HomeMy WebLinkAboutBuilding Permit 99-0424
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This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances afthe
City of Prior Lake regulating building construction or use. For the following:
Use Classification SINGLE FAMILY Bldg. Permit No 99-424
Occupancy Type R3 Type Construction VN Fire Zone N/A Zoning District Rl
Legal Description 1,11 R'\ l{NOR HTU, ?Nn AnmoJ
Owner of Building 'iiteAddress 4636 HUMMINGBIRD TRAIL
Contractor'sName&Addres~ HOMES BY CHASE 1668 E. CLIFF RD, BNSVL MN 55364
Date:
/ROBERT D. HUTCHINS
I I
. JjJUilding Official
fA' j/-.-" ~)./4.o0
City Planner
Date:
JENNI TOVAR
Job Address SIb 3b tID .., lJAi ~ . h5 J
Heating Contractor 0!>V11-V' l/~U~~
Name of Tester f(t;
Date
Percent OR
Percent C02
Percent CO
Stack Temp.
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~
~o~
r>~
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED.8-l i-~
ADDRESS q~3(P +f-o~.~~'C
OWNER C~TR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
1/ ~
ar-
PERMIT NO.
C, 7 - 4.~<{
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 GASLINE AIR TST
o
-
In I '\-- () -
UbJL 1rcAfu _ .tilt ~
Y, PROCEED
DfROCEED
K, ALL FOR REINSPECTION BEFORE COVERING
I spectDI: Owner/Contr:
c!Lted~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"-I:O~IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
~~~
INSPECTION NOTICE
DATE TIME
SCHEDULED
9k~/97 3 :30
ADDRESS
4c,,3rc /7t1/"1H / NGt3/~.D
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-Qz.tj
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING I III 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION f'J" 0 SEWER HOOKUP 0 FIREPLACE FINAL
;e(FINAL "Bt....D~, A 0 PLUMBING FINAL 0 GASLINE AIR TST
o SITE INSPECTldN )<MECH FINAL 0
COMMENTS: P~1'P D~n... ~ ~ ~
[i;( 6)'\(& F~. ~"hUY"",,",c. ~
~ ~('} c;"."d has ~ '-.) ~ r~
(j~ ~~ -.;2
~ ~~h-~ c1lr:S
~ 0 k, ~~~<9 r,w:~
.~
.- I
'\ ~ C#'Q f '10
~ +11--<.0 ~ L.cvl5, 'iq
-------------
DWORK~TI AC~~
k+-
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10 -I$"""- Cjq
CALL .~7-985 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
QUIR 'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
"~o/t;9 '9: ~
~~3~ //O/l-1H/ t/C3;/5/,e.o
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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
tf) 0 SEWER HOOKUP
~ PLUMBING FINAL
o MECH FINAL
DATE TIME
q9- lIzif
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:@ ~ ~ ~,.. ~
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r131 ~~ r~h ~ ~/~ol.cn.
ro ~ ~~P:t:-~.
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(f) ~ t 14, ~-'r'
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o ~K SATISFACTORY, PROCEED
a"CORRECT ACTION AND PROCEED
o CORRECT W~K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~. Owner/CDntr:
- }
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
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tku"lJ'l"hK /; />-1
t/
CONTR.
OWNER
PHONE NO.
PERMIT NO.
tf'f- 'ki./
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
A:ECHANICAL
~ATERHOOKUP
SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHORENVETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
/
COMMENTS: tj tJ :..{...~ L/ 0
4o( 1'/ . . I~~
~~,~-
~fAyV ('30 ~
I Jl)~ u..J' cf?? / !
~ ~ tHL r-J~
__I
/
III WORK SATISFACTORY, PROCEED
o CORRECTijCTION D PROCEED
o CORRECT W C A L FOR REINSPECTION BEFORE COVERING
InspectDr:, Owner/CDntr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE
-,?};~
l-!uJ11I1f,i1ah,/'/ /r~~/
\.../ .
