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Home My WebLink AboutCertificate of Occupancy CITY HALL Inspection Services Div 215 Church Avenue ~POBOX1130 ~ Oshkosh WI ~ 54903-1130 OfHKOfH ON THE WATER City of Oshkosh Approved: February 9, 2006 Insured Income Properties 17207 N. Perimeter Drive Scottsdale, Arizona 85255-5402 CERTIFICATE OF OCCUPANCY An Occupancy Permit is hereby issued for the interior remodel, located at 800 S. Washburn Street, Oshkosh, Wisconsin 54904 as described in Building Permit Application number(s) 117749. This building is to be used only as a restaurant and is located in the C-2, General Commercial District. LIMITATIONS: Maximum number of persons: 99 Occupants A new Certificate of Occupancy shall be required prior to occupancy, should additional building(s) be erected, or should any buildings mentioned above be altered or moved. The use of land, or buildings, shall not be changed until a Certificate of Occupancy is issued for that occupancy. All conditions noted above must be complied with in order for this certificate t valid. cc: DMllnc. Burger King CITY HALL Inspection Services Div 215 Church Avenue PO Box 1130 ~ Oshkosh WI ~ 54903-1130 OfHKOiH ON THE WAm City of Oshkosh Issued: February 3, 2006 BURGER KING 17207 N PERIMETER DR SCOTTSDALE AZ 85255 TEMPORARY CERTIFICATE OF OCCUPANCY A Temporary Certificate of Occupancy is hereby granted for the restaurant located at 800 S Wash bum St., Oshkosh, Wisconsin 54904 as described in Building Permit Application number(s) 117749. This building is to be used only as restaurant and is located in the C-2 General Commercial District. . LIMITATIONS: Maximum number of persons: 99 NOTE: This temporary occupancy expires on March 3, 2006. A new Certificate of Occupancy shall be required prior to occupancy, should additional building(s) be erected, or should any buildings mentioned above be altered or moved. The use of land, or buildings, shall not be changed until a Certificate of Occupancy is issued for that occupancy. All conditions noted above must be complied with in order for this certificate to be vali cc: DMlinc Sfatus as of: -�- . . , ' ':*.: �:�`: ::��. � .�. �:::G �: � � .�. . �:::;..::.;..=:;:;�...:�'...��::�::;`.:..,.�.':�.�.�.:��''''..':'::�:":'::`;;:�':''':'��:��:�:':;�;:�:::�;'':''��:;:'�:�:::�'�'�::�:�:;: • � ��:�� } .:��: ' ,�+� :� � ��. . ::� :�••: �� .�J� .;�'•• :�•. .��'�':�:;:�;;:::;�:�. :�f: Address: . . Projec�: . �a � - Plan#: � �-�� - oS • . •:�:.: .; �� ;: .I': 1�35' :_�.. � �� ,: .?��: � .��= .D��.: . • Bu7din �.� _�� . Petmit#: � � . . : Elec�ic: � -e . : PeRnit#: �?. o . . HVAC: _�_o� � ; ' � � � Permit#: 1��3� : _ ' � _ Ptumbin -3 0� • �' : Permit#: 7 �'l� " . . -�''✓s uQ,dp -�z��r� �,�o��,er7-.,�-� ; �:• /'7�o-i y �o��,�� Nofes: s��on-..� frz ��zs� �-�,�� ,J�, . . «._ S . j � i i � � i � � ` ' i • ! ' � � • • � r �ti �2�� BUILDINGS, HVAC, COMPLIANCE STATEMENT SBD-9720 This form is required to be submitted by the supervising professional (architect, engineer, HVAC designer or electrical designer)observing construction of projects within buildings with total areas 50,000 cubic feet or greater and bleachers (Comm 50.10/Comm 61.50). Failure to submit this form may result in penalties as specified in Comm 5026/Comm 61.23 and/or local ordinances. This form must be submitted prior to the plan approval expiration date or another submittal may be required. General Instructions: Prior to the initial occupancy of new buildings or additions and the final occupancy of altered existing buildings, submit this completed and signed form to: � The municipal building inspection office and • Safety and Buildings, 10541 N Ranch Road Hayward, Wi. 54843 Note: If the review was done by the municipality, the compliance statement goes only to the municipal building inspector. A copy is not needed by Safety & Buildings. Personal information you provide may be used for secondary