HomeMy WebLinkAbout1993-005599 (mech) PEI�.�I
CITY OF ORONO PERMIT TYPE:
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2750 Kelley Parkway • P.O. Box 815 f�°�-'•�u=.�_:!-,�.
Orono, Minnesota 55356-0815 �I Permit Number:
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(612) 473-7357 Date Issued: s�_j f�j ._,.;�,_;
SlTE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: I WNER: — 3=;��r:t ; ��s�—,�.. —
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APPLICANT/PERMIT SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO APPL ATION FOR MECHANICAL PERMI'T
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
i. You may apply for mechanical permits by mail or in rson at the City offices. Applications will be
reviewed and a permit will be issued within 2 worki g days.
2. Pernut cards will be sent by return mail after a revie is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PER'�lIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical DesiAns - Compiete calculations, details d specifications are required for each heating,
ventilation, humidification-dehumidification, and air co itioning installation ir}cludin�heat loss/heat g�iu
calculation, design temperature�, equipment ratings and dentification as to type, manufacturer and model.
Data shall be presented on form provided. Identification of and specifications for water heating equipment J
shall also be provided.
4. When any new construction or remodeling is involved, a separate building permit must be obtained.
5. All work must be done in accordance with the U iform Mechanical Code/State Building Code
requirements.
6. All work must be inspected (rough-in and final). Call 73-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before al.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSE . If you have questions, call 473-7357.
Please check one: New Addition epair �Replace
'�Residential Commercial
JOB SITE: �10 c� ('�a7's��r- 6��-0^�p Zip: 5�3 s�
Owner'sName: �vY�ru: yhV�.rLiv�zo� elephoneNumber: �-{�J�j -CO;'�
Mailing Address: �i� Sv (���5�r��� R � City: De��i.� Zip: SS3�`J
Contractor'sName: c TelephoneNumber:
MailingAddress: City: Zip:
: .►
SYSTEM DESCRIPTION
I
HEATING SYSTEMS
Quantity: � _
Make: �'�v J IQ
Model: iJ(�� b ' U?�;�-U"��
Fuel: r��;�- �����
Flue Size: 3 "
Input BTUs: 7 ��c�0 �
Output BTUs: 5 f , G o a
CFM: i 2 , Cx�c�
COOLING SYSTEMS
Quantity:
_ _ _
Make• '
Model: � �
.__ _
Tons: - - —
H. Power ' ��
i �
^ <
WOOD BURNING EOUIPMENT _
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
Total
VENTII,ATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
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������ ,,.� x .0125 $ a � . � �:z
(contract price)
2. State Surcharge. ** Add the State Building Code Division �i c:
Surcharge to each permit. x .0005 $ ��'�'
� .� (contract price)
or $.�0, whichever is greater
3. Post��e and HandlinQ (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �=�s�
��'.: �
* CONTRACT PRICE or JOB COST means [he actual or estimated dollar amount charged for[he permitted
work including materials, labor, profit, and other fued costs. It is the amount to be charged to the
customer for the work done. If any material, equipment, labor, or installation are furnished by the owner,
tenant or any other party the reasonable market value of such items must be added to the estimated cost
or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ciry may request the submission of a signed copy of the actual conuact.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. F�r valuations over 31,000,000 ca11 the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do
all work in strict accordance with the ordinances of the Ciry and the regulations of the Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and conect. .
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Applicant's Signature: i'°``'`'�L � irG22 _ Date: 0 ( `I 3
Approved By: �- Date: 0 (o a3
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' Daily Range °F Cooling Heating
Area . U CLTD C TGC U HLTD TLH
. Description (h�) Factor (°F) (Btu/h) Factor (°f) (g��/h)
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Door
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Part
2
Total transmission,cooling(Btu/h) Heating �l Z . �
Description Area SC SHGF CLF SRGC SC SHGF CLF SRGH
1
N
2
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o �
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t
W 2
Total solar radiation gain cooling(Btu/h) Heating(Btu/h►'
— �nput(W) CLF IGC LF IGH
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Total internal gain,cooling(Btu/h) Internal gains
heating(Btu/hl'
— No. SHG CLF LHG LPGC PGC Lf SPGC
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Total people gains(Btu/h) heating(Btu/h►'
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� Figure 5-1 Heating/c oling load calculation form.
