HomeMy WebLinkAboutBuilding Permit 00-0559
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g~~~ PRI~ DATE RECEIVED CITY OF PRIOR LAKE
fj ,\~.~ LL.:O.lL.AL BUILDING PERMIT,
I~EMPORARY CERTIFICATE OF
\ ~ ~ ) 3&,<r-7 b I 3 ZONING COMPLIANCE
~ :/ AND UTILITY CONNECTION PERMIT
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\JUn.. .! ~ : y enq~
File
City
Applicant
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PermlfNo. .00, {) 55'1
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN I J r :.:I
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) '" - v - V\ 00 0 BUILDING INFORMATION
2. SITE ADDRESS 11. SIZE OF STRUCTURE
~~ ~~, WOO l) IJ lL'- t\ L Ii n e.. tt~) (;C'l
:~~GAL :;rRIPTlON BLOCK I p'o ~S- _ ::. '37- MOl -() 12. NO. OF STORIES ~
...... L '." ^ t I, " D .." A ~ .... 13. TYPE OF CONSTRUCTION
ADDITION ----I-D f!- ~, L IJ. .s _lJ - ~ - C!.Ll.IJ ) · I/)"'" 511 e k F t. H'tYI e
4. OWNER (Name) /AddreSS) p (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
W t.. n ,~Ih It n 11 H OMt:~ 8<16- /..R ZR 0 r. f-ItJnn &'SI-If()'..I.1..,() ~'-:75' ~ (/ ~
5. A~HITECT (Name) 1Address) (Tel. No.)
---r e...lJ) A L< t ~ D')I1 1 t'l5'" 11 LA 'Z A . () t. l A-e, II h "5'/-'10' -1I'-1D 0
6. BUILDER (Name) (Address) (Tel. No.)
We116tr1R")1 J'O'1'1e~ '''0''15- PlllzA- ()~ f,Pj 11 h t,.>I-IID/'-""DD
(Q!lpth)
,6)(, I
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS .".., () /J e L
7. TYPE OF WORK Fireplace;' Septic LJ Deck LJ Re-roofing LJ Porch.
New Construction a Alterations a Addition a Finish Attic a Re-siding a Finish Basement a 16. PROJECT COSTNALUE
Chimney a Misc. ;l.!:ft) I 0 CJ()
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. 'J ~I btJ() Width '10' Depth I "ID ' Yes ~ Cf - 3 - () 0
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
bulkll'!l ~.!.511" ""'If' J 1':k: J;:se. ~urthennore. I hereby agree lhat the city official or a designee may enter upon the property to perlonn needed inspections.
X ~. · I"IS~ -.b-I'~octJ
Signature License No. Dete
SEATS
FOR ADMINISTRATIVE USE
SE1BACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS a PERCOLATION TESTS a
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2~ary"")
PLANS & SPECS a
SURVEY a
PLOT PLAN a
SETS
COPIES
USEOFBUILDING ~ nJ
TYPE OF CONSTRUCTION: I II III IV f!J
Occupancy Group A B E F HIM (!; S U
Division 1 2 6J 4 '1
Permit Fee ................................... $_I,l., 5 · tr
Plan Check Fee ............................. $ " ~ (p ~ · 21
State Surcharge ............................. $ I ~ 5 · 00
Penalty ....................................... $
City:
Amount Brought Forward .. .. .. .. .. .. .. .... $
Park Support Fee ........................... $ ~. t!)I::)
SAC ......................................... $~ tJ(J .~
Collective Street Fee .. .. .. .. . .. .. .. .. .. .... $
Sewer Tap ................................... $
III " $
Pressure Reducer ....:~.....!.......... $
70.05
lOt).. OD
I 0l'J. oiL-
Sewer & Water Permit ...................... $ is' · SO
G~.S repI e ~~.,:....:. $ . "(>.DO
Th I ti m "'1:1 . '~rmit ben~;e.ve~ ~ 0
B _ Date. 7" Lt!)....,
Certificate of Occu~
Meter Horn .. .. .. .. .. . .. .. . .. . .. . .. .. .. .. .. ... $
Water Meter ................................. $ 2.5'0 . a.a
Sewer & Water Connection Fee ........... $--it-2 ()(J · DO
Water Tower Fee ........................... $ 700 ~a
Water Tap ................................... $
Builder's Deposit ............................ $-1 I S"aD ~
I -
Other ......................................... $
PaJ~'.O~ ~.i...f&......~:i~;~O$ ~ ;i 4~
Issued Date 't7 J () 3- iuv By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City ZOning~a~~ proceed as uested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate 0 pancy must be Issued.
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Plumbing Permit Fee .. . .. .. .. . .. .. .... .. ... $
Mechanical Permit Fee ..................... $
City Planner
Date
Special Conditions if any
24 hour notice for all inspections (952) 447-9850
. ,
The......Building,....Engin~ring, .andPlannlng...D~partments..have reviewed the 'building.. p~rmit
application'forcoflStructionactivilywhich,isproPQsedat: ,
~01a~~E
Accepted
Accepted With Corrections
~
Denied
Reviewed By: Date: 7- 3.,c;)o
Comments:
.... ~t8~~~{J~ 1AJ~tl:
. 0~ Ar~'4 ~ .! ~ ~v'u y<, tJ tLJ ~ ~~
liThe issuance or granting of a permit or approval of plans, specifications and
computations shaH 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 shaH not be valid. II
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White - Building
Canary - Engineering
Pink - Planning
The Cenlu of the Lake Counlry
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLISI
'vls:,~Q.nV"\ ~'. i~f> ~
lJune . qtl,) ~OOO
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.30gaW~ \)u~K t~E
Reviewed By
Comments:
ed With Corrections X
Accepted
Denied
Date:
Gs:cr~
p~ a.ffi~~ h~
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.1I
Th. ('."1';01 Ih. t..~.CO;'nlry :' .
-~ 00-055";.
, ..Whlt~J\.Bulldlng'."'l":
.' Canary' .. Erigln$erfng
Pink . - Planning' '
., '
. " . .
. '.
" '
BUILDING' PERMIT APPLICATIONt2EfARTl\deNT~CKLISI ",
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NAME OF APPLICANT '.. ~'C\ r'.~
. APPLICATION RECEIVED . . 'Llu f\e" qt"l' ,.~()O
~ '.
.' ,
. . '. . .
The Building, Engineering, and PlannirlgDepartments have 'reviewed the. building ,permlt
application for ~onstruction activity which' i~ p~opose~ 'at: ". " .~ ". '.' . ' .
..:30ga~1)UCiK ..A'NE
. . .... .... 1 ....;... .
,', Accepted " ~,"
. .
. '.Accep~~dWith Corrections. .',
Denied .' .' . . ,
, ,Reviewed By: (;rallf. Gf"hH\ ,
. Comments:" 5et' 4{,e."ill&.,iHa''/'D/l' PJ('
(;r.~'<otJ "tM.. ' .siJt'Pfo/it/7
"',Date:J/~/a? ','
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/'nes, i;,.~// k .~caq4""2.eL
~,"'ct~~r>\nh~.I. Fi^..1 (.)(~(.:GIspid-io" ", :1:r\+",t>\..!i2K ~.., f>l~
3 t:="r'"OSIOTI., C M.frO( Measu.(e<:::. #f-rost(J~ r'~/ a;J( "
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.IITheissuance orgrariti"g ,Of .a' permit or approval of plans, specifications and:
computations shall not be construed Jo be a permit for, oran approval of, any violation of '.'
. any.qf the provisions':of this code or of 'any btherordinancebf the jurisdiction. . Permits'"
"presuming ~o . give aut~ority to violate or cangel the' provisions of this code 'or other
ordinances of the jurisdicti9n shall, not be' valid." '.
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Job Address 3O'6Z ~))~
Heating Contract~ rl- Ifl~''-'
Name of Tester K" (,
? -'7 - (!JJeJ
Date
Percent 02
Percent CO
Stack Temp,
Percent C02
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CITY OF PRIOR LAKE Me
. 16200 Eagle Creek Av. S.E. PermU No. C!JO-~.'i
Prior Lake, MN 55372
HEAnNG APPLICATION I PERMIT
DaI. f/JIoo P.J' 6?5- 337 - O~- 0
Sillt Addr.. ~,f::; Ii )/)')IO~nt I we,
Lot ,6) Block \ Addlion (A1 i , <:1.~ e,rcl AMrJ
Own"'s Name !J Jd..~~,." . .~-=-r
Acktess
HlaUngConllador ALLI!!D FIRESIDE dba PIRESIDE COltllRI.
Addreu 2700 H. PAIRVIEW. IOSEVILLE I K'N 55113
Tm~8' 651-633-2561
FtRBPLACI I
PlIR1MP Make I Model ^J, 1'..:1 JJ (0 La
, .
ModelSiz8. ~CU) TL- L
Conn. Load
Fuel aM
Supply Openings
Return OpenIngs .
Input . Output ,),7 ab
Edr.
elm..
Allerations
Repair.
FWI Siz.1 .
TYPE OF SYSTEM
Warm Ai, Plants
Gravity
Mechanicat
Aft CondJtbnlng ,
V In!. System
HEAnNG OR POWER PlANT
Steam
Hot Water
Radiation
Special Devas .
Other Dwices
Replacement
TYPE OF WORK
NflW Construcion '>I
&1. Cosl $ I J 00. t!11J
. I .
HEAliNG PERMlT FEE $ /'
STATE SURCHARGE " ~O
TOTAl PERMIT FEES ,'/
"P
Ift/aJ
Buld1ng Permit II rrn -O-'~~
D \NrrH
, PAl PERM\1'
9U\\..D\NG
E.l. Comp. Dakl
Receipt ,
TYPE OF STRUCTURE
en
(I)
::J
J. 'h' . F11e r+
1.~. .~, OJ
J. YdIM . CwbI:Ir ~
Single Flmily
Commercial
"T1
t-f
:D
m
en
t-f
o
m
(')
o
:D
z
m
:D
Two-FMlify _
InduslriaJ
Multi-Family
Public. Ofler
Fee Schadul&
Industrial, Comme,ciat & Mulli-Family
Residenlial, He.lng & AC
ResidenliafT Healing Only
Residential, Gas Fireplace
R esidentiat, Addkions & Alterations
Residential, AC C?nIy
.
Remember to add Ihe Slate Sun:harge on Ihe bonom of this application.
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The price of your heating permil mdudes one rough-In and one RMJ Inspedton. ~
Addilional inspeclions wi be billed at 135.00 ead1. :
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House HeaOng Tesl Record musl be sabniRed wlh IuiiIiJ.g IlIDDiI 0WDbI1 betore bulk..~
ing i:8f1iticale of occupancy wiI be ilsu8d.
HEAT ~AI ~~,. ATlnN~ RFOI nRFO will number of Sl4'PIr and ,"ur" opening. lisled .
room with CFM's per opening. New slruclures or addilonl ..nd rtoor plan wUh IuppIy
and relum lacalions shDWII. HEAT lOSS CAlCUlATIONS, PAYMENT AND
APPUCATK>NS MAY BEMAllED1OTHECITYOFPRI0RLAKE.112DO EAGlE
CREEK AVE. S.E. PRIOR lAKE. MN 55312.
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Cily Hal buslnsss hours are 8 8.m. . 4:30 p.m.
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ALL WORK MUST BE INSPECTED (ROUGH"N AND FINAL) .. CALL CITY HALL
447.t1UO
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I hereby apply for a mechanical systems permit and'l acknowledge that 1he
information above is complele and accurate; thaI It\8 WOlle wltl b. in conformaoct
with the ordinances and codes of the elly and with 'he ~1.1. tJuildlnvtmech.nic~
codes: lhat lhis form does not become a permit untit signed by the BUILDIN(
OFFICIAL; 'hat 'he work win be in accordance wllh the approved plan m h
case 01 all work which requ.res review and apprcw.1 0' plan..
&hA ;/~ AI/fa.
-Iff ' · AppIicj1l's'SJgnature ~ ' Dal.
lAhl ,/ Cl~J A J., ',4-1 ) Q; J tJq /rJD
BuiJdng '-' .......na1ure - - / D""
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~1'" em OF PRIOR LAKE. ! i
~ . ~ . . 16200 EIllIe CnIek Av. 8.E. 'emdl No.. ~ M'l-.. v q:
" J Prior Lake. IIN &5372 ,
~,",/ HEAlING APPLICAnON I PERMIT ' single Family . V'
iata -J tlo 'cL:> PIO. rl..<;'" - ~7 - o6~'-() .. CorDllllrdal. InduIlriaI
~.. Mdt- '.' ?...~2- I 1.~Y"'A. Ie- \r .' ( ,.j
cial SIock \ Add,lon. ll.)\ \ 'O~ ~
z
OWn.'" Nlme \ ".1 11. 'r\C;..l~ \-\-r~ ~
Addl8U_ IW~6 l=>'A9;.PI \')L~ ~ 2nD F-~
HiatlngConltador'" C~~ -Q'I~ 0
AddrIS8, 'U1un.~ enb.tJR..~ TlI.l- '2.r"'t~"'~
TeIepholIl', t '" 61- L..\- ~ _ I l44 AlllMlmbflr 10 add lhe SIIIe ~8 on Doe bollom of this' eppIIcellon.
Furnear Make & Model . ~Lv\.1\O '" TYPE OF SYSTEM
r 7 ""1..,", ). I Warm Air Plants V
Madel SIzl.J...:;" .... ",l ~ 0 ~ -- \ riO Gravfty, '
CoM. Load Mechanlc81 ,
~ . _. n AIr Cond'~ ~ ':1,."..,....)
~ Fuel_~~. eP7fIu. Size . . Vlftl. System,
N
!ll Supply Openings . \ In tlEA1IIIG-0R POWER PLANT
L;i Steanl I
U) Return Openings 0 e, HoI W.. , ·
~ c, D _....r'\ Radlatlon
b:: Input ,~... 0'000utpUt. ~ · \JU '-' SpecIal O~k:.s ,
~ Edr. ,
w
(!)
erm.,
Other Device.
nPE OF WORK
New Conltruc11on y
E
<I
[I-
~ Alterations _
tD
Repatr, Est. Camp. Da18 ,
~ Ell. Call $ . ~'8rm.' on-:- (')f::.-SCl
N ~.
u5 H EATtNB PERMIT FEE ,/ 1l&1I"'I"LI
~ /" PA\OW"'~
~ ST~TE SURCHARGE $ .50 BUILDING peRM1T
TOTAL PERMIT F&:s:q to / Receipt', ·
/'
Replacement .
l. PI" -. R1e
1. Gee Ckr
1. Y4 : c.....
,-YPE OF STRUCTURE
. lWo-FernHv,
ltum-FarnIV '
Pubic
_ Olher
Fee Schedule
Industrtal, Commercfal & Mullt-F..mty
Reaklfmflal, Heating & AC
RllIdentlaJ. HeaOng Only.
Resldenlall Gas Ffreplace
R~sldenUal. Adfltlons & AleraGona
RMldantral. AC Only
1% 01 Job coil (fo'l:II cilmldmum)
. \'-:} /;:::\ :-r:
99.60 '. ' )H:~:J;."
tI4.50
'39.60 .,
$39.50
$39.60 ·
828 2000
The.prtce 01 your heaUng permit Includes one rough.1n end OI\ellnalln&pectlon.
AddRtonal inspection. wi be blRed a' 135.00 each.
House Healing Tesl Record mult be IYbmlned wIIh IB.ifdbl ~.... number before buld-
k1g cerlfica'. 01 occupancy. b. Issued.
~.T ~.I~' ....T~~~ ~FOl"~J:=n with number ot .~Iv and Htturn openings IIsled per
room wII.h CFM'. per opening. New structures or &ddidona aead floor p1an wilh supptv
and rehlrn locations ahown. HEAT LOSS CALCULAnONS. PAYMENT AND
APPLICATIONS MAY BE MAt LEO TO THE CITY OF PRiOR LAKE. 16200 EAGLE
CREEK AVE. S.E PRIOR LAKE. MH 65372..
City Hall buslneu hours are 8 a.m.. 4:30 p.m.
.AlL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL errv HALL
447-4230
I herebv apply for a mechanlcat system. permit and I acknowledge 'hat the
Information above Is complete and accurate; that the work wlS ba III confo.mance
wIth Ihe ordfnanc88 and codes of the ~IIy and with the .Ial. bullding/mechlnlcal
cod..; 'hat Ihle 101m dOl. not become. permit untll signed by Ihe BUilDING
OFFICIAL; Ihatlhe work win be In accordance with the approved plan fn 'he
cal8 01.... work whlch.,!quIr88 review end approvel 01 plan; 1'/( 11
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CITY OF PRIOR LAKE ~ =- L
.PLUMSINGPERM,'I # Cf'a-~q
AppliQant: ~~- IL.~ Phone: It.l.-~ -~-~14\J
Address: 'Ulu..~ ~ ~ 1"l'2..L.- ~rJ 11 , ~
.Signature: ~ 1 ()L~ "'" "
. a.gal Description: lot ~ Block' Sub 11 ~I. \ ~~ ~rt..r:l
Site Addrass: 'a~~ 2- l J..~.it' ~ ~ ~ .
Building Permit_ ~-~, - PIDt~-~~7-0~-()
.'__ ~Nv I 1;: This pennit ~ll not be processed without complete infonnation.
FlA I URE UNITS
JUL. 26.2000 8:07AM
GENZ RYAN 6513226147
'hot C , ".af"'. L".~ C_b7
.a,26aw
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Quantity Type of FIXture
'2- Bath Tub with or without shower
, Dishwasher
, Floor Drain
Lf Lavatory (bathroom sink)
\ Laundry Tray C' or 2 campa. ~. .ent sink)
\ Shower Stall
l Sinks
Bar Sink
, ~ Water Closet (toilet)
Quantity
~
t
rl:l: SCHEDULE
. Industrial! Commercial & Multi..Family
(1 % of job cost. 539.50 minimum)
Residential. New One & Two Famny
Residential. Additions & Alterations
State Surcharge
_ $99.50
$39.50
GRANO TOTAL
NO. 947
P.2/6
Type of Fixture
Rough..ins
Water Heater
Water Softner
Srand Pipe (washing machine)
Sewage Ejector
Baeldlow Assembly (API, DoUble Check, PVB)
Bac:k.fIow Assembly Test
la~ Sprinkler
Other
I
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$ /
I
$,
$
$
.50
r PAlO wrn..\ ,,^\l
BU\l.D\NG ~E.~
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16200 Eagle CreekAv. S... . r Lake, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-42~S
Az1 Equal OpportUnity Employer
PRIOR LAKE DEPARTMENTOF ....~
. · BUILDING AND INSPECTION
~
INSPECTION. RECORD
srrEADDRESS 3082. WOOD Duc~ L~N6
NATURE OF WORK ~e-LU H()M.~ S.F;'D,
USE OF BUILDING ,ees. s. F'.D.
PERMIT NO. Of) -055Q DATE ISSUED iJ1Ja /(J tJ
CONTRACTOR yJENSta\~ f\ow...es p~Ne"'l.,~r:- itJ,--'C:/()(J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING t!r.r. . '7/'6lt?O
FOUNDATION (Prior to Backfill>f'~ ~ 1/11/ If) " ~ . ? /,7/0 /) .
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC, 1 fh-l~. ? 17 If 0,
FRAMING W ((, ) I t ~lJa1
INSULATION V~ ~, fJ/D/~J ~ J . f//I/(}[)l
ELECTRICAL ' . -, I
PLUMBING 1\ ~ t! q' ( 00
HEATING (If required) (\ l{~ 4'1.'7, OJ)
FIREPLACE . t r j II 1fiJ' W
G~S LINE AIR TEST (jp i" 1rO 1
COVER NO WORK UNTIL ~.OVE HAS BEEN SIGNED
WALLBOARD
FINALS
~IB
~-~
, (X'
OCCUpy UNTIL ABOV~~AS
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.
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
4,/0-01
4-1;J.~1
~\~ .~
BEEN ~IG ED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
.
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D~ TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~ _~~
ADDRESS 30fJ 2. Wood ~ rr~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
D FOOTING
D FOUNDATION
D FRAMING
D~NSULATION
bit le-
D SITE INSPECTION
D PLUMBING RI
o MECH RI
D WATER HOOKUP
D SEWER HOOKUP
~ PLUMBING FINAL
~MECH FINAL
COMMENTS:
P\~ r a
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f..J.,L 4
~~
(uU~
Uv~
Q1\.,
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0\1\--
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D EXIGRAD/FILLING
o COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLlNE AIR TST
o
Inspector: Owner/Contr:
CALL L7-9860 F R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~QUIREM~ ARE FOR YOUR PERSONAL REALm. SAFETYI
\J uaNOn
Mk nilE
CITY OF PRIOR LAKE "
INSPEcnON NonCE - SCHEDULED ~~
ADDRESS 3082- WOQd.~
OWNER CONTR.
PHONE NO. PERMIT NO. ~ ., SSCl
o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~ULATION o SEWER HOOKUP D FIREPLACE FINAL
HAL D PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
~~~~~?~~~~
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/~.-. ,- r-;-",
(\"~ c..O. -b, 0 I ~ ~/)
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/
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EINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
,~
CALL 447~1860 FeR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
7. -t.0l) :3 \ 3D
ADDRESS
..30B2. WOOO DUClK
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~OOTING ~
, FOUNDA TIONtrS'
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~ECH RI
'A TER HOOKUP
EWER HOOKUP
. 0 PLUMBING FINAL
o MECH FINAL
-559
/
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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Inspector:
Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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