purposes[Privacy Law, s. 15.04(1)(m)j. 1. PROJECT INFORMATION: Please fill in the following with information from your plan approval letter. Transaction ID Number Site Number Site location (number&street)_ 'bOO s , k/As�..p�� City ❑ Village ❑ Town of_ �sµKps�4 County of W 1 fJ(J�E g 2. PURPOSE OF THIS STATEMENT: (Check Box A, B, C, or D to indicate purpose and complete any other applicable boxes and information. Attach additional pages if necessary.) Check those which apply: f'1 Building Object ID#_�Z1-�Oq-I105 � HVACObjectlD# RI-lo°�-��pSH ❑ Lighting Object ID# ❑ Partial Completion Description of Portion Completed A) �Statement of Substantial Compliance To the best of my knowledge, belief, and based on onsite observation, construction of the following building and/or HVAC items applicable to this project have been completed in substantial compliance with the approved plans and specifications. ❑ BUILDING/LIGHTING ITEMS 1. Structural system including submittal and erection of all building components 10. Exterior lighting&control requirements (trusses,precast,metal building,etc.) 11. Interior lighting&control requirements 2. Fire protection systems(sprinklers,alarms,smoke detectors)designed, 12. All conditions of lighting plan approval installed,and tested(including forward flow on back flow devices)by and applicable variances appropriately registered professionals 3. Shaft and stairway enclosure 4. Exits including exit and directional lights 5. Fire-resistive construction,enclosure of hazards,fire walls,labeled doors,class ❑ HVAC ITEMS of construction,fire stopped penetrations 6. Sanitation system(toilets,sinks,drinking facilities) 7. Barrier-free including Comm 18 elevators and lifts �• HVAC system including final test 8. Energy envelope requirements 2• All conditions of HVAC plan approval and 9. All conditions of building plan approval and applicable variances applicable variances The following items are not in compliance and must be addressed: B) ❑ Statement of Noncompliance Due to the following listed violations,this project is not ready for occupancy: C) ❑ Supervising Professional Withdrawn From Project (use A or e above to indicate Project status as or tnis date.) D) ❑ Project Abandoned 3. SUPE�ISING P�OFESSIONAL S/I1GNATURE FOR: t�Building L9�HVAC ❑ Lighting (w E ORGE P2oS��,i�1 t O S Name(please pnnt or type) Date 2 b p (o Phonenumber _�1-'gj�'3•0'�p(,�ustomerlD#_ �prj�'��jq Signature � SBD-9720(R.02/2004) - • Building Permit Work'Card ` Job Address 800 S WASHBURN ST Permit Number 0117749 Create Date 1/4/2006 Owner INSURED INCOME PROPERTIES Contractor DMI INC '� y Category 232-Altecation Stores&Customer Service O��'B��-, Type � Builcj�n� � Sign � Canopy � Fence � Raze � Plan R1-109-1105 9�E Zoning Class of Const: Size Value $192,614.00 Unfinished/Basement 0 Sq. Finished/Living 0 Sq.Ft. Garage 0 S Ft. Ft. 4• Rooms 0 Bedrooms 0 Baths p Projection i Stories Height 0 Ft. Canopies 0 Signs p Foundation � Poured Concrete 0 Floating Slab Pier � Cj Other � Concrete Block 0 Post 0 Treated Wood Occupany Permit Required Flood Plain No Height Permit Not Required Park Dedication #Dwelling Units 0 #Structures p Use/Nature omm/Interior remodeling as per plans. of Work HVAC Contr Plumbing Contr Electric Contr Inspections: Date 2/8/2006 Type Final Inspector Allyn Dannhoff approved Date/Time requested: Notice Type: Phone Number: Access: Ready DateTme: Requested By: Q Reinspect Fee � Fee Waived ❑ Reinspect Fee Paid Page 3 of 3 . - Building Permit Work'Card ` : Job Address 800 S WASHBURN ST Permit Number 0117749 Create Date 1/4/2006 Owner INSURED INCOME PROPERTIES Contractor DMI INC Cqti2 Category 232-Alteration Stores&Customer Service ��B �� O � Type � Buil�lir,� � Sign Q Canopy � Fence � Raze � Plan R1-109-1105 �TE Zoning Class of Const: Size Value $192,614.00 Unfinished/Basement 0 Sq. Finished/Living 0 Sq.Ft. Garage 0 Sq.Ft. Ft. Rooms 0 Bedrooms 0 Baths 0 Projection Stories Height 0 Ft. Canopies 0 Signs 0 Foundation � poured Concrete 0 Floating Slab � Pier 0 Other � Concrete Block � Post � Treated Wood Occupany Permit Required Flood Plain No Height Permit Not Required Park Dedication #Dwelling Units 0 #Structures p Use/Nature omm/Interior remodeling as per plans. of Work HVAC Contr Plumbing Contr Electric Contr Inspections: Date TYPe Inspector Ailyn Dannhoff Request Line-above ceiling mechanicals for permit#117749 DatelTime requested: 1/31/2006 01:25 PM Notice Type: Phone Number: 920-559-7712 Access: Ready Date/Time: 2/1/2006 07:00 AM Requested By: DMI INC-Ron Q Reinspect Fee � Fee Waived ❑ Reinspect Fee Paid Date 2/3/2006 Type Final Inspector Allyn Dannhoff approved w/cond. equest line/would like inspection tomorrow pm 3/06 T.O.P.B 8 H OK Datemme requested: 2/2/2006 01:14 PM Notice Type: Phone Number: Ron 920.559-7712 Access: Ready DateTme: 2/2/2006 01:14 PM Requested By: DMI INC Q Reinspect Fee Q Fee Waived ❑ Reinspect Fee Paid Page 2 of 3 • ~ Building Permit Work'Card ' Job Address 800 S WASHBURN ST Permit Number 0117749 Create Date 1/4/2006 Owner INSURED INCOME PROPERTIES Contractor DMI INC 'y Category 232-Aft�seGon Stores&Customer Service Q��e�,� 9TE Type � Builc�;ng � Sign � Canopy � Fence � Raze � Plan R1-109-1105 Zoning Class of Const: Size Value $192,614.00 Unfinished/Basement 0 Sq. Finished/Living p Sq.Ft. Garage 0 Sq.Ft. Rooms 0 Bedrooms 0 Baths 0 Projection Stories Height 0 Ft. Canopies 0 Signs p : Foundation � Poured Concrete � Floating Slab � Pier � Other � Concrete Block � Post � Treated Wood ccupany Permit Required Flood Piain No Height Permit Not Required Park Dedication #Dwelling Units 0 #Structures p Use/Nature omm/Interior remodeling as per plans. ' of Work HVAC Contr Plumbing Contr Electric Contr Inspections: Date 1/12/2006 Type Rough In Inspector Allyn Dannhoff � approved w/cond. FOR WEST ROOF SECTION ONLY-DISCUSSED FIRE BLOCKING AND ATTIC ACCESS REQUIREMENTS.OK TO CONTINUE. Date/Time requested: Notice Type: Phone Number: Access: Ready Dat�me: Requested By: Q Reinspect Fee Q Fee Waived ❑ Reinspect Fee Paid Date 1/25/2006 Type Rough In Inspector Allyn Dannhoff � no time XT 5051/CALL TO VERIFY,WOULD LIKE INSPECTION LATE AFTERNOON DateTme requested: 1/24/2006 08:10 AM Notice T ype: Phone Number: RON 920-559-7712 Access: Ready Date/Time: 1/24/2006 08:10 AM Requested By: DMI INC � Reinspect Fee � Fee Waived ❑ Reinspect Fee Paid Page 1 of 3 Electric Permit Work Card � Ownc,r INS'�RED INCOP.r PROPERTI� �V ." te Date 01/06/?n�5 C�� Job Address 800 S WASHBURN ST Permit Number 117809 _ Crea � � ,_ � , :.,� � �,�^ � � /�,, �n � . _, 8 -----_ =-- < �, Category 643-Commercial-Addition/RE __ _ Oqr F Service 0 New � Change� Ten ,. � �'�:; � TYp� C ':-r'iaad � �_'n,'- � ��o!,nd � 'v,'A � Volts Circuits 5 Fixtures 0 Amps 0 Switches 0 Receptacles 3 Fee $162.00 � Value $7,700.00 Appliances �__— -__._ _... —_ _ _--- — ---- -- - ---- ---- Use/Nature BurgerKing 1 Interior remodel,replace luminaires,add 3 receptacles,replace the counter receptacles of Work � . � Inspections: Date 02/01/2006 Type Abv Ceiling Inspector Adam Krause approved Request Line-prefer this afternoon Date/Time requested:02/01/2006 10:51 AM Notice Type: _ Phone Number: 920-379-0775 Access: Ready Date/Time: 02/01/2006 10:51 AM Requested by: ROYAL ELECTRIC INC-Roger • Q Reinspect Fee� Fee Wavied ❑ Reinspect Fee Paid Date 02/03/2006 Type Final Inspector Kevin Benner approved w/cond. REQUEST LINE/WOULD LIKE INSPECTION 2/3 @ 1:30 Panel schedules,K.O.plug in lighting contactor enclosure, Called the E.C.confirm the above noted work is complete. Faxed to the E.C.2/9/6 Date/Time requested:02/02/2006 12:16 PM Notice Type: Phone Number: ROGER 379-0775 Access: Ready Date/Time: 02/02/2006 12:16 PM Requested by: ROYAL ELECTRIC INC � Reinspect Fee 0 Fee Wavied ❑ Reinspect Fee Paid Electric Permit Work Card ` S " Job Address 800 S WASHBURN