HomeMy WebLinkAboutBldg Permit 06-0174
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main ~~11e
Date Rec' d
-:s ~ 3.- Ci(J
'-"
(Please type or print and si~n at bottom)
ADDRESS
/i L.\L,'C\..
-' Yellow Applicant
PERMIT NO. Cj4/ _{~ (74- j
, '1 ~ 38
Pc.,--.-lv " ~".v
/Vw
L^,
LEGAL DESCRIPTION (omce use only)
LOT 15 BLOCK
ADDITIONJ"e {(c.r.s
P (l'~~
J:".'r.{ f AkL ,r f,'~""
PID c)S"-'-{3)-ctl'f- 0
OWNER
(Name)
B.." \Ju"'-
(Phone)
(Address)
BUILDER
(Company Name)
l-\c,.........eJ.
\.0..1...",..' MI'A"'.......
ZONING (omee lIse)
.flts-o
(Phone)
(Phone)
bS- j.- 40b - I.{<.(00
~\.l.- 36~'- )cl11-(
M. "./ $-..5- J () ~
(Contact Name)
(Address) R- J..l S
oV\"'~ ~
Au . iJ;/'I5
R.- 5l)..M :,it' r
,8etS- PI~<7,:'< [)/', <..11'
1'-::'(") (~c"\.,,-
t::-J j
Sv, tc ~DO
TYPE OF WORK r1cNew Construction fXIbeck OPorch ORe-Roofing ORe-Siding j;iltower Level rUllSh ~rlrerlace
DAdd,tIon OAlteratlon OUtlhty ConnectIon
CODE: ~LR.C. OLB.C. o MIse.
Type of Constmction: I II III IV V A B PROJECT COST IV AL UE $ l \ C, OC t1 . () n
Oculpancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have turmshed mformatlon on this applicatlUl1 which IS to the best of my knu\vlcdgc true and Cl)JTeeL I also certify that J am the owner or illltlll1nzed agent for the
above-rncntlOncd property and that ;lll ClJl1structiun \\'ill conform to allC\LstlOg state and lucall.1ws Jnd will proceed 10 accordance \\'itl1 submitted plans I am aware that the buddmg
~rlClal can r~ ~~~'t 2IU~1'~}=I' I hereby agree that the City offiCial ()I a dej,:ee;a:;nter upon the prnpel1y to pcrt(nm ne;d~'s1;ec~"n~, b
-'SIgnature Contractor's License No. ......... Date
/J
Paid &"J'lfJ/. /,f' Rec{;(pt No. 51/72-
P:"~ '1 ~_ ~...
~ ~ ~~,
fhlS IS to ceItlfy that the request III the above appl1catlOn and accumpan'y'lllg ducumcnts is III Jccordancc With the City Zonlllg Ordinance and rriAy proCl'cd as rl'qlll'~ted ThiS d(JCllmcnt
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Permit Valuation
I~'; 3 I. IJtJo, 00
I S I i. 3~. 50 I
S ~OS-' t;B I
(p ~. 5"0 I
.-
Water Meter Size 5/V Hja, .~'-
Pressure Reducer ~ ~ .
Park Support Fee
SAC
#
#
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechal1lcal Permit Fee
s
s
Sewer/Water ConnectlOn Fee
#
#
S /00, Of)
S /OD. 0 D
s 35", s-o
S ~O. {)f)
Water Tower Fee
Builder's DepOSit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTAL DUE
Tlus Application Becomes Your Building Permit When Approved
~~
3/ z.../ /0(.
ll11tldlll~ Ultiel<li
Dale
P]ann~ng Director
Date
,
Special Conditions. if any
2-t hour notice for all inspections (952) -t-t7-9S5n. fa, (952) -t-t7--t2-t5
16200 Eagle Creek Avenue Prior Lake. MN 55372
$
$ /5 <E;o ~ ('Jf)
$ 32.5".po
$ I~ e ()
$1S0(). a-o
$ /oO(j. 00
$'/,500.00
$
......"-
I
I
I
1$8.3&/. /8
,
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R.2 Districts
Reviewed by:
Date:
Building Permit #
Address: /1 d "3 ~ 'I tJ, '-12 I
Legal: LI~ 1~.15, B I
I'I/IS
Existing Structure? YES /~
PID: Zoning:
'i ~ 'I" P /'rYZ IL VI ~-iJ L.~c ~ W ~ ,'~
Subdivision: 91~ ~~ /f't'
Existing Nonconforming Structure? YE~u
CONFORMS TO ZONING
ORDINANCE
eyES!)