CONTR. ~ by L%,.S'e..-
r?- 9q7~
1.;11 , OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 4".63,6
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION
FINAL
o rE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(!LL"~~bY /5' AI::--
......
TIME
I
XF=X1GRAD/FILLING
/0 tOMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
""
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~y, CAL; ~EINSPECTION BEFO:E COVERING
Inspector:)<F~ ~r/~ontr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IN8NOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
QATE R~
81a 81}
JIRECTIONS
'SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Prinl or Type and sign at bottom)
Permit No.
:rUt; /qCj
f{1-
1. While
2, Pink
3, Yellow
File
Cily
Applicanl
QQ-4z4-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(H'~ Z'
,
12. NO. OF STORIES
')
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LOT
PID 2!5-"3"3t:f -035- 0
2. SITE ADDRESS
/:#; ~/., ;/~ n1 ;' n e;.J0K cL- 7:::' _/
3, LEGAL'DESCRIPTION . /
'/ :? BLOCK"--
I~.~ /-IdL ~~,rI_________
4. OWNER ... ((~Na ." J /., ~ddresS).i./ ~~.
-4!f/"~ r /::JW ~~~ 077 '/f7.~~?
5. ARCHITECT -,r (Nam/~~tf - 7' ~~ff ~ (Tel. No.)
6. BUILDER (Name) . ;' /(Add.reSS) (Tel, No.) 15, NUMBER OF OCCUPANTS OR SEATS
#~~///~ /?/~ ~~~~~CCUPANTS
Fireplace CJ Septic CJ Deck CJ Re-roofing CJ Porch CJ SEATS
Alterations CJ Addition CJ Finish Attic CJ Re-siding CJ Finish Basement CJ
ADDITION
7. TYPE OF WORK
New Construction CJ
13, TYPE O~CTION
14. FLOOR AREA APPORTIONMENT USE
16JP I~J):CT COSTNALUE
Chimney CJ Misc.. 7' 2-t. t,tJ (;)
8, PROPERTY AREA OR ACRES 9. PROPE~ DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq.Ft. Widt0//~ Yes No ^ ?,l> J:?8.y f
I hereby certify that I have furnished informatfOn on lf1is application Whl;h"Lto the best of my knowledge true and correct. I also certify that I am theowner or authorized agent for
the above men' e roperty and that all constructio will conform to ::iI~~istlng state and local laws and will proceed in accordance with submitted plans. I am aware that the
voke t~0or' us urthermore, I hereby agree that the city official or a deSig7neem~7t ~ the property to perfo~neJded inspections.
X ~~/' 07 V~~9
VI - '" > Signa ure / License No, ' Dale '
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
.~P~
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ
SURVEY CJ
PERMIT VALUATION
Il(~ ,~ClO ~ C90'
CJ
TYPE OF CONSTRUCTION: I II III IV C>
Occupancy Group A B E F HIM <R' S U
. Division 1 2 <a> 4 c;;-
Permit Fee ................................... $ I o4l. 2
113.';).')...
"') IlC)'U
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
1\ ,o~
~~
11>0.00
/6 (') . CJe>
35"" t s-6
Gas Fireplace Permit ....................... $ q 0 t .Cf:)
This A~~m~ur Building Permit ~~pJQ,V~.
By ~/'l-.. Date ~--- 5-':/
Certificate of Occupancy
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
PLOT PLAN
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
5k, " $
Pressure Reducer .......................... $
Meter Horn ....~.z T(....................... $
Water Meter.. . Ie. .......................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
SETS
COPIES
~s-o . (')6'
In c:;o .0(")
q 50 lJQ
I 2 tJ;'c;o
I. jol')~CJd
'1t2(') . CJtr
Water Tap ................................... $
Builder's Deposit ............................ $ /. C;; 0 (') . ct2.
t
Other ......................................... $ -
Total Due .............................. $.:JJ(J 2(0 {("(.L
Paid 7(,u'&'r1 Receipt No. ~11Z-
Issued
Date ~/;3Iqq 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 proceecVa:'~equested. This document when
signed ~\7\~st~rary Certifica~ of Zon~mPliance and allows construction to commence, Before occupancy, a Certificate of Occupancy must be issued.