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• Dsily Range °F Cooling Heating
Area , U CLTD C TGC U HLTD TLH
Deuription (ft21 Factor (°F) (Btu/h� Factor (�F) (Btu/h)
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Part
2
Total transmiuion,rnoling(Btu/h) Heating L� �Y . �6
Description Area SC SHGF CLF SRGC SC $NGF CLF SRGH
, _.
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c
o �
q E ? .
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W
2
Total solar radiation gain pooling(Btu/h) Heating�Btu/h►'
- Input(W) CLF [GC LF IGH
m ,
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d �
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Totalinternal gain,cooling(Btu/h) Internalgains
heating(Btu/hl'
- Nr SHG CLF � LHG LPGC PGC LF SPGC
n Sentible �
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a Latent � People ysins
Total people gains(Btu/h) heating(Btu/h�'
�C:Cw Z 6�'
c
- CFM �T �W LVG SVGC Factor GT CFM SVLH
^,o $ensible 1.10 1.08 L�
_ �
� _ Latent 0.68 Total ventiiation and
j c Total ventilation and infiltration infiltration load
losds,cooling total heating(8tu/h�'
Coolinp Ioads Laten $ensible Totel hgating Q
(Btu/h) load(8tu/h) ���� ' /
. -� - �Not necessarily used to
offset heating loads
- Figure 5-1 Heating cooling load calculation form.
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' Outside / ��Z.'F �F �')i;��v`��*G1/1 _
' � Inside / ` °f °F
' Daily Range 'F Cooling Heating
Area , U CLTD C TGC U HLTD TLH
, Description ift21 Factor (°F► (Btu/h1 Factor 1°FI IBtu/hl
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N
2
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F loor
Door
1
Part
2
Total trmsmission,rnoling(Btu/h) Heating ���,„�
Description Area SC SHGF CLF SRGC SC SHGF CLF SRGH
1
N
2
c
o �
q E ? .
� _
S �
q � ��
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1
W
2
Total so�ar radiation gain cooling(Btu/h) Heating(8tu/h►'
— Input(W) CLF [GC LF IGH
�
c Lights " X 3.413
dv .
� o Applia�ces X 3.413
Total internal gain,coalir?;{gtu/h) Internal gsins
heating(8tu/h►'
— No. SHG CLF LHG LPGC PGC LF SPGC
Q Sensible —
aLatent People geins
Total people gains(Btu/h) heating (Btu/h►'
( (iC+s^"yz,' ,��i�
c
— CFM OT �W LVGC SVGC Fector AT CFM SVLH
0 o Sensible 1.10 1.08 �V �-3 C-��G'
q •� ��
� = Latent 0.68 Total ventilation and
j c Total ventilation and infiltration infiltration load
losds,cooling total heating(Btu/h1'
Cooling loads Latent Sensible Total heating r-
(Btu/h) load(Btu/h) ���� 'G
. � . 'Not necessarily used to
offset heating loads
� Figure 5-1 Heating ooling load ca��:ulation form.