I Yard Setbacks: NA I FAIL~OMPLJ~
· Front Yard (can be 20' if avg. wlin 150')
. Side Yards
Standard
25'
10'1
25' if abutting a street
· Sidewall exceeding 50' requires additional side 2"
setback for every l' over 50' in length
I. Rear Yard
· Patio Door: provide for minimum 10' deck or sign
statement indicating no deck will be built in the future
· From 100 year flood elevation ofwe.tfc:md/NURP
pond
· From OHW (Prior or Spring Lake)
10' setback +
2"/1' over 50'
25' .
1 0' sidel
25' rear
30'
75' or setback average of
adjacent structures, but no
less than 50'
, Floor Area Ratio: NA I FAILStdt5MP~
.30 Maximum
Yard Encroachments~ NA I FAILS' tc'OMf't.J~
, .Eaves ami Gutters no. more than 2: feetln width and': no
cfoserthanSfeetto a lotlrne (Easements)',
AiCand!:other:.equipment cannot encroadtoninterior '
sfde.:yard~i.
Standard:
J rreepreservation(MI FAilS f COMPLJES
I.. Totafcaliperfnches
[. Permit25%' Removal
I ., CaliperJrrches Removed
I. · . CaliperJnches Preserved
I., Replacement
I:'
f
,
Standard
Yz:1
L\TEi\tfPLA TE\BLDGLlST.DOC
NO
. .,
-----.--_..-.
Proposed
2.'(' 1f2 ~~. (PUD'l.O/Au.o/iJ~
'., ,
5.35 ,
I Z5. 3, ~.~~..'
5. "jd'f I..';'::'~.;~&~ Ie (!, &.c:-
o ~'.-; ~:,at~:iE':~-"
, J. ..
tYA_
f Se:c 4I24RH/~-
~,~Si~' ::.>,:~~;~-~~~;~~{t;~:':/~_~
"
Proposecf,~;{tliq.~",< 1
PropC1secr;:,~~itq ~.)
\ .
.-
I~
~
I Driveway: NA I FAILS (COMPLI~
· Maximum wIdth at property line
. Required setback
I. Maximum slope
· All parking areas to be paved including R-Vor
spaces adjacent to the garage
I. Location to match subdivision grading plan
I Building Height:( COMPLIE~FAILS
--
Shoreland District: NA I FAILS I COMPLIES
Minimum lot area (square feet)
I Minimum lot width
I Shoreland alterations
I Impervious surface
I Bluff in Shoreland~ FAILS I COMPLIES
. Setback from top of bluff
I. Bluff impact zone
I. Engineering certification submitted/approved
I. Grading in bluff or bluff impact zone
Floodplain: ~,i)1 FAILS I COMPLIES
. 100 year flood elevation
. Lowest floor elevation
· Proposed lowest floor elevation
. Elevations 15 feet from structure
. Road access must be no more than 2 feet below
Regulator; Flood Protection Elevation
I Accessory Structure:(N~1 FAILS! COMPLIES
I. Size-
I. Not located in front yard (Materials)
I. Side yard and rear yard setbacks
I. Maximum height
I
I. Materials comoatible with princiole structure
LTEivIPLA iF BLDGLiST.DOC
Standard
24'
5' from side lot line or
30' from r-o-w on corner lots
10%
35' Maximum
Standard
7,500 Rip, 7,999 Non-rip
50' Rip, 57.3' Non-rip
30% Maximum
Standard
By planning dept.
20' From Top of Bluff
By City Engineer
No importing/exporting
Standard
908.9' Prior lake
914.4' Spring lake
909.9' Prior Lake /
915.4' Spring lake
Must be l' above flood
elevation for new and existing
structures. If existing
structure was constructed
..- ....-- ..-.--
9/1 9/90~ 11/22J97. then'.
additionaf footTsrfbf'requfrecf:
Must be flooet elevatfon.:or
-higneY
907.9! for Prior lake
913.4' for Sp-tfrig"CaRe
I Standard
I 832 sq.ft. or 25% rear yard
10'
15'
Proposed I.
t t. · I,
<Y'h....
5'".D. &.{.~ 1c.3 l/"S-to,l~
- , , ~ ,I
Ok-
dh-
2...,'
Proposed
;....,.
(0 vc.-n.. ) n'e1L.:y 'TO TO- (s .
Proposed
""\ K OF '--''']
-~vlaln,~l ,e
rWhite - BuildinQ::>
"--CeI.,a. 'i - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(V--'-'J/)i,.) vn a ).t--/~
3~3-0~)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I t-l~ 0 f? 'j) {)./J0--i:.r2L~/ LIL/
Accepted
Accepted With Corrections
/
Denied
Reviewed By-r ~
Comments:..KcRd ().....{,f
r
~
~ (' IlL) ~
~ '-'0 ~ ~ Y-k-
Date: 3/z. ( ~"
, -
~
IJ
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."
Main .rIle
White - Building
~ry - C "neering
, - Plannin
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections
/'
Denied
~~
Comments: fJ~ ~ A7/:"" 4 I' ;Yf
.J~, ~ a-U ~
trl ../. ~ ~ ~ ~ ~ ~
~ ~;/~. All ~ ~
II/,lf /~ ~ ~"L/
,~ ~ ~
Reviewed By:
Date:
:J' /'2- / /0 ~
I
~~
j..)tJ
-
~
"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."
Main Fi~_e
White - BuildinL
~~anary - ~n!l'neerinlD
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/L}-I21'1.<.) vn t:t:/ /}{/),
3-3--0b
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
11-/;), 6 &' ? aJf.L I , ~--U L jt/
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
m1~
Date:
]-10-04
Comments: See Rev..er~p Sirlp. for Arlrlitionallnformation!
1I1~(~ h'le. r
.I 1 ,
See Attachments: I )'Gra.ding Plan, 2) Erosion Control Measures
"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."
03/09/2006 TIlU 12:36 FAX 952 767 1900 GENZ-HYAN
@003/037
rt PRlo
~~~
~'N"'ESO~t-
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(.Please type or print and sign at bottom)
ADDRESS
ILld\'~X
1. Blue File
2 Gold Chy
1 Yellow Applicant
II'ERMIT N~ . I i4-r-
t~(tvf<V( [GU
L-n.
ZQNING (office use)
LEGAL DESCRIPTION (oruce use only)
LOT
BLOCK
ADDITION
PID
~~e~R lUPYl~YYI(}J\n -+--\Oy~S (Phone) Ltf5J4L~):'j /Cf1
(Address) I Y'Q5 P )(]7tL,Dr -ff,'](i) 1~:71a(]Jl Mf'd 5G/:;);)
. J .
APPLICANT (......, . D( (f '
(Name) Ot/112- - ...-lil Ch1
J .
J cj '. - '^ J I'
(Address) ,.~j-U() I; v. d\,\! Cj_
(Address) _
(Contact Person) KII~
APPLICANT SIGNATURE f.-~
L3
C~I c.---2 -iI j-'--' (' (:) (,..)(~",
(Phone) .") ~- IV/ - _ _ J
DCtlll.1C,V I (It, M N
(City) (Zip Code)
(Phone) Cf5l~ :-707 (O()O
k-?;J flAUlJ?c DATE () /q j({1
I ~-~
/-z--r-;'7 -
'--. --..., ,"- .' '"j I
../ ./c_)v
-,
APPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture
\ J).. I Bath Tub with or without shower
) I Dishwasher
I Floor Drain
~ Lavatory (Bathroom Sink)
II Laundry Tray (I or 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
c2 I Water Closet (Toilet)
Quantity
3
I Type of Fixture
I Rough-ins
I Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
lndustrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, Ncw Onc & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Pennit t!
