HomeMy WebLinkAboutBuilding Permit #00-0025
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
JAN t 8 2000
Permit No.
00.0025
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
34C},o ( J ;"'OV /J(J ~/) (kL : v-<'"
1. DATE
/... /~-r;p
pun
BUILDING INFORMATION
11. SIZE OF STRUCTURE
.!~) / ~~
12. NO. OF ;TORIES
13. TYPE OF CONSTRUCTION
Sl.~i 1.::-:1<. 1.....-_
14. FLOOR AREA APPORTlcffiMENT USE
(Depth) ~
<"'~
3. LEGAL DESCRIPTION
.L9
Lu~'lcJ>
LOT
BLOCK
J/2r/
PID.Z5r~- O~
ADDITION
4. OWNER
(Name)
(Address)
(Tel. No.)
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
AAddress) f.
/jfJf41 Ve,t.-( d- n....
fYle (j,'kVld C:f!!J--oi-, 1!.,.O( Il.{S0.s1'lt) (.,Ij..-Lr:J9r?wl
7. TYPE OF WORK Fireplace~ Septic 0 Deck ~ Re-roofing 0 Porch 0
New constructionJel Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basemen~ 16. P&JECT COSTNALUE
Chimney 0 Misc. . ~ t ? Lf 9
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. C . MPL~ON DATE
Sq. Ft. !J f!){) Lf ~ Width I '-!S-- Depth I'J:'" Yes @ 5"= (!) ()
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner ~thOrized 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 plan~. ware that the
'";.;~" "'9l" '''''I''~;'''' i'" ~~. '"rtho~~,' h.reby "'00 "'" "" city ""0" '" _. m,y MO' _ '" pro"", to _~ """" '" .~.
X {'........fi-- e;b0 ;l.j 1 (/) {... /8-
Signature License No. Date
. FOR ADMINISTRATIVE USE
(Name)
'(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
6. BUILDER
OCCUPANTS
SEATS
./
/'
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
2,,'5'1/c?cn . OJ PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
bFO
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $ I ~ loe:l. 2~~
Plan Check Fee ............................. $-1-. oCJ"'?...._1./.:
I?:? .~
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $ SSO .O~
SAC ......................................... $ /,.1 t')(') -01'"'1
Collective Street Fee ....................... $
Sewer Tap ................................... $
State Surcharge............................. $'.
~~b
.. $
Pressure Reducer .......1................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
10. CJ~
Penalty ....................................... $
Plumbing Permit Fee ..Q.Q:..Z~. $ 100 . 00
Mechanical Permit Fee P.9.:..zfi.. $ U:w _ ~7\
Sewer & Water Permit ..00:..26.. go _<~.st:>
Gas Fireplace Permn ..QQ.:.."'h5:.. S'. 40 . (Y)
This 'J'f!j)i9'frfisecom~~ur Building Permit When Approved.
BY~~' Date I':;J,G,-~OOO
Certificate of Occupancy
;;t 6:0 . eta
I. ::J... CJ C) . I'fO......
, ')tJO . ~/'L
I, S~() . t!rtl
Total Due .............................. $
Paid a, C7J. "7 I Receipt )fCl.
Issued ..'
Date 5./ t5V By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zorling ~inance and may proceed requested. This document when
s~ Planner constitutes a temporary ce1fi~2:.~~Plian~low~nst~n 0 cr~cupancy, a Ce~cate of Occupancy must be ~SSUed.
- City Planner Date - ~ - specialcon~ ~
24 hour notice for all inspections 447-4230
~ PJE:lJ. '7 J
} - ,
.:$07~7
~
Job Address J (,l(J C400J {}(LLf<
Heating Contractor Controlled Air
,.
Name of Tester
Date
Percent O2
Percent C02
Percent CO
Stack Temp.
Pti
'-:/- /I-Cn
7
o
~
3s:o o~
\
~
00 -(;()2-b
Tht Cfnltr or Ihr t.kt Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
J16DOAlI1 LD CONs I R
/ / /8/ ZOO[)
f I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3420
vV OOD DUGK Df2...
Accepted
Accepted With Corrections
1--
Denied ')
Reviewed BY(,.dJ@'"j- 0
Comments:
Date:
(- 2G:, - 2CJOcf
J. ((J cJL at-{ c..c~ U~~ols...
"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."
,.,. ,( /' '~-""l: !
f I -' i. / -
1.., \'" ',G--
n. C.nl<r of lh. Lok. Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/ 'L/( I-I L-Jj: (I (i v i f-----
J! _
/ / I';: /),,;/ (/, /\ /)
/- I '--.' L. '--,j
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-;; /-',
<'--- . -,/
" '..
\ 'lI "
\,' ""
L..
( :: ; ('!:::'" L' \ J..,)
.J_-" \,./ '...~, ,--............. "I ,'-_.. ..
Accepted
~
Accepted With Corrections
Denied
Reviewed By: ~~~
Comments:
~y ~~ ~~ <V~ W~&.~
fJv~'\ 'I Gw.... +- <::JTMrV A...C).u/ io
Date: I - 2-K'-ex:!:)
~~~-
r Jy.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."
OQ-002-b
Tht Ctnltr of Iht l.kt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/16DOAfI1 LD CONSlf2-.
. J / /8/ ZOOt)
I I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3420
WOOD DL)GK Df2...
Accepted
Accepted With Corrections
"'F-
Denied /)
Reviewed By~$"I-0
Comments:
Date:
1- 2G, - 2(!J{Jd-
I. ~Q. c:Jt a.H c<.c::~ U~~~
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."
CITY OF PRIOR LAKE t ~~L ~:licant
. PLUMBING PERMIT_ PPNo 00-002b
ApPlicand~,ve :S-&i' PI"", J,; n" JhC Phone: 6q- 'IsJ- ~ /<f()
Address: 1aq~ ~wpl ~,_SrJ.V;C:;;;;aje Gt"O~'P / Mn .,s-ro;c,
Signature: Af~ -rfZ.- .JJ~. I
Legal Description: Lot ~q BloCk_Q).II ~ubJlj, kif 31ld .Add;1ibh
Site Address: .3 '-I ryf) IJ/tM~;:;K IJr, Ve Pl/O
Building Permit # 00 -()~ PID# 2.5- 337- OZq- 0
I
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
$
$
$
$
GRAND TOTAL $ Pd 1Jt/ h"', /Jihj ff:rllJJ-
/. .... '0 W\1"\-\_, "\'1"
(~\}\rO\NG pS'\".',;. \
Tht Ctnttr of Iht Lakt Country
Quantity Type of Fixture Quantity
,--3 Bath Tub with or without shower
I Dishwasher ~
a Floor Drain
S Lavatory (bathroom sink) I
I Laundry Tray (1 or 2 compartment sink)
/ Shower Stall
1/ Sinks
Bar Sink
LJ 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
$99.50
$39.50
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
,>
.50
This permit is granted upon the express condition that said
contractor. shall comply in all respects with the ordinances
of the State Plumbing C and the amitints thereof.
R I ..3 t.3 00 DATE
, ,
.13m
ATIEST
Call for all i pections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372 / Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
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c:;)
C!l
CITY OF PRIOR LAKE Me
18200 Eegle CreekAv. I.E, Petml, No. 00 -0026
P,lor Lake, MN 5&372
UJ
~
(j\
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z
'HEAlING APPUCATJON I PERMJT
Da,.;? - _ '( _ tV+\ PID' 2-5- :337 - 0 L CJ ,.. 0
SIl. Addrell r) l/ ~ t.. ~Q 1:), ,,,..1/
to1 Z q Block I Addillon. W f t.,06 31€.O
OwntfINam.. ~n;() r ~h
Add,... . A b J e (//I/k (4-
HeatlngOon',1ICIol -, GdJ"lr\/k R) t1: I"
AddtellrO/~/(,) &>AAJ A, \ P. r ffi1;;". ~I\.'J.
TII.phone' ( G 51 ) ...y'"" - (:;r'\~.Q 0
...... ./
FurnaCl Mike" Model ~,""D. <=:A tClas1'YPE OF SYSTEM /
. I~.--/ Warm Air Planls f
ModeJ S~e 01".:), QO:) GIIVI1y
Mechanlall
Air C>>ndllionlna ~.
Vent S~8m '-"""
HEAnNO OR POWER PLANT
Stlam
Hol W.t"
Aadiation
Spedal Dlvices
III
~
N
~
['-
~
~
N
..-t
I.J)
t
U
I
0:
o
Z
0:
(!l
Z
-
....
0:
UJ
I
a:
-
0:
o
UJ
...J
...J
a
a:
....
z
a
u
Conn. Load
Fuel.A!A .;-
AUI Size
~ /1
Suppl, Op.nings
:/c,
7
ntlUln Openlngs
InpuV~iW'
Edr.
OUIpv1, /C"ta ~r\r'\
I
Othet Device.
elm.
nPE OF WORK
v/.
N
..-t
Me,ationl
. RlplKlfllent, New Conslruclicm
(j\
c:;)
&\. Comp. Dill
c:;)
c:;)
"-
lD
c:;)
"-
1"1
c:;)
Repalr
Ell Cast .
HEATING PERMIT FEE S
r PAlO W\i\-\
t aU\LO\NG PEF.:.).\T
Reel" . .
Buldlng Plwi. .
CJO -00z..5
STATE SURCHARGE $
TOTAl PERMIT FEES .
.50
'I.... . ...
1.. . ......
51ngll Fmnlly
Commerdal
TYPE OF STRUCTURE
c/ Two-Family MulU.~,
Industrial Pubic __
Fee Schedule
Indus'rill, Cammen:l81 & MlIIll.F8mll, 1% 0' Job coat (1318 .. - J
RealdeRtlal, Hlallng & AC '98.&0
Residential. He.lI", Only '64.50
Relkl~la~ Gal FlleptlCI '39.60 . WI 8 DIl
Relkftnlla~ Addlllonl & Attera'lonI S39,fiO
~~~ntJ, AC Onl, 139.50
~m8mblT 10 add Ih. Sla'e SUICharge an the bottom of Ihl. .,pIiCllllla
Ttle price of JOUr h.ltlnt Pflmlllncludes one raugh-M and one fln" ....w1lr
AddUionallnspecllons wI be titled III 136.00 each.
Hous. Healing Tlst Record mUlt be submtUed with JmlIdfDg amDIl............~
Ing C8,liliCll, 01 ClCCUpancy wll be i88U1d.
HEAT CAlGUl ATlONS IRFn' IlqFn wllh number at tllppl, and 'elum"..4_A__1iIIed per
room with CFM's per opening. New .Iruclurea or Idcflllons lend n-,..,.....,
end retllm Iocalonsllhown. HEAT LOSS CALCULATIONS. PAYMENJIlm
A'PUCATlONS MAY BE MAltED 10 THE CITY OF PRIOR LAkE. ,.. EIRE
CReeK AVE. S.E.. PRIOR LAKE, MN 55372-
Cfty Hall bustness houl' Ir. . l.m. . 4:30 p.m.
ALL WORK MUST IE INSPECTED (ROUGH-IN AND fiNAL) - CAI1.CIIT~
447-41aO
'hereb, Ippl, for a meahanic.' .y.tema permit and I ack",~ ......lIhe
Inlormallon lIbov. I, cDmple'e and accurate: lhlt tha wInk wll"lI-.. - ...ce
. with 'hi o,din_neB' and cod.. o' 'hi elly end wHh Ihe .'.lll --."t - .".eal
. codes; 'hi' Ihls form doe. no' become 8 permU unUl 81gne. ".. .-DING
OFFICIAL: Ihll 'he work wHI be In accoldlneB wilt the .p"........... ,thl
. CISI ~~ work wt~h requite. revlew;:;tpproVII of pi....
>fpn-),~.J J $-~CC'\
75/8/crtJ
...
GREEN - FILE
YELLOW - APPLICANT
GOlD - CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.w. No. ~O -ODz5
NOTE:
Sewer and Water
contractors must
be registered
with the city.
ADDRESS:
::r6~ exLJAv;
~ . Y I &Mr~vt k1w
PHONE:
T]J6 7LfS~
2/11/00
APPLICANT:
DATE:
SITE ADDRESS:
DUC-K
BLDG. PERMIT # OO-Q02!S
PID# .?~- 337 - OLq-O
./
FILL IN THE BLANKS
1. Estimated length of water service
3D
feet.
2. Size of water service}
3.
Location of any couplings
Type of sewer pipe. ABS
Estimated length of sewer
inch(es) .
from structure ~
PVC ~ Cast Iron
line .7{) feet.
feet.
4 .
5.
6. Clean out (if required), located at
structure.
feet
from
::::~::::::::~~::::~::::::~::::~:::::~:~~~;f~~~~~~~~~=
~~=~=~~~~~~~~~~~~~=~~~~~~~=~~~~~~~~~~~~=~==~=~~~~~~~~~~~~~~~~~~
FEES: $ 35.00 Sewer and water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
* Fee for either sewer or water individually is $J?~ 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
RECEIPT #
REC'D BY
Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
PRlOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3 'i ~O tJ()~ t)uc.'... ~.
NATURE OF WORK _~e.\A.\ ~e!,~_
USE OF BUILDING ~FD
PERMIT NO. 00 -O~ DATE ISSUED J - ~l.- :ZOOO
CONTRACTOR 11~ t)1M~.w_ ~A
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUME "T ,
I FOOTING I 'NsPEcTOR1\ I 'V\ '" ~TE
I FOUNDATION (Prior to Backfill) ',~~ f.;P 4.l'/.. :} ( ;b "l"lb ~ 'w.r- A
PLACE NO CONCRETE UNTILLABOVE H.AS ~EEN s(GNED
ROUGH -~S
SEWER I WATER I SEPTIC . Vf{ ) / 2/1~\ 'din I \
FRAMING f\ I (\) w v s 110
INSULATION ' '(~. I k '-Il:r 1rJ() I J
ELECTRICAL /\ V . VI /I
PLUMBING ~ 3f17/tP {P blr/ro
HEATING (if required) ') 3/'dtJ/ /l) v ,/
FIREPLACE' l
GAS LINE AIR TEST ~ 3 ft;/oU
COVER NO WORK UNTIL ~OVE ~AS BEEN SIGNED
I I
FINALS
~fl
"
\Y)
---..-------
,. -=-~_.-.. --
-.. _ . - -,. .. .. - . ....
GRADING (Prior to Soddi,ng)
BUILDING 'fUJ -rv i/;/((D
ELECTRICAL
PLUMBING
HEATING
~.I"'%-{)z,-,
..
......
/m.
1.,1/ / tJD
BEEN 'SIGNED
DO NOT OCCUpy UNTIL ABOVE
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
if:.t;;;,..:',.'
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L
I
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DATE TIME
CITY OF PRIOR LAKE Cf:hQ
INSPECTION NOTICE SCHEDULED <: -/ -00
ADDRESS 3 L/ 20 t))ood ~
OWNER CONTR.
PHONE NO. PERMIT NO. O~Z.5
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 ...fLUMBING FINAL
~ MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
COMMENTS:({J ~~ J.dhA./
1'J_ .. '(/ r---
(.5) ~ UVk---c~.
- V
~) :;-tA..c.. <L:?~__n .d:(~ - ~, (3')
(l!) Jd- 'A. ~ ~ · ~
f\
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WRv.- ~ ~ ~ ~o*-
t~. ~t '"(~~ ~ ~Uvz. ~,
~~
o WORK SATISFACTORY, PROCEED
,.)l( CORRECT ACTION AND PROCEED
::~CT~~L FOR REINS:::,:::EFORE COVEmNG
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 7-8't7Z.-
ADDRESS 3~ W~ /)Vc,/<.
OWNER CONTR.
PHONE NO.
PERMIT NO.
60 -(!)Z~
o FOOTING
o FOUNDA nON
o FRAMING
_ 0 ~NSULA TION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~p..ij__ru IY~ING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Cvr6 &~ ,. c;/:-
S+,
;S:::WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect ~ ',.:::---....... Owner/Contr:
Of""/~~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
ADDRESS
34 ';Lo
_ )~AT_.
SCHEDULED ~Z
tiJ~ 1)Ll~ 1Jr.
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o )NSULA TION
, FINAL
o SITE INSPECTION
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 GAS LINE AIR TST
o
COMMENTS:
/.~e +~\e
, ~SU ~ ~./I()..
pORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK~ ~ALL FOR REINSPECTION BEFOR.E COVERING
Inspector: ~.. \j (J.,Aj.(J Owner/Contr:
\
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
SCHEDULED 2J~~~
~ -rL.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 3'420 Wocrl
OWNER
CONTR.
PERMIT NO. /J ()- 2S
PHONE NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION ~MECH RI
o FRAMING ATER HOOKUP
o INSULATION EWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
TIME
Ie : !(:)
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENt
~&c,.1 4:J (Jv'C. 1
\~ 11 \C- ~ - f'Jo
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..
(r1 (~_ alA.-
'S ~ OK-
'~~t- ~ ~
L<-c...k>
,
/a;t(.
,
-h (jv~dJL
~
~w SA FACTORY, PROCEED
ORRECT A ON AND PROCEED
o CORRECT WOR L FU~EINSPECTION BEFORE COVERING
Inspector: / Owner/Contr:
CALL ~7-9850 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE
INSNOTl