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' Outside /--(2°F °F (�q���vt �-I�JV'L'1 �
' � Inside / °F °F
' Daily Range °F Cooling Heating
Area , U CLTD C TGC U HLTD TLH
, Description (ft�) F�tor (°F) (Btu/h1 Factor (°FI (gtu/h)
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N
2
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F�oor - �
Door
1
Part
2
Total transmiuion,cooling(Btu/h) Heating f��J . �y
Description Area SC SHGF CLF SRGC SC SHGF CLF SRGH
1
N
2
c —
o �
q E ? ,
�
� S ^�
A
� L
�
W
2
Total solar radiation gain cooling(Btu/h) Heating(Btu/h►'
— Input(W) CLF IGC LF IGH
� Lights � X 3.413
��
� o Appliances X 3.413
Total internal gain,cooling(Btu/h) Internal gains
heating(8tu/h►'
— No. SHG CLF LHG LPGC PGC Lf SPGC
a Sensible
0
a Latent Feople gains
,.��
Total people gains(Btu/hl heating (Btu/h►'
� ICiti� �-�G�r
c �
— CFM �7 GW LVG SVGC Factor AT CFM SVLH
s ,4 Sensible �.io �.oa �c, � 3>;? .y
cq Latent 0.68 Total ventilation and
j c Total ventilation and infiltration infiltration load
loads,cooling total heating(Btu/h1'
Cooling loads Laten Sensible Total heating Z c�
(Btu/h► load i6tu/h) �/�7^�/
. • r . 'NOi necEssarily used to
offset heating loads
� Figure 5-1 Heating cooling load calculation form.
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` Outside /r.�1°F °F • ��� �' �J �
' inside / °F °F
• Dsily Range °F Cooling Heating
Area , U CLTD C TGC U H�TD TLH
Oescription (hZ) Factor (�F) (Btu/h) Fxtor (°F) (Btu/h)
N � `J 'F'"L6���
2
1 .�-
E —_ _
2
3 � ,b v _ � � ,Z
s2
W i � , . � p , 5
2
1
o °� Z
, J_
E N
c Z
F E 1 �
� Z
� S � " 3 Z5 1-
Z
1 � _
W Z �v-
Floor —
Ooor �
, � .-,. .. i
Part .
2 L—
Total transmission,cooling(Btu/h) Heating 7 —
G .
Oescription Area SC SHGF CLF SRGC SC SHGF CLF SRGH
1
N
2
c
o �
� E z .
,. �
A S �
� 2
t
w
2
Total solar radiation gain cooling(Btu/h) Heating(Btu/h►'
— Input(W) CLF IGC Lf IGH
c � Lights � X 3.473
:: ,�e
� o Applia�ces X 3.413
Total internal gain,cooling(Btu/h) Inter�al gains
heating(Btu/h1'
— No. SNG ClF LHG LPG PGC LF SPGC
a Sensible
0
a Latent People gains
Total people gains(Btu/h) heating(Btu/h►'
c
— CFM OT �W LVG SVGC Fector �T CFM SVI.H
n o Sensible 1.10 � 1.08 L , �
_ a
c _ Latent 0.68 Totsl ventilation and
j .`c_ Total ventilation and infiltrat�t:n infiltration load
loads,cooling total heating(Btu/h�'
Cooling loads Late t $ensible Totel heating
(Bt�,h) �oad (Bt�,h) YS�I,. �
, � .• 'Not necessarily used to
offset heating loads
- Figure 5-1 Heatin /cooling load calculation form.
1'�!: �
i,
r�:..:.__ _ --- _ _ _ _..__ . ._ .
' Outside -�Z1 ��°F °F '
(, v1 �'I/�..�.-
• ' inside / (�k•oF °F _`-—` —� .
• O�ily Range °F Cooling ` Heating
Area . U CLTD C 7GC � U HLTD TLH
Description (ft�1 Factor (°F) (Btu/h) Factor (°FI (Btu/h)
N , .Z , ,v j� "v o-� , z
z
� —
E
2
3 S � 3"� �� � o Z � L
z
� � � � , �
w2
o � 2�� �G v �Yz-
O z 2
_ � , � �` Z
E N Z
C
h�` E 1 --
� 2 .
