HomeMy WebLinkAboutBldg Permit 01-0824
~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please we or print and siM at bv..v...)
ADDRESS
3~8 (J,t.-P ~#~ ~~l--e-
Date Rec' d
7-/2--01
I. White File
2. Pink City
3. Ye\low Applicant
LEGAL DESCRIPTION (office use only)
LOT (, BLOCK f ADDITION 1ff.e. W, trPJ ?-H AI?"T'~
OWNER
(Name)
~~tJP~) ~tV
3t'Io GA~r 4 ftt ke
G. I~.
~Afi.t7PEe.
(Address)
BUILDER
(Name)
4~ 4J, #AJ~
(Address)
,
TYPE OF WORK ~ New Construction
DLower Level Finish
D Misc.
DDeck
D Fireplace
PID 25...375-($7- ()
(Phone)
q~2..- 4().3 - q ItX'"
M,;o
%?71
r'
/
/
DPorch
DAddition
DRe-Roofmg
DAlteration
r Park Support Fee
I SAC
I Water Meter Size 5/8)';@
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
tfI ~L.eT,.J
18<-2-01
(Phone)
PROJECT COST /V ALUE (exc1
Connection
oc.
j 74/CQ:::) ,
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 e above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. a aware that building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~ter upon the 0 e to perfo eeded inspections. 7t, r;? I 7. h tJ lei'
Contractor's License No. ,~
$13: " #. ~
.. 7' J ~ ,. ~( I Paid ~"t.H. ~ - RecewWo. 4'd JU I
Date I Date ? 3' d'1 BY:fl/'l-- I
~ to c~ that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and ~y 'proceed as requested. This document
'~ned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
7(~t(9{. ~~~ ~~~~
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
r Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
_...... /7
~----
. $ 1 tttf/ (!)rJr.} . ~
$ lJS'I8. 'S-
$ Loa G, .16
$ liq.50
$ IfJO..co
$ ( "" ..CtJ
$ 35".5V
$ 40 .t!)0
ilding Permit When Approved
#
#
. $ eS-O.oa
$ t.,..15J1. 0(')
$ 25O.CXJ
$ . fJtJ. O('L
$ 1/:1.00. ~
$ 'i'7,OtJ..OCJ
$ !1c;-m.67
$
#
#
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMI~ JUN 2 5 2001
(Please type or print and sign at bottom)
ADDRESS rJ I ;/ / 1
331; f li);/ tf/14/st
1Jt/~
j :
j' "
v)
IV
,
U GL->
1. Blue File
2. Gold City
l. Ye\low Applicant
PEIDVllINU. !-~~ r
ZONING (~ce use)
R(
LEGAL DESCRlPTION (office use only)
LOT ~ BLOCK Lf ADDITION V illrM c~
. OWNER (J ii,.. /) 1
(Name) ~!lll tltl?t ( :t tL-S .
(Address)
~;;~fANTi!a 1!lft JJ/!J#. bJ fM /
(Address) ?/;O ~&rl4fff
(Address)
(Contact Person) el/'l ~ ~
APPLICANT SIGNATUREO......--"\ ~-
Quantity
~
(
(
3
/
I
I
.3
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)
"
PIrM) -375- 0 3 rp
(Phone)
(Phone) 1),jc2 ---I/Pc2 ~ cY/~ /
~70rlll;{_ j~J62-
(City) (Zip Code)
(Phone) ~ ;2/f/ f o!-.J/ J /
DATE I7JtJ~ ;2pt, tJ /
"
Type of Fixture
I.