City Planner ~ Special Conditions ~ any
24 hour notice for all inspections 447-9850
CITY OF PRIOR LAKE i ~~L ~~licanl
t..UMB1NG PERMIT # qq- L/-Zt/.
Applicant: 0//17?/r~/1-_ Phone: ..-l/qz-C/C I .
Address: ;/'d1M r/'/t'. r--/~ /77':/7 ,~~
Signature: ~~ ~/7L:d .,
Legal Description: Lo~ /3 Block 5 Sub ;:NO~ I-//{.. {.... 2 NO
Site Address: ~~~ U./.h??7/7'J?./ /Y7/Y~/ h iI2.. /
Building Permit # qt::; - 42 4-".J PID # 2'S- 33q- ~35-CJ
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Th. C.nl., of lh. L.k. Counlry
Quantity
c::
/
I
:3
/
/
/
/I
~
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
3
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
/
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
~\'\\'\ ~~ )
~~\O G ~~~
ro\j\\,"'~
$
$
$ .50
$99.50
$39.50
GRAND TOTAL $
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
R~~~}/r //,/q1 DATE
~", AITEST
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
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CITY OF PRIOR LAKE Me
16200 Eag.e Creek Av. S.E. Pel mil No.
Pdor Lake. MN 65312
~ fA 1-0 I
QQ_6jz3e-1 L
:rYPE OF STRUCTURE
l. 0- . O!J
J. YeU", . u..-
'HEAn~ APPUCATION I PERMIT
Oa'.~l q 0(9/ PIO. 25-33f:j- 035-0
ij,'" IJ"
SIl, Mdte" , ~ tlo rt U MfV1I1Jbf> I ~..r\ { ~ 9-- f2- I
lo1 / B Block .5 Adelll\an ;:.tJ 0 B HI L-l- 2. ND
OWIII"tNeml ~J1faJ.-' (e--~ '
Addr.. , *t3 C, f- u m'(VJ 1"'6 B hfJ) '-4JJ rJ.
H&lllng Conllac\or ,~~ ol'v
dJ )..,0 't;,Jo ~ fl, UL-
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Add.e8!
Teltphone' ,
FUIRIClI Make & Model -r-~
Model Size, -rUD {fX)(!,q~G,
Conn. loBi 73 53(, ~ J
F\oIl ~ll 0'1'
Supply Openings
Return Openings 7
Input /~ tPJ Oulpul io ()I 0
Edr.
elm.
S\ng18 Famlly
Commerclll
x
Two-family ,
Indullrial .
fee Sc.hedull
I nduatrlal. Commercia' 8. Mut\1-Famlly
ResidenlIal. Hltaling , AC
ResldenUal, Healing Only
Residential. ~s Fireplace
ResidBnUal. AdditiOn!! & AIIef8dons
ResIdential. AC Only
Public
MulU-Famlly
Oltter
~ cos, ($39.50 mWnuI
~
164.60
$39.&0
$39.60
$39..50
Remember to aud lhe State Surchal'9' on the boUom of thIs application.
TYPE OF SYSTE",- ~
Warm Air Plants, ^
G.avlty ,
Mochanical
Air Condi~ioniog ,
Vent. SYll\Om ,
The prlclt 01 your heaUng pennlllrtcludBS on8 rough-in and olle finallnspecllon..
Additional inspectionS will be billed at $35.00 each.
House Heeling T851 Record musl be submlned wnh bYikIiIm IlIDlUt mAJDbllbllaI8.....
lng certiflca'. of cCC.\Ipancy wnl b. issued.