� S �
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i —�
W Z �
F�oor 3 Ff- L ti6f+,. Z U . � �
Door L - t� ,Q
1
Part
2
Total transmission,coo�ing(Rtc/h) Heating 4:�7��
Description Area SC SHCF CLF SRGC ' SC SHGF CLF SRGH
1
N
2
c
o �
p E _ ,
$ Z �
q � �
VJ �
1
w
2
Total solar rodiation gain cooling(Btu/h) Heating(Btu/h1'
— Input(W) CLF IGC lF IGH
` � Lights � X 3.413
� � ApplianCes X 3.413
Total internal gain,cooling(Btu/h) Internal gains
heating(Btu/h►'
— No. SHG CLF LHG LPGC PGC LF SPGC
` Sensible
n
aLate�t People gains
Total peopie gains(Btu/h) heating (Btu/h�'
��uv„4 1 r-,.�j�h L-
— CFM �T �W LVG SVGC Factor �T CFM SVLH
c �
.4 o Sensible 1.10 � pg L
q q Latent 0.68
�_ ._. _ Total ventilation a�d
j `c_ Total ventilation and�nfiltration infiltration load
losds,cooling total heating�Btu/h►�
Cooling loac`z Laten Sensible
Totsl heating ' '7 � 2�
(Btu/h) load(Btu/h) �'� Z �
, � � . 'Not necessarily used to
offset heating loads
- Figure 5-1 Heating cooling load calculation form.
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w�
' Outside / �-{ZF F �j��`` Y� i,
• � Inside / (��°F °F
o Cooling Heating
' Oaily Range F
Area , U CL7D C TGC U HLTD TLH
Description (ft�) Factor (°F) (Btu/h) Fxtor (°F) (Btu/h)
1 �"±C �; Z ' `Z,
N
2
1 - —
E
�
2
3 5 , 6, 3 .v o L�7 ,
2
1 � ,O 6 � 'L '
w 2
g � I •6 .c2 7L
o � 2
» � 3 , �
'E N ..... • C �.�._ � C7 �7
c 2
m ..__
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� 2
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2
1 �� �. �
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,�
Floor
Dpor
1
Part ---
2
Total transmiszion,rnoling(Btu/h) Heating �'��� Y�
Description Area SC SNGF CLF SRGC SC SHGF CLF SRGH
1
N
2
c
o �
q E z
. $
� S �
A
� 2
t
W
2
Total solar radiation gain cooling(Btu/h) Heating(Btu/h►'
— Input(W) CLF IGC LF IGH
c � Lights � X 3.413
r q
� o Appliances � � X 3.413
Total internal gain,cooling(Btu/h) internat gains
hecting(Btu/h►'
— No. `,;;�G CLF LHG IPGC PGC LF SPGC
�' $ensible
n
0
a Latent People gains
Total people gains(Btu/h) heating(8tu/h)'
I G�L�� (�,
c
— CFM �T �W LVGC SVGC Factor �T CFM SVLH
4 o Sensible 1.?0 1.08 �'1 �' t �
- � Late�t 0.68 '
c = Total ventilation and
j c Total ventilation and infiltration infiltration load
losds,cooling total heating(Btu/h►'
Cooling loads Latent Sensible Totsl heating ` �y
(Btu/h) load(Btu/h) � ✓' Z/
• � "Not necessarily used to
oNset heating loads
� Figure 5-1 Heating/c oling load calculation form.
ii�
_�,.
' Outside /,-.�Z�F "F
�1✓i/'�ti: /Li'�� w,
• ' Inside / , °F °F
' Daily Range °F Cooling Heating
Area , U CLTD C TGC U HLTD TlH
. Description (ft2) Factor (°F) (Btu/h) Factor (°F) (Btu/h�
1 .-�� '
N
2
E � 2 `ji' �
A
2
3 �
S o o , 3`�,
z
w � �� v . c .7Z.
2
g ' �... 'Z" ,o`t. � 3 l . �
o � 2
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A
f:. E 1 -�'
� 2
� S � �> �. � � QC�
2
W z � Z �Q t� L._
F�oor y -� ��
Door (p, � 3 �.� [
1
Part
2
Total transmission,cooling(Btu/h) Heating 6�C}�, . ��
Description prea SC SHGF CLF SRGC SC SHGF CLF SRGH
1
N -
2 .�.
o � _'_" ' '
� E ? .
