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Home My WebLink AboutBldg Permit 06-0542 &~ _ 1ft OJ) CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLL.\.NCE ... Ob AND UTILITY CONNEC~ION PE~T..... Jl.t.- () /,,; ". (Please me or print md si~ at bottom) ADDRESS .533 / ~\L\V\V\~ S~v-e.J LEGAL DESCRIPTION (office use only) . LOT \ BLOCK 4 ADDITION fv\uo \.e 0\eN\V\ \ OWNER (N ame) L ) I t\ C$Dv\S~uJ10'lI\ 2-?10~ ~1- \y ~A 15~O (Address) Date Rec' d l. While File I PERMIT NO 2. Pink City . .' .0(; .05+2- 3 Yellow Applicant ZONING (ollice use) (2-1 PID ~~- ~.r;J. -01'-0 (Phone) t>\w.J \>,,~ I U\ M S1oO"l1 v ~~~;~Name) t~A \0\* CD,^S~O~ (Contact Name). :::r~~V\ \A.h * (Address) \~~(J ,2,W'h. -st W I N.UvJ Vr~ (Phone) 9S;'i-I~ l.,\cfp (Phone) lol" - ~(P'1 - ~ "6 ~ 2- \i\w SenDtl TYPE OF WORK'.;g(New ConstrUction ODe~k OP~rch ORe-Roofing ORe-Siding OAddition DAlteration DUtility Connection 0 Misc. CODE~' . I.R.C. OJ.B.C. Type of onstIUction: I II III IV V A B Occup cyGroup: A BE F HIM R S U Division~ 1 2 3 4 5 OLower Level Finish o Fireplace PROJECT COST /V ALUE S 300 , 000 (excluding land) I hereby certify that !. have.fumjsh~t;linformation on this application which is to the best of my J.-nowledge true and correct. I also certify that I am the owner or authonzed agent for the above-mennoned pl'Op~rty and chat all constrUction will conform to all exisung state and local laws and will proceed in accordance with submitted plans. I am awar.e that the building ;cial can revl~:::"S, ~ust cause. Furthermore. I hereby agree that the ciry official or a ~::q :;: enter upon the ,..u,....J to perform necded ;;~:J O~ V Signature Contractor's License No. Da~ I Permit Valuation I Permit Fee Plan Check Fee State Surcharge Penalty I Plumbing Permit Fee Mechanical Permit Fee Sewer & Water Permit Fee Gas Fireplace Permit. Fee I ;?~)~ 1$ - ;;1;2.5'3-> ~6 I $ I L/6 L-/" 1& I $ /5rJ. 00 $ I $ $ $ $ 100. - / 1X1;-- . 35. S'O l/O,CJO This Application Becomes Your Building Permit When Approved ~.~ Buildin!! Otlicinl (P121/o6 I Dnte I Park Support Fee # I SAC _______ # I Water Meter Sif 5/.v I"; Pressure Reducer Sewer/Water Connection Fee # I Water Tower Fee # I Builder's Deposif I Other I TOTALDUE ~ ("ZI,OC. $ $ $ $ $ $ $ $ -- 7556.- ~56,- {~(? - ) PjtJo. - /()O/), - I J5MJ-- $~ 9 q.3. 78 I Paid I Date q9~:';. 7~ c,. ,;),/, (/ (, $ l' No. 5158(1 ThIS IS to certify that the request 10 the above applicauon and accompanY1Og documents is 10 accordance with the Ciry Zoning Ordinance and may proceed as requested. ThIS document when signed by the Ciry Planner conslltlltCS a lemporary Cenificate of Zomng compliance and allows constrUctlon to commence. Before uccupancy, a Ccmficate of Occupancy must be iS~ ~ 6/zll~~ /~ t:1JL( ~ Pianning Director 'Date Special Cl16ditions. if :my :!:4 hour notice for :III inspections (952) -'47-9R50. f:lx (95:!)-t47 -4245 111:?-00 Eagle C.rf'~k Avp.nl1p. Prinr T "l;p MN ",\.7'') Residential Building Permit Checklist New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts ~eviewed by: ///. ~ Date: ~~, Building Permit # PID:...z.s~ 4/f..2 · 0/' - 0 Zoning: 12 I Address: 3.13/ <5J;.,;,~e" ~I Legal: L I ,B jC Subdivision: ~~ ~ ~;-& Existing Structure? YES I NO CONFORMS TO ZONING ORDINANCE t Yard Setbacks: NAI FAilS' COMPLIES . Front Yard (can be 20' if avg. w/in 150') . Side Yards . Sidewall exceeding 50' requires additional side 2W setback for every l' over 50' in length . Rear Yard . Patio Door: provide for minimum 10' deck or sign statement indicating no. deck will be built in the future . From 100 year flood elevation of wetland/NURP pond . From OHW (Prior or Spring Lake) t Floor Area Ratio: NAI FAll~OMPLlE~ t Yard Encroachments: NA' FAll$1COMPl!ES' Eaves and Gutters no more than 2 feet in width and no closer than 5 feet to a lot line (Easements). AlC and other equipment cannot encroach on interior side yards. - t Tree Preservatlon:~ FAilS' COMPLIES . Total caliper inches . Permit 25% Removal . Caliper Inches Removed . Caliper Inches Preserved . Replacement L:\TEMPLA TE\BLDGLlST.DOC Existing Nonconforming Structure? YES I NO E:YEV NO ~ Standard 25' 10'1 25' if abutting a street Proposed 2..9,5' ~s: zs..... ,~ 10' setback + 2w/1' over 50' 25' 10' sidel (25"rear ~ 30' /0, z...s- 5..2 sz. ;// 75' or setback average of adjacent structures, but no less than 50' -- I I 8' 'J1,. L .30 Maximum Standard Proposed rJ err-! tF IVaNe- Standard Proposed 112:1 , Driveway: NA I FAILS I COlfLl~ . Maximum width at property line . Required setback . Maximum slope . All parking areas to be paved including.R-V or spaces adjacent to the garage . Location to match subdivision grading plan I BuildinqHelAht: NA/FAIL~ I Shoreland District: (~'~FAILS 1 COMPLIES Minimum lot area (sQ~are feet) Minimum lot width Shoreland alterations Impervious surface I Bluff in Shoreland{,I(:;JFAILS 1 COMPLIES · Setback from top of bluff . Bluff impact zone . Engineering certification submitted/approved . Grading in bluff or bluff impact zone r ~ FloodplalnrltWl FAILS 1 COMPLIES . 100 year flood elevation . Lowest floor elevation . Proposed lowest floor elevation · Elevations 15 feet from structure · Road access must be no more than 2 feet below Regulatory F100d Protection Elevation I Accessory Structure:(Q FAILS 1 COMPLIES . Size ,- . Not located in front yard (Materials) . Side yard and rear yard setbacks . Maximum height . Materials compatible with principle structure L:\TEMPLATE\BLDGLIST.DOC "' c:=li'C~- :~:.- Standard Proposed I 24' ~4 5' from side lot line or //" 30' from r-o-w on comer lots 10% !tJ"'/. .~~UJ ~ RaA ~. ~ I 35' Maximum I ~q~ Standard Proposed 7,500 Rip, 7,999 Non-rip / 50' Rip, 57.3' Non-rip hl/l /'fl / 30% Maximum I Standard Proposed By planning dept. 20' From Top of Bluff ' I rf By City Engineer /1 /1/ No importing/exporting Standard Proposed 908.9' Prior Lake 914.4' Spring Lake 909.9' Prior Lake 1 915.4' Spring Lake Jlj Must be l' above flood elevation for new and existing structures. If existing structure was constructed 9/19/90-11/22/97 then additional foot is not reQuired. Must be flood elevation or higher 907.9' for Prior Lake 913.4' for Spring Lake Standard Proposed I 832 sQ.ft. or 25% rear yard 10' 15' ." :r -'IP!~ ~.~_~~ _ _ _ ~ . ~BUlldlng ) \,;anar~ - engineering Pink - Planning BUILDING PERMIT APPLICATION OEP.ART~NT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED K 1'1 tu / i!- f& M5l ~- /- ~ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: SI6)A//IJ~r ~ r / Accepted Accepted With Corrections Denied M:'~ Date: & I tf' /tJ , - . . Comments: - ~;,;' ~,;, ~~;.. ~.