PLUMBING PER1\1IT FEE $
STATE SURCHARGE $
TOTAL PERl\fiT FEE $
.50
(Orfi~e Use Only)
This Application Becomes Your Building Permit When Approved Paid
-PAlO WITH
Bi 1H.'PlI~lr;.~~F,lMn
, .,,-' e elpt I o.
l
I
I
Date
By
Building OmeiaJ
Dale
24 hour notice for all inspections (952) 447-MAlira:t (2524" ~.rh4245
03/09/2006 TIlU 12:36 FAX 952 767 1900 GENZ-RYAN
[4) 004/037
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Dnte Rec'd
(Please type or print and sif;n at bottom)
; ~'::n ~:~ I PERMIT NO.', ."~".JI
3 Yetio,," ^rr''''^' U I TJ
ADDR, ESS 0
ILI~~) D
)/lV-1< \/ It UJ 1- VI
ZONING (O([lCO
use)
LEGAL DESCRIPTION (officc use only)
LOT
BLOCK
ADDITION
PID
OWNER II J/J'nC1n/1fl n (, ..-f'--)n"mu
(Name) /\. L-.l' \1)1 r ~A I
(Address) l gq~ PfOZtlL)V. ~1r2W
(phone) (J5/ ~ {j{J5 - ]It{1
f?tgaJ7 J tL1 AI ~J:5i:)d
APPLICANT (-"f'''' n I
(Name) '-/1 vi' ,'{- I<~LILU'J_m
j
(Phone) CV)~ ~7 LiF? " I COD
(Adc1ress):AXO UJ, t'-tllJL:) r '3 BLlynsvi lie ~J5'3-'~)-7
./ . (Addrcss) (City) (Zip Code)
- /" 11\1\ -2..Jc-",;-~ {/i Cj '7/ "'7 / lVi' ,
(Contact rerson)_~=~_L ) , __,_(Phone) '_ ,",/l-<"1tf /~)c;t-.. -' (1/)'1 GV )
_,,"PLlCANTSIGNATURE t-+iin ~:~t)AJ __ DATE. I3iq/(j/
/ AI~PLlCANT :iEASE COMPLETE BELOW
C6Jt1EW CONS-tRUCTION P REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL .(?~ltjV)O L(I) I ~VH~: .~I cEx Cf10 FUEL (YlutJ)fJ5___
fLUE SIZE RETURN OPENINGS ~'1.-I INPUT gg()UJ OUTPUT?j(jCrUlJ
TYPE OF SYSTEM
~1SlWarm Air Plants
[]Gravity
i:J:Mechanical
~ir Conditioning
w-1.cnl. Systcm
I-lEA TING OR POvVER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Othcr Dcvices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Jndustrial, Commcrcial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
S39.50 minimum
$99.50 Residclltial, Additions & Alterations
$G.UO Residcntial, AC Only
539.50
Residential, Heating & AIC (New Constnletion)
Residential, Heating Only (New Construction)
'>3950
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
.}
.$
.50' PAID WITH
BUlLOH'~G PERMIT
(0 fncc Use Only)
This Application Becomes Your Building Permit Wilen Approved
Buildin~ Offici~1
Dn(c
I Paid
Date
MM{
~ ; 1-1-
t ,)
I Receipt No.
I l3y
I
'j
24 hOUI- notice for all inspections (952) 447-9850, fa:.: (952) 447-4245
DEPARTMENT OF Mail) File
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS /~ Z,J8 f!A~ t1D.J t.I'fAJr ~ W.
NATURE OF WORK ~ ~.,.J'Jr: ,~,.",. fl:tNl1ff!' ~ No fblte,H
USE OF BUILDING . ~I=: A, ...
PERMIT NO. ()~. O/7c./ DATE ISSUED ::Jla.l/,. .
CONTRACTOR ~f~,J Ht_n ~. PHONE~ - SCf
NOTE: THIS IS NOT A PERMIT FOR P.NY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING )/l/IP -.l -1. )-,0-v:L
J FOUNDATION (Prior to Backfill) r l/0/:' I ,4/;-Jl:)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
Ll (< r Ifn 8~~t~ ROUGH - IN~ '
SEWER I WATER I SEPTIC 5U"'~"i j)~. rJre3/t;--"
FRAMINGl (I f1
. INSULATION t..Jc,. 1/5 ~~
ELECTRICAL _ A ,I I _ ~ J
PLUMBING ~0. //f0~;:'6 rl' s~.Y1~
HEATING (if required) I If~
FIREPLACE I
GAS LINE AIR TEST
I
I ~ fUl, /"l~
I r I
I
I
l ~/(,;~
I - ~
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
Jt.l'frH~"tJJ~ MJ','jjPJ tl%j~ I
<v~\;,,\\~v\ FINALS
GRADING (Prior to Sodding) li.Ji/ 7)r! J U
BHILDING ,I \1
, . '" I
ELECTRICAL I,
PLUMBING It) c. It;) U'd1.
HEATING Jl I l1
DO NOT OCCUpy UNTIL' ABO ~' HAS
NOTICE
~\~\~
I
.I
I ~\\S\~~
BEEN'SlGNED
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 availabl~, card shall be placed near main entrance.
FOR ALL IN~PECTIOf\1S (952) 447-9850
,', '.~ \~". .., '..-~
.... .,,,,. " ---.... ~ ,.;., y., -,..; '~T ......~..,.A' -;""'. .. ._
@~rfifitctf~ llf @ttupant\!
CITY OF PRIOR LAKE
~:eparftutuf nf ~uil~tUB JI uspttftnu
k(Final Pennitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 11 0 of the 0 Residential I 0 International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
Use Classification .s / /v Cj L t: ;:::,q /0/ L V Bldg. Permit No. () (". . () /74:-
Occupancy Type
/::3
Type Construction
VN
_ Zoning District
PfJ~D
Legal Description _ L /5, t..: /, JE.. F F 6;:::.5 ,06 /J 0 / ~T /) DO N.
Owner of Building Site Address / 4Z~f3 /.JAKK-VI6t.V LN.
Contractor's Name & Address It 6 /15/' /n IV /../ /JI.CifTl E-.S
/r!..QI)FJc.T 0. 1-/t/7C-fll IJ'::; (.j//!-/City Planner j fiNE I::::..AtJSI6R-
~(: Building Official V V
Date: :.1 I q /'. (1 Date:
I I '/
I
..
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7-l1""~
ADDRESS
1'i2J ,a f,~ /L.. V I ~ v L..,
OWNER
CONTR.
W~Nl
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ fll4AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~Y.~C:IlLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
br-1j~ - r-J t
Cu! 10 &~".~ - 17(_-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:~~ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
conE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/iOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7j;J~
TIME
ADDRESS
J 4'7 s~ eC:::.v,'-e...-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
& - [71
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~~R HOOKUP
~ ~.':.~.BING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
J.~~~~
o WORK SATISFACTORY, PROCEED
)('CORRECT ACTION AND PROCEED
o CORRE7J/lO LL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL L 7- 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
if .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
(j2ku t'~
ADDRESS
I LrL ~PJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o ~SULA TION
,i!f FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o YLUMBING FINAL
".ff MECH FINAL
COMMENTS:
I.. C),'C~~~t
~ ~+ (~
L-
l').l,~ ~ C
f
le?
DATE
Cf/'~n&
TIME
(p - 17Lf
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
,..8""GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
A. CORRECT ACTION AND PROCEED
o CORRE~LL FOR REINSPECTION BEFORE COVERING
Inspecto ( (/ { Owner/Contr:
CALL J;98SJOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI