HomeMy WebLinkAboutBldg Permit 06-0001
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
(Please type or print and si~ at bottom)
ADDRESS
14 ~hL/
A C- o-c....'o.
P~lvl'tl,V
L^
LOT l/ BLOCK I
LEGAL DESCRIPTION (office use only)
OWNER
(Name)
Bv: \Ju'--
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) Ilfl~
I White
Pink
Yellow
File
City
Applicant
NiIV
ADDITION "Se.fled ;'".J J:.rc..j AJJ;-~\'l:.."
l.,J~~
f\t''''''';-~
Planning Director
(Phone)
fL
fl:jJ;'j; JB'qr ~~
J../ c-e s:
S.- h""" VeL r
Ik.JL S'u:k ~D
(Phone) /....r:;I-LiDb-i..(l./oD
(Phone) J..\~-16q- ")q\. L(
&.l........ MAl SS"I;}.":)..
f\ile.,,,,,-
Date RI
/1.14.05
PERMIT NO. 6'0-. OOQ II
ZONING (office use)
p(JSC
PID ~5-t./3}-oo""-o
TYPE OF WORK ~ New Construction ~Deck OPorch ORe-Roofing ORe-Siding ~ower Level Finish ~Fireplace
'OAddition OAlteration OUtility Connection
CODE: ~I.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
III IV
H I
2 3
V
M
4
o Mise,
A
R
5
B
S U
PROJECT COST/VALUE $
(excluding land)
I '0, COO; Oc)
I hereby certify thai I havc hlrnlshed Information on this applicatIOn which is to the best of my knowledge true and COlTecl. I also certify that I am the owner or authonzed agent for Ihe
above-mentioned property and that all construction will conform to all eXIstIng state and local laws and will procecd In accordance with submllted plans, I am aware that the buildIng
~li:ial ca~=iLr~o~~::1lrthermore, I hereby agree that the City official or a de;l~c~;enter upon the property to pcrform nee~e; ~n~~c;):;-
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
II
F
1
1(;.3/ ()OO,OlJ
$ ,t3', f$()
$ . SC5, /,'1
$ (,,5.5'0
$
$ /00,0'
$
I $
I $
It) () . t) 0
35, !>o
J{tJ. fJo
This Application Becomes Your Building Permit When Approved
~~
l3uildlllg Ofticial
1;t,Iz.-h~
I Dltc
I
$.8 3/1-/8J
,1 I _
Receipt tIo. <"7/141 I
By ~. I
/jV(!ft67'fSc O~ ~,oe1LV/()~ ~
FU~
r Park Support Fee
I SAC
I Water Meter ~
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
/!tJ
I^'
f ]ILti/
2. Z 7"..11,::
#
#
$
$
$
$ . 76-.0(,
$/540, tIIO
$/fJOO,OO
$ 15'(J(), OIJ
$
"rH-15
1550.00
.300.0(
#
#
ThIS IS to certit)' that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner consl1tutes a temporary Certificate of Zonmg compliance and allows construction to commence, Before occupancy. a Cemficate of Occupancy must bc
~~
a/~/o S- /AttIt9ul/fFk.S' ~ t".Al-JT- Ce /~~
, . Date Special Conditions, if any !
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Distrjcts
Reviewed by: ~~ ~ Date:. !Z./z-/'O 5
Building Permit # PID: Zoning:
Address: /'-I;;'~ 1'Id.{,~1 1'1 ~G.'if /"1 ~ ')() I'~ fle. ~ ;J,t;j~t~._-
I ... - :,' - -:::.:. ,:1,.::::. "
Legal: L/, 2.:.'3/V B ! Subdivision: 1~' ~~ ~~
Existing Structure? YES ~
Existing Nonconforming Structure? YE~__~ ~m_~-~_~
I CONFORMS TO ZONING
ORDINANCE
YES
NO
i Yard Setbacks: NA 1 FAILSI COMPLIES
· Front Yard (can be 20' if avg. w/in 150')
· Side Yards
Standard
25'
10'j
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 wilr be built in the future
· From 100 year flood elevation of w~tt~nci/NURP
pond '.
· From OHW (Prior or Spring Lake)
10' setback +
2"/1' over 50'
25'
10' side/
25' rear
30'
75' or setback average of
adjacent structures, but no
less than 50'
,lit
, --~~'.",,;:
-....:
, Floor Area Ratio: NA 1 F AIL(I COMPLtES".j
.30 Maximum
f,t'u.o Seti'~
~::~~~. h:~f,:~ft-~~~,~{tI;;~:~::;~~ '
-.-- "
Yard Encroachments: NA I FAILV~"oMPLlI;SY-
'~Eavesa!'lctGuttersno:more than. 2: feet in width: abd':no
- . .' '.-
. ctoser than 5' feetta a lot line (EasementsY.
AlG:.ancf other: equipment cannot encroacfton interior .
side.:yards:.~;' '.
Stan cfarct
"
Prop" ose;.r: ;<6',;c-,:c._~ .
, '.' . Ut:T':>'~- :..;-:y~,:, f
. ~.~
'.' ~-
.'--,
-~
. -. /f'):' r'-'--.-
J Treeprese~'atio~EN~FAILS~ COMPL1ES~'~
I., TotaEcallpermches .': . .,' ,.
I. Permit 25% Removal
I .,.. CaHperJrrches Removed
I,. . CalrperJnches Preserved
I., Replacement
I'
[
Standard'
., ~.
'. <,' .;.,
+
:-:;~. c-:""<:7::::-~.~;o.?'~~tf-;'1>:~,
,_ ." C-. .',_,._:,' ,..~;.._.;__...... ...~. .
':..;;~.,~: ;.,:;'"';;'~'~-~~/i
..'....,. ..,-......,.-..,
%:1
Ie
~
.,r~
t
L\TEi'YfPLA TE\BLDGLlST.DOC
Driveway: NA / FAILS /(t(6M~
. Maximum width at property line
. Required setback
. 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(C?MPL~ES) FAILS
Shoreland District: NA I FAILS I COMPLIES
Minimum lot area (square feet)
I Minimum lot width
I Shoreland alterations -=\: ~ )
I Impervious surface (~ (I'tt... LA-)
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
Floodplai~ ~ FAILS I COMPLIES
. 100 year fiood elevation
. lowest fioor elevation
. Proposed lowest fioor elevation
. Elevations 15 feet from structure
.' Road access must be no more than 2 feet below
Regulatory Flood Protection Elevation
.--- Accessory Structure(Nd) FAILS! COMPLIES,
. Size
I. Notlccated in front yard (Materials)
I.. Side yard and rear yard setbacks
I. Maximum height
I. Materials compatible with principle structure
L: \TErvIPLA TE'BLDGL~ST,DOC
Standard
24'
5' from side lot line or
30' from r-o-w on comer 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 otBluff
By City Engineer
No importing/exporting
Proposed
lltl' -(1)
"-'d k fJ va
c;. J,_ ,. 2.: 16'''l 'i~' r ~
trl....
trlc-.. .
~I?' ed--
t
Proposed
53 . '''t'?d' .}t:nt~
Proposed
Standard
908.9' Prior Lake
914.4' Spring lake
909.9' Prior lake /
915.4' Spring lake
Must be l' above fiood
elevation for new and existing
structures. If existing
structure was. constructed ..
. 9/1 9/90~ ttl2219ttfieli:~.
additioria.rf60nsnbt'requrre(f.~ ~':-'-.,
Must be f1ood.el~w?tfqn'flf,
.~.. ]Tig.fiefc:::~~"",'" .
907.9! for Prior Lake
913A' for S'pnrigTaRe
Standard
832 so.ft. or 25%. rear yard
10'
15'
EJropOse~P;;fFf~;~;J ,.~
Iii .
,.;.~,~~~~
"
>C
.''!II'
r
.--t
.VIain File
White - Building
r:canary - Engineer~
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CI:-{J:CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
//(/ [. /115//1'-1 IV IJ
/ I. /~, {J S-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ 4- Z (.4- /)//Iz/C (/1 E VV' L--/~/.
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
IhfftS
Date:
1/- 25-0,\,
Comments: S(::e REVf~rF;e Side for Arlrlitionallnforma~i~n!
IY! tJtl'n F; I c-
See Attachnlents: 1) Gradinll Plan. 2) Erosion Control Measrifes
. - .
"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 "File
atJute - Build~
Canary - t:r'Jgmeering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
w~/IIsn,q/v' N
/1./'1.05
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4-2 &4 p;1/Z,KI//e W L--N.
Accepted
Accepted With Corrections
/
Denied
,.
Reviewed By: ~ ~. ~ Date: / I /30/o~
Comments: ~~ a.b.. ~. AID _~~~ It.
'- / P
~/''P~/,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."
lVlainFile
White - Building
cana,? - E"gi":ij)ng
(liink - Planning
''-
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:
,I
Accepted
Accepted With Corrections
/
,..,.
Denied
Reviewed By:
Tv~
~~
,..
~
Date: / ,)./~ /0 S-
,
~~~. ~}j~_n,~~
~"~JJ ..;) , ~ ~~~)
~
Comments:
.A-Jc:J
~.~
~~.
"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."
12/08/2005 THlJ 10:42 FAX 952 767 1900 GENZ-RYAN
~ 014/029
. '&,
,.~-:
.,~.
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
(Please type or print and sij1;Il at bottom)
ADDRESS' .
Lf'2{tl, PCV- s-y 0 l~~,{j~f~L
()o~1
~)~ IPERMITNO~~
API'''''''' w~
l. Pin~
Z.G_
3. YeHow
ZONING (ollie.
use)
. LEGAL DESCRIPTION [office use only)
. LOT 1-1 BLOCK i ADDITION
PID
~~~R \,\ lel'\Sn'\(i ..I'jl'l ~~DI"f"C;
1 3~ '-.'>
(phone) Lc51- 6r Or} , le/1
(Address) l ~q5 iO(CrlCL. ().r, Sk. ?DO
E-n.{1 ell" f\/1 f\1
- ..) - ,
c:::..r-f. 'J~.
,..7:.) ! __ r,~
APPLICANT (' Q
(Name) L:Terrl. - '<-.i j (J'y,\
OF)' 'I -( r ~...,/ -. / j')U~\/)
(Phone) i. (J) UI v v
(Address)~Xt) U0. t-h.UvlI3 Bw/nsvli Ie 55??>]
- , ~dress) (C~ (Zip Code)
(Conta" P""on) ua Zni(L,)L~~C fY\Ct(\ (fhone) 452- 7/ p 7 - fl.'52
APPLlCANf SIGNATURE ~ /~tn. ~rwy\_) DATE -1l jfjj 0 '5
-, APP ICANT PLEASE COMPLETE BELOW' \, I
Ji<lt1EW CONFRUCTION , . 0 REJL~CEMENT 0 AL TERA TrONS ,
FURNACE MAKE AND MODEL i.fl')(\()X {~'-IOUH -~)(PK '()')n FUEL \~(~t. 60\
FLUEsrZE RETURN OPENINGS INPUT "jGLJ()() OUTPUT ~,~oOO
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants
DGravity
o Mechanical
ilAir Conditioning
OVent. System
o Stearn
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AJC (New Construction) $99,50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
$39.50
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
t-'AUJ WITH
~tLD'NG PERMIT
(Office Us. Only)
This Application Becomes Your Building Permit When Approved
Date
I Paid
I ~~C 0 9 Z005
, Receipt No.
Buildinl! Official
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
m
\~~~J
~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFlREPLACE PERMIT
Date Rec'd
I. Pmk
2. GIttJl
). Yellow
F,I.
City
Applical1l
I PERMIT NO.Qt;.--c#)/
(please type or print and si~ at bottom)
ADDRESS
\Yd-lJl~ ~~
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER' '\
(Name) WJ~/O~ ~
\)?C1C:; pO.(" 0-0.. -0.-, i:!:-~
(Address) ~ ss.1~~
(phone)
GS'/-C/Ottr'1L/dJ
APPLICANT
(Name0l~^h:r...,LJ~iJ.o fXIA> d-- F. P (phone) ~lo3- Sfll-dSdS
(AddressL
X9CD I09.u. 0--" 1"f'_ iJ #/000 Chn/Yn..l1j1~ ,rnl'1 SS3/to
(Address) , I (~ity) (Zip Code)
(Contact Person) -f:::c\3 ~np~.- (Phone) ~CiJ3 - Sfllo--/;) IIp
APPUCANTSIGNATIJRE .t{I\A~ Ue~ DATE
APPLICANT PLEASE COMPLETE BELOW
. ~W CONSTRUCTION 0 REPLACEMENT 0 AL TERA TrONS
FURNACE MAKE ANn MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
DWann Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Stearn
D Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL ~ C~D<-I':L~ nIL
. FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
$39,50
$39.50
$39.50
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
PAID WITH
.5SUIlOING PERMIT
(Office Use Only)
Buildine Official
Date
Paid liRe~eipt No.
Date APR 2 U 2006\ ~y
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
ZOO~
HOOG H~VHV~ JI~VWO~rrv
66ZL 9L9 ~9L XVd ~9:91 90/S1/~O
MainF~ile
1'RIOR LAKE
INSPECTION RECORD
SITE ADDRESS 11/2(P 'I ~1It2-J(. y IItW tlt~e J,).I4J.
NATURE OF WORK ~I;.-W ~,..J,rA. CA.U7tJft-) (..v~4.. 1=""1i.J/r if<fl))
USE OF BUILDING S, F."" ·
PERMIT NO. ()(~, 6001 DATE ISSUED rU1..-!"r
CONTRACTOR ~ ~""ElJ li..ic~ PHONE'f'l..-5(Jf--"2Jf
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING ~,ND INSPECTION
INSPECTOR
DATE
...
, FOOTING I V'-1f/ I "5,(-0(,
, FOUNDATION (Prior to BackfillV tfl (/~t-r' P ;? ~/~..J
L / / /
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
j/ JI/I
{liP'
f/J '~~b
tit; '1./; 7 ~-h
ffJ '
(}!!?
" 7
.~/,;i(~
#181 / /IV
/ ....
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING lJ,/r\ M '1-7--0\"
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
,
/1 J -,J l~
/ d/<;->> I v v
fp /~~
, y
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
LATtlG' III ~lIrCu)1t1frJ ILaJpl'J L{ vKds I
,
FINALS
Nf-j
, - ?ff
1/. J-: 0<:,
/1 /9}" {
/ /
GRADING (Prior to Sodding)
BUILDING 'f4 ~b 8-\ 'O(P
ELECTRICAL
PLUMBING
HEATING
V'I ttf-
tuc-
I I
r /) / q;~ ~
UNTIL ABOV'E HAS BEEN--ts/GNED
NOTICE
DO NOT OCCUpy
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.
FOR ALL INSPECTIONS (952) 447-9850
".,i1(\f~:~';"If.:~':'.:of~:"..,t ,
;,.l.,'
dtnfifitaft of ~ttuJlant\!
CITY OF PRIOR LAKE
~tp:atftttenf of ~uil~ing Jf nspttfion
)tJ Final Permitted
D Conditional C.O. Expires_
This Certificate issued pursuant to the requirements of Section 110 of the 0 Residential! 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 followin1!:
Use Classification $./ /1/ t$ t..-e F,r.} MIL V Bldg. Permit No. (Jc,...lJ OOl
,
O. 7 ? VAl PV'SD
Occupancy Type. ~ Type Construqtion Zoning District
~ /rl
LegalDescription. L. T, iJ I , J5FFGIe.S P6/J.t.J
Owner of Building
Site Address I ttf 2&4- ;)/1 K..K. VI i- ? V L IV ~ .
H 0/"'/ e::s
IV€/IIS/vJrllNtV
, J I
~f)61a- v. HvJ7(!..rI/N.$J I
Building Official V v
Contractor's Name & Address
City Planne-
011 Nc lCA Nfl[;,te-
Date:
Date:
.';7-""I,;,,\"'-r~,,,"'''-~.>'
.
.
. .
\ .
. ,
$fli/ TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
Q<<,~
ADDRESS I q "LW
OWNER CONTR.
PHONE NO. PERMIT NO. o G - ()() I
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL J2l PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMME~JS:_
J.. ('4iJI tor
tv n"t )
\.,../
U~
. ,.
Cl~~
1~~
(1. ~{L)f
o WORK SATISFACTORY, PROCEED
\q' C~ ACTION AND PROCEED
/0 "C..,RREr 1 NORK, CALL FOR REINSPECTION BEFORE COVERING
'n'p< ctor, . / Qwne'lContc
~AL..L..7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'--V .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
i(~.
~) /d-\~
/l
{rrCXJ/~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 1<-\ Z (p4
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~INAL
./0 SITE INSPECTION
COMMENTS:
I. fi~ C~
~.
s.
_/ r-
'ff
Q7:::;
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
9? PLUMBING FINAL
JU MECH FINAL
,
rJ t-~a:f- r~-r
- - J
--
c\ ...,+' () +0
w~
TIME
(0 - Ot:> (
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-----
<f3 - {- fL1p
o WORK SATISFAC RY, PROCEED
o CORRE~TI AND PROCEED
XCORR T W, FOR REINSPECTION BEFORE COVERING
Inspector J Owner/Contr:
CAu/44~~HE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPEcnON NonCE
SCHEDULED
ADDRESS 111').(,1 '4~(V.'~ LYI.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
CJI'FINAL
o SITE INSPEcnON
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~/(
-
{JL6 ~ -t!>L-
DATE TIME
II-('Jd,
"".~"
~-t>>.
o<.~ILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
~.4S{
KWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:~ Qwner/Contr:
CALL '"7-1850 FOR THE NEXT INSPEcnON 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SA.J'JH i'J