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Home My WebLink About1986-6165 - addition CITY of ORONO _ ,_ _ �3uilding Permit PERMIT NO. 6165 ' AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED � P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 ZONING�DIST ICT (�� r�` �n � � r- i L_ SITE ADDRESS PROPERTY IDENTIFICATION NO.(PID) � ""' FIRE DEPART EN� LOT BLOCK SUBDIVISION POST OFFICE ,� OWNER (Name) (Address) (Phone) >-- 3�3�� r�v�f�rl C�l� � VAR. DATE AR HITECT/ENGINEER- Must Certify Multi-Family,Commercial& Industrial Construction Plans ' (Firm) (Address) (Phone) COND. USE DATE � ,,,�_ ( �� l' `�] �� `7"� �l / LOT AREA BUILDER (Firm) (Address) (Phone) 2� �iC' �-�' - � , _ �5 ' WIDTH DEPTH ` ' � � �� TYPE OF WORK New Addition Remodel Renovate . PROPOSED SETBACKS: FR � I3. SIDE ��y- �{�y� CONST.TYPE BUILDING SIZE i��l. ��'� RE R �( L. SIDE Estimated Construction Valuation ! �V � ' `-�\ L Z W. �,�.�..� Ht. �.5 .� LAKE WETLANDS � � � OCCUPANCY PERMIT FEES CLASSIFICATION ACCESS DWELL STORIES B �7 2 3 BLDG. PERMIT Z�• J� UNITS STATE FEE � • �v NEW EXISTING GAR.STALLS NUMBER OF BEDROOMS c� AGENCY-AP . q�J PLAN REVIEW � f � ZJ CITY DET. SEPTIC APP. DATE SAC CHARGE COUNTY PROPOSED USE SEWER UNIT STATE PARK FEE PENALTY PRIVATE EASEMENT COUNCIL APP. DATE OTHER TOTAL DUE � . -��"' REMARKS: WORK REQUIRING ACKNOWLEDGEMENT INSP ION REQUIRED SEPARATE PERMITS . . . FOOTING before pour THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE . . . FRAMING rough-in PLUMBING ......................... THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES . . . . INSULATION MECHANICAL....................... UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- . . WALLBOARD before taping ANCE OF ALL INFORMATION. CONDITIONS AND REQUIRE- . . . WELL............................... ❑ . . . . . . FINAL before occupancy ❑ . . . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- WORK BEYOND OR WITHOUT A RE- SEWER.............................. � SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES ANO STATE JECT TO PENALTY. WATER.............................. ❑ OF MINNESOTA BUILDING CODE REQUIREMENTS. GRADING& FILLING ............... ❑ INSPECTIONS MUST BE CALLED-IN 24 HOURS IN ADVANCE. FIRE................................. ❑ �—�,�G Signature Date COPY:WHITE-FILE GREEN-FINANCE CANARY-INSPECTOR GOLD-RECEIPT PINK-ASSESSOR Approved ��/��/it�y of Orono Brooklyn Prtg.&Adv.Co.Inc. (612)561�4470 /' • . ci��Y oF o�or�o � : , � I3UILDING PERMIT APPLICATION EUILDI[JG PI:RMIT APPLICATIOP REQUSRF:N£�7T& ,, � _ �- i Requiremente to bo hnnded in with Duilding Permit Application: Con3tzuction Plans nhould include: I 1. Building Permit Application - to be filled out i aigned. 2. Energy Calculatione - filled out. 1. Pirst floor plan. 2. Footin and foundation lan. � 3. Purnieh Septic Report i Deciqn. 9 p a. Purniah a Certiflcate of Survey, includinq hardcovez 3. Elevationa (of all sides), calculationa and grading and drainaga plans aa requized. �. wall sections 6 croas sections. 5. Fuznish 2 sets of Construction Plena: 5. Details - Btaire �nd any special connections. o) 1 set foz City to keep on file - b) 1 eet for builder to use on eite _ TB$ ABOVS IEJFOF2MATIOP7 MUST SB SII�NYTTLrD BESORH PLAN RSf/IEW I3 DOY7S Work Seyond or without a required inspection will be subject to a penaltyi ZONING DISTRICT SITE ADDRESS 1 7�� +�hnral i nP l�ri va Wa�» h4T� � � � � r rc�tr3r- �` PROPERTY IDENTIFICAT60N NO.(PtD) �_� <-�"� � �� - ;� 3 ` L �I - L C%�'� FIRE DEPARTAAENT / / LOT BLOCK SUBDIVISION [.� , G+ r POST OFFICE �� . OWNER (Name) (Address) (Phone) MR. & Mrs. Irwin Jacobs 1700 Shoreline Dr. 337-1800 VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family,Commercial 8 Industrial Construction Plans — (Firm) (Address) (Phone) COND.USE DATE _ Cradit & Associates 9th & Miss. River 379-4947 BUILDER (Firm) (Address) (Phone) LOT AREA ,� ,�.� .4 c -�- Jensen Homes Inc. 900 E. Wa zata B v 4 W10TQQ, DEPTH QO r TYPE OF WORK hlew Addition Remodel Renovate . C 8 PROPOSED SETBACKS: AddltiOri ' FRONT i R.SIDE Op ti � /ST!!U(� CONST.TYPE BUILDING SlZE Estirnated Construction Valuation REAR � L.SIDE � y3� � L 42 W 42 Ht• 1 75 000 . 00 LAKE WETLANDS I t � STORIES B '� 2 3 PERMIT FEES �� BLDG.PERMlT �fsO •SO ACCESS New xisting DWELL. SQ. FT. 1 7 6 4 UNfTS STATE FEE �• Sd AGENCY: City Cty StatQ I GAR.STALIS NUMBER OF BEDROOMS qT7, PLAN REVIEW � �� ` ��-- DET. SEPTIC SAC CHARGE APPROVAL DATE(S) : APP. DATE HARDCOVER PROPOSED USE OCCUPANCY SEWER UNIT Exieting 8: �o/ � , CLASSIFICATION Psoposed �: C l�' i PARK FEE PENALTI' GRADING COutvC�� Staff App. Dat /N �2 OTNER ��CUP Apn. Date APP. DATE TOTALDUE � Q/��s REMARKS: INSPECTION REOU�RED �'1�ORK REOUIRiNG S[PARATE PERMITS O......FOOTIN6 Oe1or�Dour ❑......fRAMING roupRl� PlUM61N0.........................❑ ❑......INSUTATION MECHANICA�...................... ❑ Tho undersigned hereby mAkea Application for a building 0......wauoo�aoe.��..�oo��o . ezmit for thQ work deacribed, a 0......r�ron�aro�.oc��c.�r� ��'�'� '�'��"��"'�'�� p grees to do all work in stric accordnnce with the ordinances of the City of Orono and rulir ❑......bITEINSCECTION EEPTic..............................� of the State IIuilding Code Division, nnd declares that ull WOHK DEVONO OR WITNOUT A RE• �+EWE��•••�••••••�•�••••••••••••••••� facts and repzesentatio statedi�n�e true and correct. OUIREp INSPECTION WILL BE SUO� yyqTER..............................❑ �j JECT TO PENALTY. � OR�1D�N0�FIllINO...............❑ ?4 N UR$NgAOVANGE. CALLED-IN i1RE.................................❑ 9-8-8 6 . Date gnature . �� D CIiECK OFF LIST FOR ISSUIINCE �� ' 1 ��\ J � ��`.M,'Si+'.._,"Y"�'.�Y�.�. Address : _ _ � �� n� � Initial Area of Review , Remarks �!' '\ , u �� BuilBing Code Review �-�� '%�`" ,�� Zoning Review 8� � �, l2 . -- Access � a) , State .� b) Hennepin County . � c) City (Public Works Dept) � d) Private Roads � (Publac Works Dept) . Utilities (Public Works Department) / a) Sewer ` / b) Water �_ Septic Review MCWD • LMCD __� Special Grading Review �_ Engineer' s Review � Attorney's Review �'`� Special Assessments Things to be noted on the permit: �JAM �TJJ MPG � JRG � DMH � I �T. r � .. . :♦ _ r;� . i , � ' )� 1 ` .. `�,�� eFl�'� �.Y` �� .�,�'',, +�'�.,$ (�I'1�'�' Of OR011T� � `' �`��s� „,"g:� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices 0 9 y ��:^ �.d,..r . 4r��,��r#�3�`� On the North Shore of Lake Minn.etonka �`:�� DATA PRIVACY ADVISORY In accordance with t�i.S. 15. 165, "Righ�s of subjects of data°' , we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential inform- ation. You are notified that: � 1 . The information you furnish will be used to determine your qualification for the permit or license requested . 2 . You may refuse to supply data, but refusal may require that the City deny the permit or license. 3 . The information may be shared with other local , state � . or� federal agencies to the extent necessary to process the permit or license. , 4 . If your requested permit or license reqires council action to approve, same information may becom� public. S . Xou have certian rights under M.S . 15. 165 to review private data on yourself. ' 6 . Your ful.l. name, and date of birth are reguired to process this application or permit. Fir Middle L t ress ,/ �y8s �,� - Date of birth (do�s not apply to buil.ding/gen.eraZ permits) 7S- �.,:t�L Phone I understand my rights as stated above, X i�� ignature BUILDING& ZONING—473•7357 • ADM[NISTRATION&FINANCE—473•7358 • P[IBLIC WORKS—473-7359 ASSE?SSING �� • • 379-4947 crad�t a �.sociaee., �nc. YIA��Ibl�y n.�.mpl�,minn.66�13 � - ;� , "srchitsctunl d�afyrnn of out�bn n ort»s �� _: . � EXTr�tIOR ENVEIAPE AV�tAGE "U" COMPIITATION � OWN.F�t '�IZ-� I'2'.�i�., �C.-O��`' PLAN NO.�'r_�`�,"`�Z, SITE ADDRESS DATE . ��J /;�,�, CONTRACTOR --�l,.i:�.:; _` ;-�'"J+._�t�; !:- < • PHON� Determine working square footage of each 1. Total exposed wall area...... �1 �Cv.J sq.ft. x .� _ �Q � � 2. Total roof�ceiling area...... ��Cc�-� J sq.ft. x �� ;, �� r---a 3. Total floor�cant. area....... .---- sq.ft. x = �!� Total exposed wall area above Ploor �{`��•(� 'd• TOt.81 Wgll W�YIC�OW area..� �� • ��`ti�� ....� b. Total door area.............................. •�3. � c. Total sliding glass door area.... ..... ...... . — d. Total fireplace wall area.. ................ .. — e. Total wall framing area (average 1046)........ q�. t� f. Total net wall area above flonr.......... .... r'9'R.?'4- g. Total rim �oist area...... ............... . .. .. - Total exposed fourdation area 4�� 0 h. Total fourxiation winduw area................• --` i. Total net foundation area above grade.... . ... �� Determine "II" value of each wall segment a. %'?�-, �� x "U" , �'S = .�l� ,� b. �"S�, x "U" , I Z f� = c� , :Y c. a "U" _ d. x "II" _ e..��A:Cn X nUn ,D�o`l = ,�� ' b 1 • rT�,T. X nVn ,�7� = c' c— g. x "U" _ h. x ^II" _ 1. x "U" ��f Cc = �,.�� 4. ...................... ............. Tota�' _�� If item #4 is the same as� or less than item �1� you have met the intent of SBC 6006(c)2. � i .�.,,, .. ,. 3 i� � .. �� - ' ; � s � , . � Total expos�d rool�wili�ag arsa �1�o�-,d �; �. Total aiqlig�t a�a..................................... � _... k. Total rpot/o�ili� � as�ss (a�r. (.�,0�6"o/c}. ... '' (.t�2�4No�3... 1. Total rrt inaulat� root/o�ilimg ar�a.................. I�St• 'l� D�ter■ins "D" valt� tor sa� roof/oeili� a�t �• � "ti" a lc. IIo. 2S' x "U" .D2S' _ c 1.l��s�s__ x "U" . oZ 1 = , 5. ................................................. Total = S 7, °f4 If total of #5 is the same as, or less thsn �F2� yan have mst ths intent of SHC 6006(c)�i. Total eacpoaed floor/oant. arsa m. Total floor/cant. t� ar�a (averag� .10¢)........•• n. Total net inaul.�d floor osnt. sr�a.................... Dsterdins "0" valus for eaoh floo�/cant. as�t m. x "U" _ � A. x "0" _ � . ,• � 6. ................................................. Tot,al : If total of �6 is the sans as, o� lesa than �3, yan haw mst the intent of 3BC 6006('c)3. � : 7 AL2EE�NdTE Ht1ILDIt�Tti DIYELOPB D&SIalt �� To utilise the total envela�p� ayetem arethod, ths valuss est,abliahed - by the sum of itesa #4, �5 and #6 ahall � bs greater that► tbs s�m of itema �1� f2 snd �3• � 1. log.�I'co 2. `�`��"��co 3. __ �.Is�4 •3 2 _� 4, 113•52 5. 3� -�9 6. �i y ° °�sfl , �' n�=-- Prepsred by S_ � � � � Dat� 1/��(o � � # " � T � Y . � � � ,: � � �-----'__' --- � . ...i_._ ` � - -.'--'-�I'_'" ----- ------ ----- . ,�,� € � � � TF�U 3TUD �Int.�Air .68 TfiRII INS. W1L� Int. Jlir � 68 ;� . a� �/ S.R. � SIDIDK� 1�2" S.R. .�5 �/ 3A. d� 3IDI1TG 1�2" S.R. .45 '� AtQ; . �8 � Ai�.. .�� st�l �.��j _ � � r,�. 2�,o � ' z5/32" Bild. 2.06 � /�'t" Bild. 2.06 �1 �4l CL- ,G � �t 2, co'U i s�� , � � , � 5 s��r,g . �I- 4 bct. Air � r �ct. ai.r � � �! Total "R" _ ��,S 4 .Tottl "R" = 3 Z. I ce !I • � � _: ,i 1/8 � "D" _ , ' �' 1�A � w�„� �_ ,0 3 I � ;., �: __ .__.�.,.-�-�---------- � _ _ ... _ .._ _.__ -----�-- ------ : THIiU RIM Int. Air .68 T'HRII CW� HLc)ClC Int. Air .68 JOIST �a� � :C.B. (' '�' �) � , I I ? � ; � � ,, ; Opt• Styl'O• � � ppt• �na• �I, �_.�. , , � 1 1�2" Wood 1.89 ,. v ESct• Air •1? � --_:�= 25/3z� ei�a. 2.06 � � �'6 . �. s.a. . 4� � I'�._� � f ��t . S� I G , � x, �� ; ��u� � '�'� 4 � -� - : , F�ct. Air .17 0 = % :�otsl "x'� = lo �3� { Opt. Brick 1�R = ��w = •� � Total "R" _ ' � 1/A = "U" = � � � � • P� - � i :� _- --__ .__ _. ..__ .. .. ----- --.'._"--- _---- ----_--- - =- -- �' THI�U CLti. Int. Air .61 THiiU CLG. � Int. a�r .6i � '. � � ��t s•8• �.�"� ,c,� IlLSUI1TIWT ;. �.R. (/�~) .S'Zo ;� � C�. ��b. 4�� . ( ")� �5:4� + � ! , �i! ;� ;, � �• �' "); 3�Fron Still oir � � , � i , , _ � , � ' .�1 F V l,�� Still Air � # ; Total "R" - �{te,713 � ' �l l a Total "Ii" _ �d,13 � � i r Y � 1� N� _ ��Z� g .. � �: 1/R = "U" _ ,c�2 S' � � i � � � � � � ,., � �, � � � I , � ��,, j� � DATE �y/ �. O CITY OF ORONO �/C/��` CALLED IN � �0�b� INSPECTION NOTICE SCHEDULED � PERMIT NO. �� COMPIETED ' � _�� ADDRESS �b� ` .r � OWNER �ie�(� C CONTR. - �T LEPHONE NO. �f�S-��'S�8' FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION ❑ FRAMING ❑ PLUMBING FINAI ❑ EXCAV./GRADING/FILLING � ❑ INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS � ❑ WALL BD. O WATER HOOKUP ❑ LICENSING � ❑ FINAL O METER SET/TURN ON ❑ COMPLAINT Q O PROGRESS D SEWER HOOKUP ❑ FOLLOW-UP y ❑ OEMOL ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL � O FIRE PREV. O SEPTIC MAINL � FIREPLACE/WO00 BURNER Z ❑ WELL TEST PUMP O = COMMENTS: ��`� - �� W 2— � � � lV� orc., — Lt C V�oT o y ��1� � _ � o i +/�. �� [�t 1 � • � W a `� � ��S� 6US � O � Q � Z W � W R � d W � QW rJ WORK SATISFACTORY:PROCEED O PHOTO TAKEN O CORRECT WORK 8 PROCEED V ❑ COFiRECT WORK,CALL FOR REINSPECTION BEFORE COVERING � CORRECT UNSAFE CONOITION WITHIN HOURS.INSPECTOR WILL RETURN. ❑ STOP ORDER POSTED.CALL INSPECTOR. O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance. Owner n si :� � 473-7357 � White/Inspector's File Gnary/Site Notice �/ DATE T ME CITY OF ORONO CALLED IN - �C�� INSPECTION NOTICE SCHEDULEO (U t - � . PERMIT NO. COMPLETED �� ' `- •"" /Z��v ADDRESS ��U� �h�YG�� '� OWNER J c� C�NTR_ � y�.::oi7 ►`n�` TELEPHONE NO. 4� �� ' C-} �`-1� ❑ FOOTING O PLUMBING RI O SITE INSPECTION � FRAMING O PLUMBING FINAL ❑ EXCAV./GRADING/FILLING � ❑ INSULATION O MECHANICAI ❑ LAKESHORE/WETLANDS � ❑ WALL 8D. ❑ WATER HOOKUP O LICENSING k! ❑ FINAL ❑ METER SET/TURN ON � COMPLAINT � ❑ PROGRESS ❑ SEWER HOOKUP O FOLIOW-UP y ❑ DEMOL. ❑ SEPTIC INSTALL. O SEPTIC FINAI Q � FIRE PREV. ❑ SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER Z D WELL TEST PUMP O Q COMMENTS: PR�-�w� ��v� ti � ��- IC(I�'� W _ �v i �,— CL�1 z s`�/�� `'� 0 � a Z �S ��t 5 �- �'+►2�►`1� � � � (�� l< �P � `' ` O � W � ' -� aJ � � Q � z W � W k � d W � W WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN � ❑ CORRECT WORK 8 PROCEED V ❑ CORRECT WORK CALL FOR REINSPECTION BEFORE COVERING '� CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN. ❑ STOP ORDER POSTED.CALL INSPECTOR. ❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance. Owner/Contr. on site I nspector 473-7357 White/I�spector's File Canary/Site Notice i /� � DAT TIME CITY OF ORONO CALLED IN � � �:=r INSPECTION NOTICE S�HEDUIED �' � � PERMIT NO. COMPLETED /t�j �� r?"=`�� ADDRESS 7OO ` � OWNER CONTR. TELEPHONE NO. ,�FOOTING ❑ PIUMBING RI O SITE INSPECTION ❑ FRAMING O PLUMBING FINAL O EXCAV./GRADING/FILLING � ❑ INSULATION ❑ MECHANICAL O LAKESHORE/WETLANDS � ❑ WALL BD. ❑ WATER HOOKUP O LICENSING � ❑ FINAL ❑ METER SET/TURN ON O COMPLAINT Q 0 PROGRESS O SEWER HOOKUP O FOLLOW-UP � ❑ DEMOL ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL � ❑ FIRE PREV. ❑ SEPTIC MAINT. O FIREPLACE/WOOD BURNER Z ❑ WELL TEST PUMP � 0 = COMMENTS: � � � � Q /� = R�1(�— D c,� f� � Q ° C� �5 �i l�([� � W a J C O a � O � W � Q � Z W � W � � d W � W ORK SATISFACTORY:PROCEED O PHOTO TAKEN Q CORRECT WORK 8 PROCEED ❑ CORRECT WORK.CALL FOR REINSPECTION BEFORE COVERING � CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN. O STOP ORDEFi POSTED.CA�L INSPECTOR. O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. caii for the next inspection 24 hours in advance. Owner/Contr. on site I nspector 413-7357 White/Inspector's File Canary/Site Notice '' /�,�� f�ATE� TIME CITY OF ORONO � CALLED IN /�� INSPECTION NOTICE SCHEDULED d' 7` � a��. PERMIT NO. COMPLETED /D '7'� 3�•U� 1 �� . ADDRESS ' OWN ER � CONTR. TELEPHONE NO. y� .�FOOTING ❑ PLUMBING RI O SITE INS ECTION FRAM�NG O PLUMBING FINAL ❑ EXCAV./GRADING/FILLING � ❑ INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS � ❑ WALL BD. O WATER HOOKUP ❑ LICENSING W O FINAL O METER SET/TURN ON ❑ COMPLAINT � ❑ PROGRESS O SEWER HOOKUP ❑ FOLLOW-UP � ❑ DEMOL. O SEPTIC INSTALL. ❑ SEPTIC FINAL � O FIRE PREV. O SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER Z � WELL T T PUMP � ❑ Q COMMENTS: I � � � Q W 2 z / ��l�s �vP 0 � � a O-�<. -rn e J� � � O � � O � W � Q � Z W � W � j d W � W�RK SATISFACTORY:PROCEED ❑ PHOTO TAKEN " Q' ❑ CORRECT WORK 8 PROCEED C.1 ❑ CORFECT WORK.CALL FOR fiEiNSPECTION BEFORE COVERING � CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN. � STOP ORDER POSTED.CALL INSPECTOR. ❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance. Owner/Contr. on site Inspector c� 473-7357 White/Inspector's File Canary/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED �� '�j'� '�� . PERMIT NO. COMPLETED 'I� t� �S� �S ADDRESS �7C� ��U�'LZ�ti-f �2�v-�' OW N ER CONTR. TELEPHONE NO. ❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION ❑ FRAM�NG ❑ PLUMBING FINAL O EXCAV./GRADING/FILLING � ❑ INSULATION ❑ MECHANICAL O LAKESHORE/WETLANDS � ❑ WALL BD. O WATER HOOKUP ❑ LICENSING LL� � FINAL O METER SET/TURN ON ❑ COMPLAINT � ❑ PROGRESS ❑ SEWER HOOKUP ❑ FOLLOWUP � ❑ DEMOL. �IlSEPTIC INSTALL. ❑ SEPTIC FINAL Q ❑ FIRE PREV. ❑ SEPTIC MAINT. O FIFEPLACE/WOOD BURNER � O WELL TEST PUMP ❑ = COMMENTS: ` � �u' J W iJ� 2 J Z � � � � � � 0 2 3 � >. � 0 � W � Q � �7 v Z W W l,� � � d W � � �� ' �VORK SATISFACTORY:PROCEED O PHOTO TAKEN � Q ,."!`J CORRECT WORK 8 PROCEED /� U ❑ CORRECT WORK,CALL FOR fiEINSPECTION BEPORE COVERING 1 '� CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN. � STOP ORDER POSTED.CALL INSPECTOR. O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance. Owner/Contr. on site Inspector - ��-�—�� 473'135' � i White/Inspector's File Canary/Site Notice