~ / t:?rpv,.... / ~ ~ -- a,/'/ g. ~e L-Or)/.-/ 4L1-ec--~~PL Reviewed By: "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." f. ~~........ White - Building Canan:' - e:naineering r Pin~ - Plann~ BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED 11 l/ f , ;.j I /1 .)" ... , / .. .; /- /' " \0 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: l /' / / '," / -r--' Accepted Accepted With Corrections / Denied Reviewed By: ~ ~ ~ ~ Date: 6121!O~ o-IU ..,J,. 14-1-. :. -t- ~"' --.L.. H~. if'. ~ g ,..7C7~ V -A~ ~--u..:~.{) '-1-0 ~S"~ ~ .A./ ~ LJ . . 0 / ~ t-e ~ ~~(~ r;:J ~...~ ~ ~ V '---./'- J ' Comments: ~ ? , , r Air Condition d Trmts Cann t E;;..n Oth.er MeehAnieaI o croach mto Re · Side Yard SetbacJca qmred 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." White - Bulldln<<L- ~rv - Engineering) J5'In1( - Planning BUILDING PERMIT APPLICATION DEPARTMfNT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED 1::-/!-9 i-C-J { IT rf~ ;0S;} ~- /- 0 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: c- / j . r ---r-. ~!:/ !L,Nelr- ~ I Accepted y Accepted With Corrections Denied Reviewed By: -'J!fJI!, . Date: {- 2/-01 . . Comments: See Reverse Side for Additional Inforrn.a1ionl , See Attachments: 1) Grading Plau, 2) Erosion Control Measures "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 c~ncel the provisions of this code or other ordinances of the jurisdiction shall not be valid." Date Rec'd CIl i OF PRIOR LAKE PLUMBING PERl\'u.l 7, II. 0 b I. Blue File 2. Gold City 3. Yellow Applicant PERMIT NO. " .54-2- (please type ornrint and sian at b. ;,.....) ~ 33J} ZONING (office use) .F/:''-/t 11 e V' 5'~ LOT LEGAL DESCRIPTION (office use only) ADDITION A-lM- U ~o L.. PI6 9. v 601 ;D~ 1) VL. (Address) <&9Bl_~t ~ J A:~~NAT~RE :PJ tl~ OWNER i ..aIm 11 Il~ (Address) APPLICANT ~f &l.trurrU$) Quantity -') J I 'i / I BLOCK PID k- A [,UI /T eu,.s"7r -if I ~ 7..rt- J lor ,~~ nIL.. I)-M-- fJ,. fLJ tv- (City) , lfi4< rl/(j- .....rrJ..'V<f13 7J-r- 6 "J 6 r- 0'..../,/1/ (Zip Code) (phone) e 7/1//1)6 .~ APPLICANT PLEASE COMPLETE BELOW Type of Fixture I Quantity Bath Tub with or without shower I I Dishwasher I I Floor Drain , Lavatory (Bathroom Sink) I Laundry Tray (lor 2 compartment sink I Shower Stall I I Sinks I I Bar Sink I I Water Closet (Toilet) I Type of Fixture Rough-ins Water Heater Water Softner I Stand Pipe (Washing Machine) I Sewage Ejector I Backflow Assembly I Backflow Assembly Test I Lawn Sprinkler I Other FEE SCHEDULE Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum (Office Use Only) Building Official Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50,; Estimated Cost S Building Pennit # ./1/11' I 0 ~f)" Gr PLUMBING PERMIT FEE $ ./" r r' STATE SURCHARGE $ / .50 ,;2 U III TOTAL PERMIT FEE ~ V ~ ~nA By vo:L-- ,. Date --- pa~ Date~ .; II () & This Application Becomes Your Building Permit When Approved 24 hour notice for all inspectIons (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S,E" Prior Lake, MN 55372-1714 CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd ;: ~:n ~:~. I PERMIT NO./ -~~ 3. Yellow ApplIcant 'P ~ 7 ~ (Please type or print and sip at bottom) ADDRESS 3331 SKINNER STREET LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name K A VI n 1 CONSTRUCTION (Phone) (Address) APPLICANT (Name)HEARTH AND HOME TRC~()LOGI13~ l)llA- FIRESIDE HEARTH & HOME (Phone) 2561 (Address) 2700 NORTH FAIRVIEW AVENUE (Address) ROSEVILLE (City) (Contact Person) BRENDA HUSTON (Phone) 651-633-2561 APPLICANT SIGNATURE BRENDA HUSTON DATE ZONING (office use) PID 651-633- 55113 (Zip Code) 8/1/06 APPLICANT PLEASE COMPLETE BELOW xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT / O/,o 1fJ' && ;:}-(. TYPE OF SYSTEM DWarm Air Plants DGravity D Mechanical DAir Conditioning DVent. System HEATING OR POWER PLANT D Steam D Hot Water D Radiation D Special Devices D Other Devices FIREPLACE MAKE AND MODEL HEAT N GLO SL-950 FEE SCHEDULE Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace $39.50 minimum Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations Residential, Heating Only (New Construction) $64.50 Residential, AC Only Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE Building Pennit # $ $ $ .50 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid BuildiDlZ Official DatE;) Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks $39.50 0\. $39.50 $39.50 Receipt ~ By C- O CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd 1. Pink File PERMIT NO I.A. .A~~-7 ;: ~~~~:w ;;~icant . f./) I 5..,-~.. (Please type or print and sign at bottom) ADDRESS 1331 S k:.r\'i~r ZONING (office use) s-~ LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) \N' \ +1 cOAS+r\) t=1- a{\ .d-Q o~ ~'t-~ APPLICAN1\ - I..L . ).. (Name) fi..(')c:..~ ~"l<:""\j ....L-LC l00f,1 11~ s~ v.. 0 k..A. 1<;30 (phone) ~..~.. d-.l O~ (Address) (Contact Person) (Address) I \ ~..) ) ~ (Phone) c,9<' 7~-7<J(J3 Ne~~ $(011 (City) (Zip Code)' (Phone) CJ ~. ~ ').. - 4%0; DATE .:J-7...0*' (Address) APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BELOW ~EW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS + FURNACE MAKE AND MODEL _n ('r;..ry ):fOY"'" ~tr\'i~ FUEL (lK;; FLUE SIZE ~-'I (Jv L..- RETURN OPENINGS IV INPUT fOOJ ovV OUTPUT qLf)~ TYPE OF SYSTEM HEATING OR POWER PLANT DWann Air Plants DGravity JMechanical Air Conditioning Vent. System o Steam o Hot Water o Radiation o Special Devices o Other Devices PLEASE NOTE: Air Conditioner Units and Fireplaces Cannot Encroach into Required Side Yard Setbacks, Fireplaces with Box Additions or Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL Industrial, Commercial & Multi-Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only $39.50 Residential, Heating & AlC (New Construction) Residential, Heating Only (New Construction) $39.50 $39.50 Estimated Cost $ Building Permit # HEATING PERMIT FEE ST ATE SURCHARGE TOTAL PERMIT FEE $- $ $ PAID WITH oOILDING PERMIT (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Buildin!! Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372 ~ P R 10 R LA KE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS .~~'3 I ~~ S'T', NATURE OF WOR~~ ~. (JI.~J '" Co. 6)II/r~ ~J USE OF BUILDING S, ,:': b;- 4 _ . PERMIT NO. _ Of,. 054-2- . DATE ISSUED ,,~ CONTRACTOR -XIl AJirr ~T. PHONEIll.."''' ;g" NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT ~INSPECTOR . JlDATE /' _ I 6/~~~ . .. I JFOUNDATION(PriortoBackfill) I ~ I 6br~-b " , PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS . , 1i 1tH filii I ~~f I ~ I FOOTING SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING t )~I1'\ {Vf 1"'1l/'t-V HEATING (if required) FIREPLACE GAS LINE AIR TEST , /' ;r(~~-6 J'l' ?~, t/~/c4. XI! r!(P tfll/ofo J7' ?/~, ~/ ?/6-, COVER NO WORK UNTIL ABOVE HAS ~EEN SIG~D/ l~rtW~ I ~.', ~//e6. ~ ! 44-"ktV~//~ tJn~tOf.e,' FINALS /:~j, a" /s A'~ecl GRADING (Prior to Sodding) AIR ~)-, I . ~ BUILDING ~ 9/z&(:, ELECTfllCAL u j 'f~~. G PLUMBING ~ ~ fl.t;6fo" HEATING . ~ 9'//~, . DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED 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. FOR ALL INSPECTIONS (952) 447-9850 QLerfifirafe of @rntpanr\! CITY OF PRIOR LAKE ~tparfmtnf nf Illuil~ing ~ nspttfinn f Pinal Permitted 0 Conditional C.O. Expires This Certificate issued pursuant to the requirements of Section 110 of the D Residential / D International Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City of Prior Lake regulating building construction or use. For the following: Sl N ~ L c r -urll LV /" /., /< _~ A-2.- Use Classification '-I [..0 r r' Bldg. Permit No. v U" L.I - ...,- Occupancy Type _ ,e 3 Type Construction. V AI Zoning District 1< / Legal Description _ L II 134 /"1 rI /./LE G t-EN Owner of Building Site Address 23.3 I :5 K I IV IV E Ie!.. S77~6 e r Contractor's Name & Address K. Ii J V / T T; 5;ii;.d' 2. 8 0 TJ-I..5'T~ IV Dv f/ /.:!.-I-/ q u 6' 5" () 7 / Ir::::.o ff E.. /2.7 O. 1-1(/ TCrlIN ~~City Planne' JII N€ 01 N 5/61C?-. _ /.. ~ilding Official - Date: -9/ ? /' d~ Date: , / ........ CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS 333/ 5 K,i,lIe,. SJ. 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 o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: ('~/6 ~l''' r'>.,J:.. Grf,l~ - fJ K DATE nME q-I-oI, K.f1.. W.'H- ~ -~~l... )(~ILLING o cOll5[AlNT 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 InSpector:#~ _ Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! COMMEplTS: / ~ A.- ./ ,~~tz,/ ~J r- c5/- U} (~/ ~?n"A.rr ~ff7 ~9.f9? fv /hS/-~/n~ ~ /#/ P . . / ~ r ~ # tiJ ftt:d 4C~t'5S .,Lo 7-Vb )Y~ % ~~ .2/1<l L,v~ / {:fJ II <I / A./ r. .. / t!hI6'~ ~AU~~Y *"~ ~ ~~/-~ / CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS , <: < ~ / ~ ~k/1ey 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 ~~RHOOKUP ~~.':~.BING FINAL '0 MECH FINAL DATE TIllE .?~~b 0:/ '" " 'V 6 ..---rr2. o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o / ~ n-~/J , - ~ , ~/' /' ,/? ~ /' / .,.-;r / C 7u'C/C ~ ffi,.#" ~~. //h~ / -4.. -' ~L- o WORK SATISFACTORY, PROCEED ~RECT ACTION AND PROCEED o CORRECT WORK, CALL FO REINSPECTION BEFORE COVERING Inspector: . Owner/Contr: l ~ CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY/ lNSNOTl CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS J331 OWNER PHONE NO. [J FOOTING [J FOUNDATION [J FRAMING [J INSULATION ~AL [J SITE INSPECTION CQMMEN1~: ~ n ec!Y, Cf;t / DATE P/5A s;Lh;rer (')~ SCHEDULED CONTR. PERMIT NO. [J PLUMBING RI [J MECH RI [J WATER HOOKUP [J SEWER HOOKUP [:] ~~MBING FINAL ~ECH FINAL A I Hh~ I - I ~ I ~ .17;,.,/ ' 'leJeV ~,(r- Pr './#.,~ k~~ /,F; ~ / Ore " TIME ''", " " ...", 6 ---sY2 [J EXIGRADIFILLING [J COMPLAINT [J FIREPLACE RI ~REPLACE FINAL [J GASLINE AIR TST [J ./ / ~ /'/1;(, I v -? C;;o~:ne, ~ ~/ r~4 /--::/' ~/ ~ "- (' _/cQSe /7 /<0 ~ -- ~ORK SATISFACTORY, PROCEED /;;' ~ORRECT ACTION AND PROCEED [J CORRECT W~~,;~~OR 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