�
� S � ._
`m
� Z
1
W
2
Totai sotar radiation gain cooling(Btu/h) Heating(Btu/h►'
- ` Input(W) CI.F tGC LF IGH
` Lights � X 3.413
v
� � Appliances X 3.413
Total internal gain,cooling(Btu/h) Internal gains
heating(Btu/h►'
- No. SHG CLF LHG LPGC PGC LF SPGC
n Sensible
aLatent People gains
Total people gains(Btu/h) heating (Btu/h)'
(c��� ��►r
c
- CFM OT �W LVGC SVGC Factor �T CFM SVLH
3 o Sensible 1.10 1.08 (, 'Z �
- � Latent 0.68
c= Total ventilation and
j c Total ventilation and infiltration infiltrotion load
losds,cooling total heating�Btu/h��
Cooling loads Latent Sensible
Total heating �J�'7�I
(Btu/h) load(8tu/hl � �L
i � - 'Not necessarily used to
offset heating loads
� Figure 5-1 Neatinglc oling load calculation form.
;.
I
�
�j'� G I
.._��
• Vuts�de /1,�2 F F
• ' Inside / " °F °F �L�" �
Cooling Heating
' Daily Range °F
Area , U CLTD C TGC U HLTD TLH
Description �ttzl Factor (°F) IBtu/h1 Factor (°f1 �g��/h�
N 1 v �,C`.vc i� �Z(
Z 2�� �
E � �
" � S'l.c. ��A.C�� ,�}"t
w
3 �
S Z
1
W 2
o �
0
o � 2 '
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c 2
A
~ E � �° �-� . � v
� 2
� � � � � � ✓ l�
2 –
7 —
W Z
�—
F�oor f ��� � �7 . �
Door
1
Part
2
Total transmiuion,cooling(Btu/h) Heating � 3u,r z�
Deuription Area SC SHGF CLF SRGC SC SHGF CLF SRGH
1
N
2
c
o �
q E 2
, �
� S �
A
� 2
1
W
2
Tota�solar radiation gain cooling(Btu/h) Heating(Btu/h�'
— Input(W) ClF IGC LF IGH
c Lights � X 3.413
:: ,�e
� o Appliences X 3.473
Total internal gain,coo�:ng(Btu/h) Internal gains
heating(Btu/h►'
— No. SHG CLF LHG LPGC PGC � LF SPGC
� Sensible
n
0
a Latent People geins
Total people gains(Btu/h� heating�Btu/h)'
����� � �tir
c
— CFM OT OW LVGC SVGC Fsctor pT CFM SVLH
0 o Sensible 1.10 1.08 � Z'), Z� ��
•q q Latent 0.68
c = Total ventiletion and
�c Total ventilation and infiltration infiltration load
loads,cooling total heating(Btu/hl'
Cooling loeds Latent Sensible
(Btu/h) Totel heating -�]Cj C`�'G 2
load(Btu/h) / / 7 J
� -� . 'Not necesserily used to
oNset heating loads
� Figure 5-1 Heating/c �ling load calculation form.
I;
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.
. ,
.
Plat of SurveY ��,�
for_ Clinton C. �e g � � ���'''
�4YN �2 .5� � � ..� Q`
in the ilcrtheast i/1, of Sect on 6-117-23 ` + ��
�'i.'f.��� P�
ry� � � ,:';�? r� �d
y ay
. J:!�"i�"`y�'S`Y- f �'��,? ��'s . `.`S�
ry J:r�� � ':r
�'S;' ;.,:r,�?
- - ... S//. B� � .. �/SO.O'.
E coi rr af
r«. 6-ii -z3
• No.j� lint of N£'/� •
e� Secf.an 6-//7-13
h ' Cert ficate of Survey:
Ea'� /,^' °f I �lereby certify th�t t}iis is
- w.ft �;.,� oFE.t s« s-in-1J
h iro' of NE�i* oj a t e and correct repre:entation
s«f�o•, 6-//7'13 0£ a survey of the bounG�ries of
thnt part of the .,ast quarter of
� the �ortheast quarter l�'in�-, '.�est
of t e :ast 150 �'eet tnerec_`' and
I;ort of Col�nty Road i:o, 04,
iso'.
Sect on r,, Township 11? liorth,
RanE, 23 '�+Pst of the 7tr: ?:incipa.l
, A�`.eri�ian. It does not pi;spert to
� show improver�ents or encroachments
:' exce t an existing house. ?�or
"� p�arp sas of this sur�rey a line 33
� feet NorthArl3� of and p�rallel
with the ce;�ter'_ine of t.r�ce� c��
the :�d sti.n� blackt�pped ree�d has
o T�en assiuned to he tre S�u'heri;,�
^ � � �'-�e oi the above—descril:�d
� �
,; o pro� rt;�� ^'r,e� �Ie�t bcundar:� 'ir:�
� ^ � h-r.s _en s`�:.ed a.cccr:?in,:, t,-; I�..�.
y. � Gcs�:e r.r.;ent Su,v��� nrir.cipl�s, and
° nc t r. �he �.��s i� of ara�.
w
o . ^ �
N , /.
Qorc? r. :;. Coffi:� ruE;. � . 0��'�4
i.,end Surveyor ,�i:c�, P1�r.z,��r
m �on� Lr�ke, N,innesots
h
Scai : 1" = 200'
'� Date 9-E>-73
�
M o Iron r�,�r�cer
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, � � O S N W F� 7 � N ? 1- > J J tL p. a a d J a v�i �
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DATE �} � T ME
CITY OF ORONO CALLED IN ��'���-/—j
INSPECTION NOTICE — SCHEDULED �� '2/ ' � ' � �'
PERMIT NO. ��99 COMPLETED �Z'�Z�� 53 � �"
ADDRESS ��� ��•
OWNER f���..nz�c��v CONTR. r,�-n�
TELEPHONE NO. y�J �OD�'S"
,
� DESCRIPTION - � ` il��l�•z�
�
� 01 FOOTING 11 IiAA41GA�g� 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FI I�AL 18 EXCAVIGRADINGIF LLING
y 03 INSULATION 24125 W REPLACE 19 LAKESHORFJWET NDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
� � ?x�� e t..t: .4�v�
a— [.-c= �S �J �-c�--e
�
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0
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d FACTORY:PROCEED ---_ � �`PROJECT COMPLETE
W
�` O ORRECT W D /C ISSUE CERTIFICATE OF OC UPANCY
OO ft��0 HVSPECTION TEMPORARY
V�� SEFf�iEGOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -, PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR L CITATION ISSUED
❑ INSPECTION REQUIFED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J
Owner/Contractor on 'te:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATF_ � TI E
CITY OF ORONO CALLED IN � r � ' I�
INSPECTIUN NOTICE �, SCHEDULED /:� - ff I(I � G� _
PERMIT NO. .� � Y � COMPLETED �_
ADDRESS ��`����� �� � /C'C�
OWNER �✓ '. � ���✓ _CONTR. —
TELEPHONE NO. yy y� n���
� DESCRIPTION ����-'viz a<-�-�
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FIf�L�'� 18 EXCAVIGRADINGIFI LING
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREJWETLA DS
�
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVA�L
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 P�UMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINA� 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
a �-- 5 J ' �
�
J �- � �.
O
�
O
�
W
�
Q
�
Z
W
�
W
�
�
a
W t]WORKSATISFACTORY:PROCEED �OJECTCOMPLETE
� ❑CORRECT WORK 8 PROCE�D r_i ISSUE CERTIFICATE OF OCCU ANCY
W
��CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. - pHOTOTAKEN
INSPECTOR WILL RETURN
: CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-73�J7
Owner/Contrac on si e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice