HomeMy WebLinkAboutBuilding Permit 01-0444
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
4-. l,7..0/
f!'lease ~ or orint and sion at bottom)
ADDRESS
I. While File I PERMIT NO I
2. p;" c;~ -. ()/-o AAA
3. Yellow Applicanl ~
/4/597
/AJ I J. /).$
vIEw
ZONING (o_use)
PuO ^r-
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK t. ADDITION -r H.E
W/LJ>.5
(Address)
St:lfS
bolV
A vt?' 5
SOVIl}'1
l> t? fV
(Phone)
PID Zf5-Z.t:f7w lJ53-()"
(:,/~1~3 ?,qU:>
OWNER
(Name)
Wi t..LcfVrJ R JN4
/-1<. k1Vt4~7
-
~/Z '"3,3-39/-0
.sr, PAuL
H/V
BlnLDER I
(Name) tu It.. Lc).; ~ 1:/ }iJ~ Co1J
(Contact Name) b a ~ , IAI J L i. L!:. ~ rJ it )1;0
(Address) 4~es I
Vk')..-rvr?A O"""'~
(Phone)
(Phone)
WoeD t3u/?vf
TYPE OF WORK
1ilNew Construction
OLower Level Finish
ODeck
o Fireplace
OForch
OAddition
ORe-Roofing
ORe-Siding
OUtility Connection
OAlteration
o Misc.
PROJECTCOSTIVALUE (exc1udingland) S
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
subntitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the y--y-', toperfi(rmneedodinspe"!!ons. '" P RJL :;'7 - ;).001
X -d?tf) -~ ~. C;U <.P.&.J'~-:;{ ~o 0 16.., ~6 ~ II
- ~ ,/ Signature rl Contractor's License No. Date
v
I Pennit Valualion 0l:50,c>CJO. c.. D Park Support Fee # $ ~(')d
I Permit Fee $ /,"(21. 75'"-' SAC # $ 4---J-5r> .ex
I Plan Check Fee $ rlll~_ 14 < I Water Meter Size 5/S":<d $ ~~ .1'C'e
I State Surcharge $ IIC;-. O(J,I I Pressure Reducer $ "71'1 .nn
I Penalty $ I Sewer/Water Connection Fee # $ .
/, d.. DO . (~
I Plumbing Pennit Fee $ /00.00 I Water Tower Fee # $ ,., (t)() . tJ(.
I Mechanical Permit Fee $ 1~.(!)lJ I Builder's Deposit $ I, l;- (jO . Ct-)
I Sewer & Water Permit Fee $ ~.SO I Other $ .
I ~ Fireplace Permit Fee fJ $ q() . 6Jd I TOTAL DUE $ p,q;>{ 3q
JJi' --- } I
( _.~ cation Becomes . 0 ding Permit When Approved I Paid q95'/.~ IRe~R4-
5-,<- ?f9CJ! I Date /c--/4~OI By ./
I -
Building 0 . aI Date
v
. This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requesttd. This document
~ed by the City Plann" constitutes a --'-r--. Certificate of Zooing cotupliance and allows constructioo to commence. Before occupancy, a Certificate of Occupancy must be
~me ~~.
_ -_- -'&0.- ~/W~ ~1"~I'~~~~
- laOi11hg Director Date -- Special Conditions, if any
14 hour notice for aU inspections (951) 447-9850, fax (951) 447-4145
\
\,1
Th.. ('..nlO'rof Ih..I...... COUnll"Y
~i!e~ -~:i~g
Canary - Engineering
Pink - Planning
mHLDING PERMIT APPLICATION D~PARTMENT CH~CKLI!U
NAME OF APPLICANT
APPLICATION RECEIVED
\j\j I ~l8 N p)e I t\) 9
4- 2.7-01
The Building, Engineering, and Planning Departments have reviewed the building permit
application t40SrC/7 actiw 7~hDSoV rEJvv
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
AJIJB
Date: _5 -/o-oJ
Comments: See Rever8e Side for ~\lnfnrmsafiool
. ~ MaCnments: 1) Gradlngptan, 2) J:roston contrOl M.....,.._:es
;3) E~on Control Plan
"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,"
.
