....AU - 1?J~t./ OPorch ORe-Roofing ORe-Siding OLower Level Finish o Fireplace OAddition OAlteration OUtility Connection PROJECTCOST/VALUE (excluding land) $ .I 66. ~ , 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 tioned 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 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 t .e ed inspections. .. . Receipt No. 4'(rz.-~ Bv ~ o Misc. x I Park Support Fee I SAC _ I Water Meter Size"; I"; Pressure Reducer flO()(J~C;, Contractor's License No. / C(p, ()OO. ad; i,()27."3S- I {,fD 1, "J,~ 53,0t> # # I Permit Valuation I Permit Fee $ I Plan Check Fee $ I State Surcharge $ IP~~~ $ Plumbing Permit Fee $ 119 ~ . (J' (;; 1 Mechanical Permit Fee $', tJ 0 . 00 I Sewer & Water Permit Fee $ 3~""'-" u' '-.IV I Gas Fireplace Permit Fee $ lj IJ & eX> 2 -fs You< Iluilifing P..... Wbon_ ~ 12 -()C:;:O( g cial Date / Sewer/Water Connection Fee I Water Tower Fee I Builder's Deposit I Other 9.... W t'2tl..~ up I TOTAL DUE I Paid -z.,.~.ss/. 4-f- I Date 12-/-z...7 /o( # # / '-!Z0lfli Date $ R~ti..~~ $ I, i ,'O"OC> $ I' I ?SLoe> $ ~ l.{ s , I"JC> $ I, 7...~. fJt" $ . . 1o(J . OD $ I..c:;OO. 00 $ '. 35:;:)(..,) $~ ~.;)Cf. 13 , "0 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 'ed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cl!rtificate of Occupancy must be ~~-1fvj'~{et ~ k~O-(,~~ 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 Thr ern It< of thr Lakr Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED /Y. I<!.. M~7J ) / - d,q. {; I , . The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activitY"which is proposed at: /7330 !:J~~d~ 4h. !/ Accepted ~ Accepted With Corrections Denied /'"\ ( ~ -' f\^ Reviewed By: / ~ L.{ \ ~ Date: Co L~/l, (0 ( , N-o ~'}y\~ ce ~~Y..9L" 1M.... ! ~ rbk~\~~~~ fA beu~p _,_ IThe 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. II Th. (".n... of th. Lok. Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED If)-~.~ J/-~q-() / . . . The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /7330 iQ . A. f) Accepted Accepted With Corrections ?<:-.. Denied '~/YJ Reviewed By:l ~ ~ A--- / Comments: _~~t.&*~ ~~ Date: J..2- - o~ -Q ( \, 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." , ~.. ..~ , Th. Coo to< or tho tab Country o{- '3)3 White - ~uilding Canary - Engineering Pink - Planning " BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED j[)./C. ~v //--J-tJ'-() I , . . at:: The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /7330 lR ." 42t. IJ Accepted ~ r)' ... v;""" Accepted With Corrections Denied Reviewed By: ... Comments: See Reverse Side for Additional Information! /YICf/ /l Fr'/ ( 4 1IIf7{5 Date:' 12-/0-01 x See 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." 651 633 8884 FIRESIDE CORNER #5514 P.001/005 CITY OF PRIOR LAKE ~ATJ.NG/AIR CONDIIJ.ONINGIFIREPLACE PERMIT Date Rec'd I, "in~ m. ~ NO ;: ~ ~I~ r'......KJ; . 1- ''3 '( 3 (Please rvre or rnint iID4 Ii., at boJD)l2l) ADDRESS ZONIN'G (~IiIe) /1330 r:D~~ iF: ,. l) LEGAL DESCR1r llON (ol!!ce use "n1y) LOT . BLOCK ADDITION prD OWNER (Name) r:J)/l ~ , (Phone) (Ad.dn:ss) APPUCANT (N8me) ALLIED FIDsmE DBA FIRESIDE CORNER . (phone) 651-633-2561 (Address) 2700 N. F~ AvmUPl CAd4ras) BRl!:NDA Ht1S'I'O~ (Con.tact Person) 1<,) . .&- , APPLICANT SIGNATtJRE ----1::-J./Id~. ~~ ,...-- ROSEVTT.L1l! MN (City) 651-633-2561 1I;.~1'';j (Zip Ollde) , (Phone) DATE APPLICANT PLEASE COMPLETE BELOW ......... ~W CONSTRUCTION 0 REPLACEMENT 0 AL '!ERA TrONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETIJRN OPENINGS INPUT OUTPUT TYPE OF SYo;, l..etd HBA TING OR POWBR PLANT JWstm Air Plants 0 Stearn JGravily :J Hot WQT ::J Machanicat . :J :Radladon JAlr Condl~anlng 0 SpClclal l)ev;ee&I JVcnt Systr:rn. 0 Other Devices _ FtREPLACE MAI<.B AND MODEL ~,J GGr:. SL. I~ PLEASE NO'l'E= Air Conditioner Units Carmot Eur:roach. iDto Requh'ed Side Yllltd Setbacks rndustrfBl. Comml!l:'Cild IlL Multi.Punily Residential. Heating & Ale (New ConlMJctiDn) Res idend.a1 , Harting Only (NIlW Construction) FEE SCHEDULE 1% DfjPb COil Resident/Ill. 011.I FlrepllCe $39.50 minimum $99.50 Residential, Additions & AlteratIons 564.50 Residential. AC Only $39.50 $39.'0 $39,'0 E~lmilled CQst $ , BlIllding Pennit # HEATING PERMIT FEE 51 ATE SURCHARGE .L'U'I.AL "..w.~ FEE $ s $ .50 ,....... I"l PAfD Iii> &JUJ~ D" vvfi"../ . - lNG p',' '-. ~ ~I:e V.e 0"",) . Ids Application Decnml!S 'Your Building Permit When Approved Paid . Receipt ND. Building amelll Dille Date MAY 2 2 2002 By ~ 24 hour ltllfJec fllr 011 In.pedioos (951) 447-9SS0, fu (952) 447...c45 CITY OF PRIOR LAKE nEA TINGI AIR CONDIIIO:N1N"G/IfIKEPLACE PERl\'III' Date Rec'd (Please type or print and siJ!;ll at bottom) ADDRESS 1"133D I) eer +1 ~-'d br SE. I. Pink File PERMIT NO 2, Green City , .Q./-/3 a 3 3, Yellow Applit:8nl V ZONING (office use) LEGAL DESCRIPTION (office use only) LOT .34-BLOCK I ADDITION PID ~=~RD.~. Horfon Gu.sbm Home~ (Address)~ ~rid'!t. QJ'I Lo.kevi Lle.. M~ APPLICANT A I , . 1 M ---, (Name) , r (At1T etL 1. Jda!.. (Address)~{) ~r')ebec..1::r. 5!e. #j Ea3QY1 (Address) (City) (Zip Code) (Contact Person) ~f'..pre.V Z;mmp_r fI'"\ tAn (Phone) fR..5J- tl../5/) - tl77!'J APPLICANTS1GNA~;'J17t,f!1?-~"~ DATE Ilu 11>2.- APP ICANT PLEASE COMPLETE BELOW gNEW CONSTRUCTION o REPLACEMENT 0 AL TERA TIONS FURNACE MAKE AND MODEL 1>r~4n+ 3S3kA-vb2.UD'o FUEL I\JCl{U.r"n..] FLUE SIZE 4"cla..s~ "'fL RETURN OPENINGS 4 INPUT '11).ODO OUTPUT 'OlD..tJOO TYPE OF SYSTEM HEATING OR POWER PLANT (phone) 95:1... q~ -7~7.2.. 550~L.1 (Phone) t.&J- 4ff:L- efl775' .55/~ OWarm Air Plants o Gravity o Mechanical , ~ Conditioning lJI'Vent. 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 FIREPLACE MAKEAND MODEL Industrial, Commercial & Multi-Family FEE S\;ud>ULE 1 % of job cost . Residential, Gas Fireplace $39.50 miriimum $99.50 Residential,Additions & Alterations $64.50 Residential, AC .only $39.50 Residential, Heating & AIC (New Construction) Residential, Heating Orily (NeW Construction) $39.50 $39;50 Estimated Cost $ J3uilding Permit # HEA TINGPERMIT FEE STATE SURCHARGE 'tOTAL PERMIT FEE $ $ $ r- PAlO W\TH .50 BU\LD\NG PERMiT (Office Use Only) This Application Becomes YOUI' Building Permit When Approved Building Official Date ~ c: . . ... .. , Date JANJ ..t> 2002 By 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 2001 2:00PM GENZ RVAN PLUMBING AND HEATING ell i OF PRIOR LAKE PLUMBING PERlVl.u. No.7996 p. 6/21 Date Rec'd DEe I 3 2001 , I: " ~:; ~ I PERMIT NO. Of-I.' '? Q ~' ' 3. 1ollo- ,*,~t ..;> O.....L- (l'kase type or pnnt and sUtn at boU:QUl) 11~~afqq,Q0 tfje S',L ZONING (o1fice IUC) [LEGAL DESCR.u:-- uON (office use only) LOT 34BLOCK I ADDmON 1\7 rJ if ~ eln rOWNER (Name) DR Horton Custom Homes PID (Phone) 651-454-4663 (Ad~s) 3459 Washingco~ Dr Ste 204 Eagan, MN 55122 - . APPUCANT (Name) ~QT'I'7 'By;"..... 'P"111TT1h;'RS--,(. 'R...",~ (Address) 1.4745 So Robert Trail (Adch'ess ) (phone) ...1'''1_~':l_11 i.4 Rosemount (City) MN 55068 (Zip Code) (Contact Pe:rson) Mary Olson n l I (Phone) APPUCANT SIGNATURE (J~~~ ' DATE AP~~ANT~E COMPLETE BELOW I Type of :Fixt1lre I QllUtlty I Type ofFjxture Bath Tub with or without shower !'. ~ I Rough~ins Dishwasher ! t I Water Heater I Floor Drain I' I Water Softner 1 Lavatory (Bathroom Sink) I 1"1 StJmd Pipe (Washing Machine) I LAundry Tn:~.(1 or! compartment sink I Sewage Ejector I Shower $tall ", 1 Backflow Assembly I Sinks I Backtlow ~embly Test I Bar Sink: I Lawn Sprinkler I Water Closet (Toilet) I Other 651-423-1144 t 2-/ JD I 'I'd [ Quantity J . / I ? I f 2... .l'L.I!;SLJ:I.JL.1JuLE Industnal, CommercIal & Mulu-famtly 1% of job cost with a $39..50 minimWII ResidCllUal, New One; &:. Two-Fasnily $99..50 Residential, AdditiOJl3 & Alt1::tations $39_50 Estimated Cost .$ Building Pctmit # , PLUMBlNG PERMIT FEE $ STATE SURCHARGE $ TOT.AI. r.1!..flMIT FEE $ r'-PA\OW\TH.~ \-, .5~U~U)lNG PEFL\J~B~ "., j 1ffit.t. 'Use Only) "is APPliI:aF'on Beeo es YOQT BuildiJ?g permit WheD Approved DEe I A ?nm 'Qu8dmg ~aJ Date Paid " I ReceiptNo. I By Date '24 hour Mtice for .JI inspections (952) 447-9850, (ax (9SZ) 441-4245 Dec.l0. 2001 2:00PM GENZ RVAN PLUMBING AND HEATING No.7996 P.7/21 Date Ret:'d CITY ,OF PRIOR L~ ~EWER AND W AJ..~.K PERlVul DECI3m (Please type or prmt and. SliIl'at b....--> r ADDRESS ~ r7?:eD Dee.r.t1!:.i D De se. ~ E'- ~_ PERMITNOO/-/383 ZONING (9fBa IlK) LEGAL DESCRlFTION (Q.t1icc use onI.y) -.!:or,?j.f :BLOCK I ADOmON !Yt?R"r;tf-n ~ . ~ PID OWNER (Name) n'J) U9~+-Ol;\ ,...~t~~ 'QQaail (Address) 3459 Washington Dr Stl! 204 (Address) (phone) ~5' 4.511 4667 55122 (ZIp Code) Eagan. MN (City) - APPliCANT (Name) Genz-Ryan Plumbinll; & Heating (Phone) 651-423-1144 (Ad~es~ 14745 So Robext Trail (Al1dress) 1 (Contact Person) Marv ols~n I 1,11_ '~UCANT SIGNATURE iA \l( ~ "' - - -- _. ( -,. I Rosemount. MN (City) 55068 (Zip Code) APPLIC (phone) --.DATE 651-423-1144 J;2.) ) lJ / /\ I ASE COl.\tJFLETE BELOW Size of water service inches. Location of any couplings from structure feet Type of sewer pipe_ 0 ABC 0 PVC O. Cast Iron Estimated length of sewer line feet. Clean out (if required) located at feet from structure. JrEE S\;.t:IJ!;DULE te:l1dennal sewer IIJ;ld wator line: connection $35.50 Industrial. COJ;D./l &: Multi-family 1% of job cost with a $39.50 minimwn :ewer cOlmCl;tioD only $17.50 Wateir conncc:tion only $17.50 Estimated Cost $ Building Per.mit # - f"'. OwrrH " ~\,"'~'''!' .so~~JI~rbtNG PEntl:, t. SEWER AND WATER PERMIT FEE $ STAlE SUR.CHARGE' .$ " TOTALr~FEE S I , I '1fi~ Use Only) This APpIic:a"l"f"!f~1d~di~ Permit Wbcn Approv~ J!JY l.lf . \ IE l 4 ZOO' Buildiq Oilicial J)att: Paid Rec;;eipt No. Date - I By 24 hO"J" Jiotlc:e for all in:lpec:tion, (952) 447~9850t fax (95Z) 447-42~ \ fv\o.~~_~ ~ Le DEPARTMENT OF BtjlLDING AND INSPECTION PRIOR LAKE INSPECTION RECORD SITE ADDRESS Itz3~ De<t'r\~1J h.. NATURE OF WORK ~ \ew USE OF BUILDING --SF~ PERMIT NO. (J/- /383 DATE ISSUED 12 -oS'"-ol . CONTRACTOR D..R.. ~ PHONE-9~-~2~-l"3g(/ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE I FOOTING --' ~ I !J/~/D1, I FOUNDATION (Prior to BaCkflll)~ 14, 3}ll/C)"V I ~_ 3)~7/0>1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - IfiS SEWER I WATER I SEPTIC ~. / FRAMING ~ INSULATION ~ I ELECTRICAL PLUMBING l..t.~.~ ~/1/)lo1.l ~ /1' $30101.- HEATING (if required) n-::r I/;/j,/ ()t.; FIREPLACE /~ . I IP/hlpL.- GAS LINE AIR TEST ~ ql F; I ~ I6r 1;,( (p It:> v COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS - I y", 1A(vtJ I~ 7n/~~ (,fJ (!/l t!-'~l- vtf {f-fJ-o- GRADING (Prior to Sodding) BUILDING (,~~ t fj1J /4!Jr!"., ELECTRICAL . PLUMBING HEATING DO NOT OCCUpy ~ / ;)/, IlJ~ IP/f.' !a ~ 0/7/0 v r1 t:hr . ~' I,~ , UNTIL ABOVE HAS NOTICE 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. - 17~1/v;0 I ?/.3(~~ BEEN SIGNED .. Call between 8:00 and 9:00 A.M. for all Inspections FOR ALL INSPECTIONS (952) 447-9850 ,.....\$ "', ~', j;'i.-,';" ".- -, ."..' " ;--;;>I>~~,'I"'i."21~': ,.....,.~ ;,.;.~":.;.,,..~...,).,t@'i~;(-,....."";"'''''''''''' Itrtiftrateof 'ccopanty CIl iOF PRIOR LARK J)epartment of _uilbing In.pettton Fa Final ['';'uajtted 0 Conditional C.O. Expires_ This Certificate issued pursUQllt to the requirements of Section 307 of the Uniform Building Code certifying that at the time ofisSIUUICethis structure was in compliance with the various ordinances. of the City of Prior LoIce regulating building corutruction or use. For the followi'ng: SINGLE FAMILY Use C1usific:atiOl' Bldg. Permit No. 01-1383 0cc1\, ... .,'Type R3 _ Type Construction VN Fire Zone JJl.A Zoning District --BJ Legal D_,.....:1m L34, Bl, DEERFIELD SECOND ADDITION Owner of Building . SiteAddress 17330 DEERFIELD DRIVE SE D.R. HORTON, INC., 20860 KENBRIDGE CT., LAKEVILLE 55044 ContrllctOr's N_ & Address ROBERT D. HUTCHINS f1If7 City ~ . DON RYE Building Ofticial 1/. (, ^ 0 J--. Date: CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED DATE TIME /1'" fo- Od/ ~d2 /l.I1 r., '/)'L (JJ /- /35'[3 /:!J)e ~~D/FILLlNG o C....I' .-AINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o ADDRESS III 181J. 3,),/ '34 ~ C-. , I I OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION ~INAL o SITE INSPECTION COMMENTS: &A.AIl1i:6 ... (;) I,(, ~.A. ~\it;-()IL . , CONTR. PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL SoD M&f3. S ~ Pt.A()f ~ WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED OR REINSPECTION BEFORE COVERING Inspector: Owner/Contr. THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl INSNOTl DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE ?-81-J- '* r , ~(JoQ 1-a$3 SCHEDULED ADDRESS 1/]<3~6 OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING 0 PLUMBING RI 0 EXlGRADIFILLlNG o FOUNDATION 0 MECH RI 0 COMPLAINT o FRAMING 0 WATER HOOKUP ~ 0 FIREPLACE RI o INSULATION 0 SEWER HOOKUP ~ FIREPLACE FINAL ~ FINAL ~D PLUMBING FINAL 0 GAS LINE AIR TST o SITE INSPECTION MECH FINAL 0 ~OMMENTsffi ' ~~ -~ ~) ~ ~!--t---~ ; <.J II , T., C-, 0, ~ ICJ( ']1 !En/ ~~~~-~ -~, ~~ 0 o WORK SATISFACTORY, PROCEED )I CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~ Inspector: Owner/Contr: 7 CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE., CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY! INSNOTI ~',>Oi! DATE TIME ,f' CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS /?3Jo SCHEDULED 7f'jo."" /O.'tTtJ A~ ~, CONTR. OWNER PHONE NO. PERMIT NO. e;f - 1,~Jt;r D FOOTING D FOUNDATION o FRAMING D INSULATION D FINAL D SITE INSPECTION D PLUMBING RI D MECH RI o WATER HOOKUP D SEWER HOOKUP ~ PLUMBING FINAL o MECH FINAL D EX/GRAD/FILLING D COMPLAINT o FIREPLACE RI D FIREPLACE FINAL D GASLINE AIR TST D .COMMENTS~ '1ltrtd ~, (~~ ~ .,~ -M- (' ~ fn-v ~ ~ ~_ t,i ~ (1;,-. ~ ~~ ~ ~ 0" ~ .,...:tt- ~ ~ ~, ~~~* \.~ _~&D~ r . ..Lk~~~.~_ ~ c ~V~~~~ !!A- D WORK SATISFACTORY, PROCEED ,ACORRECT ACTION AND PROCEED / D CORRECT WOR~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! INSNOTI DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS ~). 1733(, .t:>6&eRELD OWNER CONTR. IJ-.T: o~. PHONE NO. PERMIT NO. 01-1383 - (J1-13f!;(, 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 COMMENTS: 5C;t/ / 17<b6 /"1 ~A 05e 7il V o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o File- , WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING Inspector: ~ Lf -(, -0- Owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTI CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl At. "---- APPLIANCE, PERFORMANCE TEST Attach to gas line adjacent to reg~/ator Heating Contractor B~r .AfR.#'" Name otTester ~jI/',- . Date ~~ 'L Job Address Heating Contre,ctor Name ot Tester Date Percent 02 Percent CO Percent C02 Stack Temp /?3J"~~ ~~~~' ~Z 7/Ol9AJZ . '" / al70 ~,V\.. , "l, B 70 3S-fo r Combustion air is adequately supplied per UMC Sec. 606 IU' 5 input ' tf~ lidO