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimu~
Estimated Cost $
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
I3UIL~j~D ~'lrH
G PeRMIt
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, (ax (952) 447-4245
Paid
___-R.ee~~;;~ ~ra.
---
Date
f ~d -0 I
BYo/
U ..-/
CITY OF PRIOR LAKE
HEA TINGI AIR CONDITIONINGIFIREPLACE PERl\tUl
.;F/~
Date Rec'd
(Please tvDe or Drint and siltll at bottom)
ADDRESS
33~8 W//dh6rcSe ~,
~: ~ ~:~. I PERMIT NO. 1_ "~J 1
3. Yellow Applicant /J (7V'-f
,
ZONING (office use)
~I
LEGAL DESCRu' nON (office use only) - -r:fS,
LOT 0 BLOCK L/ ADDITION! #)~ ~
PI~"'3 J~- 1>37-0
&~e~R c5'tZ/Jdau (::6/7s-l-rtA-cha/) (Phone) #4'~8 ...9/60
(Address)"gDLD ~A.dl- ql:!1A1/e. cfha./~el L-tA./ 5Sb79
,
~;;~~ANToAdva.r7lttqe Ai~LIIte I (Phone) _ ., o/c/cr-/9c;O
(Address) 6z.s- /Jd #? cP~ W. cP~LJee/~ ~3'/9
/) ~ /..1 (Address) (~ty).I/_ ; (Zip Code)
(Contact Person) ~D~h1 /~ "IPhone) ~C;s-/90D
APPLICANT SIGNATURE 'A.tI~.~ DATE ?- ';;;7-0/
, ./ APPLICAN.(;LEASE COMPLETE BELOW
~?W CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE^ND MODEL '1/-a./)fG, -;- CA-IfJOJ>-O FUEL A..J4- T
FLUE SIZE 17 // REnJRN OPENINGS INPUT ~ dO <) OUTPUT 7?-~ao
,
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants 0 Steam
o Gravity 0 Hot Water
. J Mechanical 0 Radiation
<' ~ Conditioning 0 Special Devices
OVent. System 0 Other Devices
}t}'/C
F~EMAKEANDMODEL rr~e...
-rr/l....D30
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
~ y)- ,fa,...,
Industrial, Commercial & Multi-Family
~( .~
Res~dent~al, Heat~ng & (New Construc~
ResIdential, Heatmg Only".. ':':Ul1.)uu\,;Llon)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
$39.50
$39.50
" eLJ11 ~~/D t1/
"-l..J11VG 11ft
PI2~.
')/V,j'l"
r~-
Residential, Additions & Alterations !'
Residential, AC Only
Estimated Cost $
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
-
ReceiR! No. __
Building Official
Da~ ' ';}- 9-0 J
,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date
BY~
{/
..e. - PILe
YELLOW . A'PLlCAIIT
GOLD . CIT'l
CITY OF PRIOR LAKE S.W. No. 0/- f;::)LI
SEWER AND WATER PERMIT 7
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANT: .& ~ /....V"("" {
Ig~k ~r- #/
SIGNATURE: (~ _ - ....
SITE ADDRESS;~~.6'~~~~ (!.IA..-
FILL IN THE BLANKS
1. Estimated length of water service~
PHONE: 9.q-;../$'1 -/J::ICl
DATE: i;?//13 /4/
BLDG. PERMIT # I}!Or,er
PID# :2 r::- - og/-Cil S-'7::7
-"!'
ADDRESS:
feet.
2 . Size of water service /
inch(es).
3. Location of any couplings from structure -- feet.
4. Type of sewer pipe. ABS PVC ~st Iron
5. Estimated length of sewer line ~~/ feet.
6.
(if required), located at
feet
from
- ------------------------------------------------
- ------------------------------------------------
permit when approved.
DATE:
1"-/3 -~/
-----------------------------------------------------
-----------------------------------------------------
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $}'V.JftJ) 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 R' - la;(J }
*
PAID ~'
AMOUNT PAl 0 BUILDING ~TH
~ ERMli
REC'O BY U
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE
nEATING/AIR CONDITIONING/~l.KEPLACE PERMIT
Date Rec'd
1-- 0/ -" L
(Please type or Print and SiM at b~..v~)
ADDRESS
~. =., ~~~y. I PERMIT NO. 01- {'/' 2- ~ ~
3. Ye\low Applicant ~ .,..-
t:-:r~'d.Cc.
/"1ev:" ~
.J. (Address)
(Contact Person) Nu\~ ~tA.~- /J (Phone)
APPLICANT SIGNATURE~/ h _1/ _~ DATE ~ #, f- 0 l..
~PPLICAtT PL~ASE COMPLETE BELOJ
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
33 Ce. 8' IN I {.... 0 I-fo JeJI:?
LEGAL DESCRL.t' nON (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(AddressL
/~~
'-- .. '.Dlam@)- U '\ <-f ~(
1 bl S I
. ZONING (office use)
PID
7'5 l.. - f.!yo. >6 ~o
(Phone)
Pr- .1)1
(City)
J,.A
(Address)
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
~PLA~KEAND MODEL
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
W 4-- ~~~2--
Pa~
Date;, .a
Ir - -, "". 0 -z...-.--
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
.s-nll
(Zip Code)
G :s Z - </'10- S'l 0
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Roeeipl Hu.
By P
/
~t#:I:'"
'<..~
x
,:; )(
Th. ('..1.. of Ih. t.k< ('ounlry
01- ~A~
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
5ANI)AU C1Jf\JS I K..
/- rz'-ol
I' .
APPLICATION RECEIVED
/"/1 (I. (.'t'"
'" ....... ---.,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
330 B WILD ~:OfC.SE, C1 R--~
Accepted
x
Accepted With Corrections
Denied
Reviewed By: . AJlrb Date: IJ -- ~ (
Comments: See RewK'&l..Side for Additional I nformation I '
-
f)!T5~.~
..... "".... "
,- -........
5ee Anacnments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
,""
',-.
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
tJl/ (P'~
Th. ('.nl.. of rh. t.kt ("ounlry
White - Building
Canary .. Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT SANI)AU (~ON~ l K.
APPLICATION RECEIVED 7 - ! 2. - 0 (
.
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33&- f> \AJ I L,U H()~c~ C( t<- ~
Accepted
~
Accepted With Corrections
Denied
Reviewed By: ~~ Date: 7/gt/6'(
Comments:
t. ~'f p- v;y~Jz1.U ?JJ-~.-~
fvr~ A-n^ns:;-:-j ~ +-~ hJJ .a. ..C)-LJ y;:;
C>>v-~,,~' .,
A-~
~ '~.J/~(A
~ ty..L-b.:- ~ ~-
...
~~~4UJj
11A""e./~8V ~t-dt 4-8V'd
If)~: U
"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 - PIJ'a'1n./nIO~d
Th. C.n..r of lh. Loke Counlry D VV )
,BUIL.DING PERMIT APPUCATION D,EfARTME;NT CHI;.CKLlSI
NAME OF APPLICANT
APPLICATION RECEIVED
SAn _)4l) Carn~ t
7-12-~1
.
The Building, Engineering, and Planning Departments have reviewed the building permit
apPIi:;oio28lruction{ Jc~\&Ch H~~ ( f
Accepted With Correctio~s --<..
Accepted
Denied
Reviewed By.
Date: /-I8-2k::o(
'The issuance or granting of a permit or approval of planst 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
PR 10 R LA KE DEPARTMENT OF
.~ BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~< Co<O (0" lAl Ho~ G-.
NATURE OF WORK k).A.J,J
USE OF BUILDING ~ro .
PERMIT NO. --,..QJ4J'O-m:. ~ATE ISSUED. 7--ta - 2wP/
CONTRACTOR ~tl~. ~- PHONE<=152.~t.kJ$ .. 9/01
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR t fATE
t FOOTING I ~~ O'a-uq I f3 (,( O(
FOUNDATION (Prior to Backfill) I ~ I b ~~ d I4!O(
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SldNED
ROUGH - INS
~U~
I
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
i~
~
\
I
~1~)fJ'
q, ~
"'
10 I of
. ,
q Jf> or
t I
t\ ~1 01
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS I J
A//? " Sy~r02/
tV,_\\~ ~J~~\~ ~.q-tJY
4:,~~ 6t\~~!'J,.....
/b . A-\\~ .O~
OCCUpy UNTIL ABOVE HAS B EN '~'G ED
NOTICE
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections h8Of4t b~n 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 (952) 447-9850
ADDRESS 33&g
OCCUPANT.
HEAT LOSS _
SOLO BY
EI.ctricol Work By
TY PE OF HEA T
MAKE
Mocl.1
S.riol
INPUT
THERMOSTAT
Vol....
lirr.il.
LimilS.llinll
Fan 5e" inll
Pilol Type
Pilol Make
Pilol Mocl.1
Pilol Timinll _
L. W. CuI orr
Pr. s sur.
3,5
'npul CFH
Stock T .mp. ~
Form 235
HOUSE HEATING TEST RECORD
lllllDHt.1?.fE elf? eLf
DATE HTG. INST.
GA
.FA
FRft)6e Dllt~ESIGN
q~3 oLJ(nF - Fft/oRC
F CV}O' fl ~~ o,lI>> / L/
I (!') D I (x'Vl
CONTROLS
Heat Plug
lat
Porcent CO2
Perc.nl 0,
Percen' CO
HW _
APT. .
OWNER
_CITY
FLOOR.
INSTALLED BY
STEAM _
Go. Lin. By _
SPACE HTR.
UNIT HTR.
OTHER
CONVERSION
MAKE OF BURNER
() JOe. - 141Mocl...
1,0
'],1
()
MOJ[_ BTl) ROling_
MAKE OF FURNACE
Moclel
Vent Sire
KIND OF LINER
Ora fr Hood _
Filter. She
Chimney locolion
o,imney Construction ~
SIZE
Regulo.o.
_Humb..r
Insicl. .
Outside
Smok.. Bomb
Droit
Wirinll
.T.sl To"
, . L illhlinO Ins I. _
~jIJ rJoA ,
I/bv~1/- 'lKt /J 1<<.
/'.( /?',A1J
Door Pressure
DOl. T..st..d
Company Testing
Name of Test.,
-I
SUBURB.
NbNF
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
$---2/-oZ
OWNER
s??R W//J H()rSe C/r
gCYlc4 (/
PERMIT NO. G / - ~ dl.j
CONTR.
ADDRESS
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~.................t1!ILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: /!
~~cl'f - (J t:..
M. XwORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR 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!
/NSItOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~3~.A
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
/0 tE LO' ~ nME
SCHEDULED ~O\..
W l'lA_ 1rSoe., C~I'-
CONTR.
PERMIT NO.
O{ -f.?~4
o PLUMBING RI
o MECH RI
o WATER H
o SEWER
o PLUM
o MEC
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
i'~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ , CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~ ~ Owner/Contr:
CALL 447.9850 FOR TJ: NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J3'F
SCHEDULED ~&-
~~
/tJ: '0
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t PLUMBING RI
o MECH RI
o WATER HOOKUP
~ SEWER HOOKUP
f\ JL.PLUMBING FINAL
o MECH FINAL
---'iJ1- ?~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
l!'t\~\Mt;~ O\(
lAt\.ekj,ea\J
/wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
D CORRE~ CALL FOR RElNSPECnON BEFORE COVERING
Inspector: UJ\ Owner/Contr:
CALL 447.9850 FOR ~E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INS1iOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED M- ,'i 11 ()
~JiJ ~
ADDRESS
33bf!
OWNER
CONTR.
PHONE NO.
~ I - fj"~'1
PERMIT NO.
It
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
tIh FINAL 0 PLUMBING FINAL
b - SITE INSPECTION 1lL MECH FINAL
COMMENTS: ~ iJ_ ,
. i:J C
- b)~~.J 1'-0 ~c-r-
;
..;,-. ~......s
~ MO{\. ~t I ~tVe--,Uu'
:lc ~('~
@~ '~{)Je, ~('",,~-lre ~I\
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
^
~1lAo, fH1 ~
.p WORK SATISFACTORY, PROCEED
o .-XORRECT ACTION AND PROCEED
.If CORRECT"K, \::ALL FOR REINSPECTION BEFORE COVERING
Inspector: '.[;) _\.a>>.I'J Owner/Contr:
CALL 447-9850"~OR Tl NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
/NSNOTl