White . Building
Canary . Engineering
Pink - Planning
ThpC'nlnoflht L.hCounll'}'
BUILDING PERMIT APPLICATION DEeART~NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WIUhN~Il\rg
4-27-01
The Building, Engineering, and Planning Departments have reviewed the building permit
application t4Srqi7 actiw i~D So\! i'5vJ
Reviewed B .
Accepted With correction~
Accepted
Denied
Date: S-?~~(
Comments:
~f)V
/ I -e-t/;' o1L...uR
. - ., "_._.0 _
~
v
( I
Oz ;,L
"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---___.~_,.
Th" ('''nl''F of Ihl- 14k" Coon_lry
White . !itulldlng .
Canary . Engln""lng
Pink - Planning
~t,~j.q;~.I: -,.;~t'. :'i)\~iI',~),;
aUILDINy PERMIT APPLlC4TION I)EPART..,ENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
V~ I LlE-l\J F~J 1\) Cj
4 - 21-01
\
The Building;. Engineering, and Planning Departments have reviewed the building permit
applicatio~ f()r construction activity which is. propose~at: \ I
i &, t}14 5 q 7 t.\J ILl) S V I Q \J
Accepted- ("./"
Accepted With Corrections
Denied
. /;,.1', / /\ - - -
Reviewed By: ~~~_
Date: d)' /10/ CY1
Comments:
MtuJ~ Z<{ ~\ ~lA~'v~'fl., A-r
~vcv\5t" w.~ 1..kWJ + ()QtD .Ll
'he> f1A~ D' "
"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 ofthe jurisdiction shall not be valid."
\
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
5""/(, -0/
1. Blue File I PERMIT NO I
2.GoId C;" '0/-0444
1. Yellow Applicant
(Please!VDe or nrint and sim at bottom)
ADDRESS
/4S'I') W, Lds
ZONING (office use)
PIJO
Vie tV
LEGAL DESCRIPTION (office use only)
LOT3BLOCK G, ADDITION 7'Jft::: WIt-OS
PIDUS-Z.!17-0S3-0
OWNER
(Name) WilL e. l} br, wI.
(Address) 24'i1 VeAl+04lllJ
APPLICANT
(Name' LlU!tJA/ fJLlA", JJlIII~
(Address) 369S ~ I.A!. N, UI.
(Address)
(Contact Person) WeNrJ,..., NeL s,nAJ
APPLICANT SIGNATURE ~ ~A
Quantity .
L
l
1-
"
,
:3
1-
q
r"n.' .
hR.
(Phone)
IV At/tl Au ~ "
. / "'3'",.. _ ~1;;{-J".."-"1aI4
(phone) 7{, '1 - lI'J... 7 - ) ~ (6
MJ/. 5nu ~
(City) (Zip Code)
(Phone) 74,'3- "1),,""- 7~'11
VJJJv-el'
DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
,
~
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
,
3
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
r PAlO WITH
PLUMBING PERMIT FEE $$ ...._01 "1~peRMIT
STATE SURCHARGE _.-
TOTAL PERMIT FEE $
.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
pai~
~at"5_/~ -0 I
Receipt No. _
~//'
BY/~
/I
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
: =, ~:~ I PERMIT NO'I'fJ_ II/}J 1 I
3. Yellow Apphcant VI '7c-r'f
(Please!\pe or orint and sim at bottom) f
ADD\~fil1 \J\lj Ids \!,PMI 1070'(omceusel I
LEGAL DESCRIPTION (office use only)
LOT ~3 BLOCK b ADDITION J-L
<
I 0 )JJ~
~=e~~\\ \\fnhillo! l'illl'ahUWDYU
(Addtess) 1J\Lil ~~1t~U'l~ 1Yv SWk)/1)
~:;~~ANTAllirml M~
(Addtess)~L /)y
I \Address)
(Contact Person) J2iU fl/1iw y
APPLICANT SIGNATURE ~ ~
PID:J5~:J..91-D1B-<)
(Phone)
~1A_NtrJ 55/Z{:;_
oJ
Sui-kJ
(Phone) 1 fJ5/- ^kS 2-- 2115
61..tJ.tlJ1 55/1-7_
- (C4YY. (Zip Code)
(Phone) '-051 452-2175
~/'f./l\ I
DATE
APPLICANT PLEASE COMPLETE BELOW
~NEW CONSTRUCTION DREPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL ~!S ~ MMJ FUEL ~ W 'f ("_
FLUE SIZE ;f'Ck- RETURN OPENINGS I V INPUT I DO. ftM') OUTPUT '1l-.<!lOO
TYPE OF SYSTEM HEATING OR POWER PLANT
iarm Air Plants
ravity
Mechanical
i( Conditioning
DVent. 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 MAKE AND MODEL
Industrial, Commercial & Multi.Pamily
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace .,/
$39.50 minimum
$99.50 ,/ Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential. Heating & Ale (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $ J Y. '-II ")
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
39. SO
.50
Mt:7.00
PAID WITH
BUILDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
-
IPai~
I 03- -'?--I-o I
Receipt No.
24 hour notice for an inspections (952) 447.9850, fox (952) 447-4245
BY~
V
07/30/2001 06:11 612-427-3806
08'08'00 ~ 11:44 PAl 0124474245
DAVE PERKINS CONT IN
......1... \I~ .......v" ..........
PAGE 02
_. ....
,....... . ..........
_D . CITY
CITY OF PRIOR LAKS
SBWER AND WATER Pl!:lUUT
S.W_No,
I-LlJii
NOTE: sewer and Water
~ontraotorB .~B~
be re9"1at8r811
with the City.
APPLJ: :AHT:
~_ ~a'" p,rIrllUl CDOtrldlna IH.
.. 14230 Basalt St. N.W.
~":~.i' Jl\" stal!- .
SIGN1i :'URE:
SITE .DDRESS;~tlf1 flJiltU VieW
PHONE:
DATE:
7 f.l3 .'tJ2, 7. 01 cJ '1
7/~O/'D I
ADDltEIS:
BLDG. PERKIT .
PIO' ri5- ~ Q'l-053-D
1.
I: .timated length of ....ater aervice
FII,.L IN THE BI~
50'
feet.
2. s....~e of wats!:' si!l!:'vice
inch(es) ,
4.
I, ,cation of any couplin9s from structure teet.
'1' 'pe of sewer pipe. ABS PVC /" Calllt Iron
50'
Eltimated length of sewer line feet.
:3 .
5.
6. C.ean out (if requir~d), located at
s. .ructure.
teet
f!:'om
=-____ 1"._ ". ......WiIA_==..3l!_..____...=-__.::=====1 - .-. --=---- .
,,- -~==!II!!"
This ~~icatlon becomelll your permit when approved.
BY
DATE:
----- ~----==----~~=-_..
---...-------
._..___c~________
FEES:
$ 35.00
$ .50
$ 35,50
.
Sewer .nd water line connecti~n permit.
Surcharqe
TOTAL
* F, e for either sewer or water individually is ~.~ plus
$: . so surchllrqe.
.
S; wer and water permits i.sued for .new construction must be
r, corded on the bul1dinq perml~ card at the time of issuance
t, insure that no duplicate sewer and water pe~Lt~ are
i, Slued. /"'AID WITH
BUILDING PERMIT
~-~D-O I
AMOUNT PAID
,all:c'D BY r
DATE ; AID
u..>;;I.\::ii:';..... '.' .. '-. ','J!
~lq.,1~ . ...11 ..REC!:J;. T ..
16200 EacJ CrPIr. Av. S.B.., Prior Lake. MinnclOla 55372/ Ph. (612.) 447-4Z30 I PAX (612.) 447-4245
I~".: ";i' .}..., ',: '. ':, Ai,..-...."'-'-'-. .'-' tuBntployu
~:"( :-~',' &MI- -..t"I""-V
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
.
SITE ADDRESS lU~q') WI' tds Vi'.... J, I
NATURE OF WORK' >>_,_ 1
USEOFBUILDING ~) "
PERMIT NO. _ nGliM4- D~TE iSSUED S-'Srax:rt
CONTRACTOR Vii rt-4-.Io.-,\f-'C. ~ (,/::t - 3c.. 3- 37 I~
NOTE: THIS IS NOT A PERIWT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING ~rck did- f)( I '-E, ~ I ~d (sf 01
I FOUNDATION (~rior to Backfill) I '1>.\) ~ ~~df)1 I ~ ~\\~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIG'NED
ROUGH~ ~NS
SEWER I WATER I SEPTIC Po ~
FRAMING ~~j,
INSULATION I.-. h 13 V 1lf I q-J
ELECTRICAL '
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I~ I I
FINALS
11/13
\\-' -')d" f~
~ -U 11M-A
q,.~~
~~~\
~),~J OJ
7!.~r
~h\
(.&.~. 7/01
~ I
"7 ~O)
-. I
GRADING (Prior to Sodding)
BUILDING Co ()\ U.'il~( --rCA/
ELECTRICAL v
PLUMBING
HEATING
DO NOT
/O'5~ol
ID - r:rDj
re
pe,
OCCUpy UNTIL ABOVE HAS
NOTICE
This card must be posted near an electrlc:a'l 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.
/a-Id-DI
,o-/ll--O!
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
~~-~~~,
~-j '0.. "..;i.:.'~;~ t 1o;,.Ylo '-'''f..!'l':'' I.\,.i!l":'-S _~:'t ".-.
l r <<trtificaU at IJaupanqJ
.-t,
": C.l.l r OF PRIOR LAKE
Department of .uilbiq Jn~pettion
IlJ Final Pennitted 0 Conditional C.O. Expires
This CenijiCOle issued pumMJ1ll to the requiremefllS of Section 307 of the Uniform Bui{d;ng Code
certifying that tJl the ti1M of isSUiJJlCe this structure was in compliance with the various ordi1l/lllCes of the
City of Prior Ulh regulDting bui{d;ng construction or use. For the following:
SINGLE FAMILY
U..Clusi_
01-0444
POD
R3
VlII
Bldg. PermiINo
NIA
Occuponcy Type
LepJ Dac:ripIioa
TypeConsttuc:tion
L3. B6. THE WILDS
_ Fire Zone
Zoning Dislri<l
~te_ 14597 WILDS VIEW
4401 iIIu..~...VA.l. DRIVE. III.. u",:'..!.J.
Owner ofBuildinl
WILLEllBRING CO..
c, "" _'" 'sNuneAAddreu.
/11'"../ ("ity_
Date:
ROBERT D. ..u...........,:;
Buildi"l OIIlcill
//- &--0)",
Date: _
DON RYE
POST IN A CONSPICUOUS PL,t,C,Ei I
, -
t 1:07)
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TillE
ADDRESS
SCHEDULED 11)-1'- / .3 c>-~
/0/597- IJ/LI&VJ I ~
OWNER
CONTR.
L / - ~"f<-f.
PERMIT NO. i.,. ,- /- 7~
PHONE NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o JIISULA~I 0 SEWER HOOKUP
.,..er FINAL J!(.aUMBING F
o SITE I' ON j;;r'\lECH FINA
COMMENTS: lL)~
o EXIGRADIFILLlNG
~ COMPLAINT
70 FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
f) 10, Not-
U
rl5?f () .-
>..t<-
(
tf./.AlL '-;:!..I/YI t),J)
L f(l.olllDtr (,vr:c> f)~t;iI!lIV,^G(1.. .-~N r;p .....