HEAT CALCULATIONS q,f.n1I'~FI). wilh number of supply and feturn opedn\JS....pBf
room with CfM's pel opening. New BlruchITe!l or additions send t100r planwtlh......
and relum 'oeallons shown, HEAT LOSS CALCUlATIONS, PAVMENT ANI)
APPLICATIONS MAY BE MAILED TO THE em OF PRIOR LAKE 16200Eff."l J:
CRE!K.AY.E..s.E.P.RIOR LAKE. MN 55312..
Cily Hall business hours ,~ I. a~. - "':.30 g m.
.-- -- --- - - ~
(\ ALL WORK MUST BE lNSPECTEO (ROUOH-IN AND FlNAL) . CALL CITY HAlL
~ ~~D\,\. 441...230
(l~~ \ hereby apply for B mechanica' sy&leme permn and lacknowledpt that"
\. ~'\ r 'nforma1ion above I! complete and accur.'e; 'hat Ihe work wl1l be huonh-.
, \' wllh Ihe ordInances Ind cod.. of 'he city and wllh the slale bulldl..m-",t . ,
codes; thal 'his lorm doe. not become a permit until signed by ,he B~
OFFIC'AL; thaI the wOlk w\11 be In accordance wlth the approved plan ...-
case of al~ofk which requIres ,evlew and approval or plane-
enA LeJ;n.. 0 . V\tf{ha-.. Q.j J I ~r
( // Aml4~ s~ ' 171, /Dat8;
7/Z7/99
~
HEAllNG OR POWER PLAHT
Sleam
Hol Watof
Aldiation .
SpecialOevice,.
Olher Devicell
TVPEOFWORK
1'1
is)
CD
is)
All8rations
R.p1loC11menl
Esl Comp_ Oil' ,
Repair
New Construction
_ BIIUdlng P&rm~' .
99-4z~
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Est. Col\ $ .
HEATING PERMIT FEE $
STATE SURCHARGE .
TOTAL PERMIT FEES $,
.50
'PAID WITH
BUILDING PERMIT
R8C8~. ,
Buiking omear. Signature
/,r:; (J. I I j /
/ . / " (~f ,. ..,. --r
! . v'"
Thr Crnlr' of Ihr Llkr Counlry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHI;CKLlSI
NAME OF APPLICANT
I-J ( ((/ ~. S t::: V
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APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
c<. i.':' I I I' , ,r: I.. I I . I-I,' T) .
" _." ( ! 'I! C') ...~ I 1<... \---' f-- '
Accepted
V"
Accepted With Corrections
Denied
~ ~AP~
Date:
L{ -t-~..~t1
Reviewed By:
Comments:
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. II
GREEN - fILE
YELLOW . APPLICANT
GOLD - CITY
CITY OF PRIOR LAKE NO. qq- 4vf
SEWER AND WATER PERMIT
APPLICANT: Mi!,//lj &///n/L/rA.' V>
ADDRESS:;[!;;() //1 /4 /7 / f~
/1.- -
SIGNATURE: ( A :"z,LJ /';/;7/'A? A?/::::J
SITE ADDRESS: ~~ % Jt//??//7JV~~
F-ILL IN ~ BLAN~S
1. Estimated length of water service
2. Size of water service I
inch(es) .
3. Location of any couplings from structure
NOTE: Sewer and Water
contractors must
be registered
with the City.
PHONE: /g:::-~21
. .
DATE: ....5' ~;L 5?9'
BLDG. PERMIT #qq-'-I-Zt./..
PID#25-,339- O..3b-O
,?/() feet.
PVC ~ Cast Iron
feet.
4. Type of sewer pipe. ABS
5.
6.
Estimated length of sewer line
Clean out (if required), located
structure.
at
feet.
//()
feet
from
==================================================================
This
DATE:
your permit when approved.
&, // /qc;
BY
==================================================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. ~
DATE PAID AMOUNT PAID ~~\O~?~~~~
, ~~""
RECEIPT # REC'D BY ~u\\,Q
,
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
Cjc; ~t/-2-1
Th~ Crntrr of Ihr Lakf Country
White . Building
Canary - Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI!i{
NAME OF APPLICANT
tdoM65 BV cHASE:
,
+/zCo/qq
I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
4-(03fo Hu Mtvll "'GJ BU<O T12-.
Accepted With Corrections -<
Denied /}
Reviewed By{~k-...
Comments:
,. S0d2 .J- 7;()#D ~ JJouk~ ~ F~
'2 ~ f-{ a.l v,-.J~__~ LA ~)-l9~,' d\---. ~ - ,f'-e.((
~ ~ rkJ ~ a-ffo~ ~_~
Date: s:- 3-77
"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."
C;CJ - I,/zil
Thr Cf'ft'f'r of .hf' ukI' Cou..e".
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
, .
1-1 C I\/[ ES i3 V C,.HA St:.-
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4-/ZCc/qq
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4-(0 3fuHLJ {'--ltvll Ny 51 1<.0 I K .
Accepted
./
Accepted With Corrections
Denied
Reviewed By: )J,h. Te~ ~"\"'AI'II\l
Date:
I I
5110/'1"1
I .
Comments: CtJNoFF f'Y1<<JST EE. C.o.uvE'r'CD 10 !lIYO AL.QoI.J6 /)J1AINAt.E. ~
QrIt..IT'r' E4sEr4iEAlT3 A.,.<". """t.J-I A' p/?,qC.Ttt'.AL _
:sEE
INf"ORMA'T'I.1\J o,.J
R~v€l\.sf; SJ Of: .
~""t:.f. AnAcHMEtJTS: I. FINA'- ('~AOe: INSPEcTIoN 1/Ilf'oltil'1Ar,OrJ Z. (kAO'N{, A..A^-l
3. t(\O~IO'" f'.oNTA..1Jl.- (ll\fA<\JltE'''
'-1. EltoSrolV CO-VTIlOL R AtJ
"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."
1CJ - L/Z4
Th. C.nl.. o'lh. Lok. Counlry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
f
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The Building, Engineekh~~<and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: .
4-(0 3 ~ H LJ t~J f'-" / N Gt,~1-'K{ff-1 K .
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NAME OF APPLICANT
APPLICATION RECEIVED
Accepted
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;I~.~cePted With Corrections
Denied
Reviewed By: WI4L. TE~ EI4IlE:~"'AI'IN
Date: s/tom
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Comments: ?ulVoFt:"
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"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."
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PR,IOR LAKE
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INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 4~fL3( n I-f{jM'MI~ toN--r>J ~,
NATURE OF WORK n0.U d.ans+r--lJ~~ I 0'""'--
USE OF BUILDING 3 FD
PERMIT NO. 91- (fL4
CONTRACTOR I!tJwJffi h'j Q~A~L
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW .
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I INSPECTORe ~ ~ I '5 k ii:r;
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, FOUNDATION (Prior to Backfill) C/JJ (,/~/-< <i ' I I I
PLACE NO CONCRETE UN"M'L ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC~ fr1 ~
FRAMING
INSULATION ~~~ ~.
\
ELECTRICAL
PLUMBING 0./r/~
HEATING (if required~ ~~, {/ ~.. l ~, j 7~ ~D ..179
FIREPLACE" k'J f /s:hcr I
GAS LINE AIR TEST ~\~ fl.~ t~r- ~. ?--'3o~'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 ~~1I-4BP I
FINALS
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DATE ISSUED 5'-3--Czc;
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GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING rn)
HEATING
DO NOT
frt,
((r)
OCCUPY UNTIL ABOVE ~AS
NOTICE
9 -/ () - 99
tf. lS ~
BEE~ 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 shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850