:-i. ~ M:.~.iZ.. DeeI'-- [2A,/..-. I~(~~
-'YlAN:u1.~L (!?) Nu~
~1f1-~ J'
Dd\E-
o WORK SATISFACTORY, ROCEED
o CORRECT ACTION REED
~RRECT WO L F R NSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
.-"n
CITY OF PRIOR LAKE
INSPEcnON NonCE SCHEDULED
"'
ADDRESS ~( IJ ;\~.~" ;1"11.)
OWNER CONTR.
PHONE NO. PERMIT NO.
D FOOTING D PLUMBING RI
D FOUNDATION D MECH RI
D FRAMING D WATER HOOKUP
D INSULATION D SEWER HOOKUP
Jl. FINAL ,u PLUMBING FINAL
D SITE INSPECTION )ll\MECH FINAL
DATE nilE
)O-/Z-ol ""2:00
tfJl- tlt/&/
D EXIGRADIFILLlNG
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
D
COMMENTS:
?I~
I. u..p IJ 1\ t' uA,1K.
1.. 7.,."",~ Co\Aa-~",," .tQ.... t-\..~.~~..--
""G."'n1....:r~l",...)
~---
,.~~..l.-~'5. ~~~
-2.. Rll..\NY"\\LL r.....^.A. ~ v,.t.....o
e. t>",;....\a.,""- ~_ ~ L'l.....\.[\l-\~~ l-"'<
esL...l.l.~o
I~
1I.~() -\okloll. \. 2Do1
D WORK SATISFACTORY, PROCEED
.,:,'.......:::10" ..A""Tlnll ANn DDn"'I:~Q~ _
CORREC , CALL FOR REINSPECT ION BEFORE COVERo/
L,
Inspector:
Owner/Conlr.
CALL ""7-9860 FOR THE NEXT INSPECTION:U HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
ID-;l;2..()/
/4547 IAJ,-/d& V /{oM
q~:50
SCHEDULED
OWNER
PHONE NO.
CONTR.
,:,..,;
PERMIT NO.
/)~44
o FOOTING
o FOUNDATION
o FRAMING
l:l)NSULA TION
~ FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
[J COMPLAINT
[J FIREPLACE RI
[J FIREPLACE FINAL
[J GASLlNE AIR TST
[J
COMMENTS: 5lf(
--
I
( U;;-r
r--
r/ L{'
/
'"
~'.\....'
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~, CAL~ FOR REINSPECTION BEFORE COVERING
Inspector: flU/II'?J - 0 L Owner/Cont"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSIWTl
",
.
":~
',\"
.'
:"
j
DATE TIllE
CITY OF p'RIOR LAKE
INSPECTION NOTJt:E
SCHEDULED
/o-~
flVl
ADDRESS
I i./59 7 w,' IdJ VIG.L.I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/') I - 'N if
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)l(FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
)( EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COr.?r.fINTS:
C.Vrh Bf'J~- I"JI:-
bmd-(r 01:..
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
In.pector:~~ f" - Owner/Contr:
CALL "7-9880 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE_
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL71f 4 SAFETYI
IN8NOTI
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
ADDRESS
/~59 7
UM
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DATE TIME
loli-zlo,
J~
9/011
tJ{ - at/tiLl
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL ~ PLUMBING FINAL
o SITE INSPECTION ~ MECH FIN/I;l
COMMENTS: P\U1M~,""'"
I. R-ov,cl..o :;;:"_..., ~~ C'1lA...~l..~ f'",,- q,+"..,...s,.I,.
T...? t')u~rQ_u.
z. 't:b..o ....u... t'....~.....
H\) At
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~~
o~
1>\..l~
l. n..~h..C"...1 ;:-~
L. 3r,...t ~ T~ r~~ dbAUlQn..y" J.-~__
3.~... ('~. ~
4, Mo.ll.U\t:.h^ ~~I'7.. ~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PR ED
XCORREi"7~~ FO INSPECTION BEFORE COVERING
Inspec1or.~I: Owner/Contr:
CALL ....7-9850 FO~HE NEXT INSPECTlON:U HOURS IN ADVANCE.
INSNt'"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/