ST Permit Number 117809 Create Date 01/06/2005 Owner INSURED INCOME PROPERTIE� Contractor ROYAL E' =CTRIC INC N� n Category 643-CGmmercial-Addition/Remodels ��8� Service New � Change0 Temp � N/A Type � Overhead � l_'nder;round � N/A I �qTc : Volts Circuits 5 Fixtures 0 Amps 0 Switches 0 Receptacles 3 Fee $162.00 � Value $7,700.00 Appliances ___ - ---- — - — -- -- - _ __ _- Use/Nature BurgerKing/Interior remodel,replace luminaires,add 3 receptacles,replace the counter receptacles of Work Inspections: Date 01/25/2006 Type Rough In Inspector Kevin Benner approved w/cond. Request Line-Partiai RI The wiring in the wall were okay,the correctio notice is for existing wiring to be corrected. Date/Time requested:01/25/2006 07:37 AM Notice Type: FC Phone Number: 920-379-0775 Access: Contact Rick or Howard upon arrival at site. Ready Date/Time: 01/25/2006 07:37 AM Requested by: ROYAL ELECTRIC INGRoger � Reinspect Fee� Fee Wavied ❑ Reinspect Fee Paid Date 01/31/2006 Type Inspector Adam Krause approved Request Line-wants early AM(ASAP)-splitting up kitchen conduits Open K.O.loose locknut-reviewed with wireman. Date/Time requested:01/30/2006 02:48 PM Notice Type: Phone Number: 379-0775 Access: Ready DateTme: 01/31/2006 07:00 AM Requested by: ROYAL ELECTRIC ING Roger � Reinspect Fee� Fee Wavied ❑ Reinspect Fee Paid HVAC Permit Work Card � Job Address 800 S WASHBURN ST Permit Number 117930 Create Date 01/19/2006 Owner INSURED INCOME PROPERTIES Contractor EXTREME HEATING AND COOLING INC �2� Category 512-Ind.&Comm-Both Plan R1-109-115-H �'�TE Fuel ✓ Gas Oil Electric Solar Solid Value $33,550.00 System ❑ New � ❑✓ Replace � � Other � ✓ Forced Air Radiant Steam ✓ A/C Vent Electric Hot Water Suppl. Con.Burner Chimney Type Chimney A � Chimney B � Direct Vent Not Applicable Heat Loss i� As Approved � Existing � Not Applicable Value 0 BTU Rate As Per Plan � Variable 0 Other Value Use/Nature ResturanU Repaice RTU's and repiace duct work as per approved pians. of Work Inspections: Date 2/3/2006 Type Final Inspector Allyn Dannhoff approved w/cond. 3/06 T.O.P. B&H OK Datemme requested: Notice Type: Phone Number: Access: Ready Datemme: Requested By: 0 Reinspect Fee Q Fee Waived ❑ Reinspect Fee Paid Date 2/8/2006 Type Final Inspector Altyn Dannhoff approved Date/Time requested: Notice Type: Phone Number: Access: Ready Dat�me: Requested By: Q Reinspect Fee Q Fee Waived ❑ Reinspect Fee Paid 5c�vti . F, " � Plumbing Permit Work Card ` � Job Address 800 S WASHBURN ST Permit Number 117918 �'4TE Create Date 01/18/2006 � Owner INSURED INCOME PROPERTIES Contractor R J PARINS PLUMBING AND HEATING I Category 0-Industrial-Interior Plan Value $7,489.00 Bathtub 0 Shower 0 Water Softner 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0 Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0 Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0 Toilet 2 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0 Res.Sink 3 Dishwasher 0 Beer Tap 0 Hand Sink 1 Urinal 1 Eye Wash Statn 0 Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0 Water Heater 0 Classrm Sink _� Sterilizer 0 Surgeons Sink 0 Ice Maker � Deduct Meters 0 Site Drain 0 Breakrm Sink � Dip Well 0 F Prep Sink _ � Gar Drain � Wtr Usage Mtrs � Roof Drain � Ejector/Grind � Drink Ftn � Sery Sink 0 Soda Disp � Misc. � Fixtures Use/Nature emode existing restrooms *`check#36375 of Work Size Material Type # Conn.Type Sanitary Sewer 0 0 0 0 0 Storm Sewer 0 0 0 0 0 Water Service 0 0 0 0 0 Date 2/3/2006 Type Final Inspector Paul Wolf approved Date/Time requested: 2/2/2006 03:16 PM Notice Type: Telephone Number: Access: ILL BE READY Z/3/06 AT 2:30 PM Ready Date�me: 2/7J2006 03:16 PM Requested By: R J PARINS PLUMBING AND HEATING INC Q Reinspect Fee � Fee Waived ❑ Reinspect Fee Paid SGA�ti . � " ' Plumbing Permit Work Card Job Address 800 S WASHBURN ST Permit Number 117918 O�TE Create Date 01/18/2006 Owner INSURED INCOME PROPERTIES Contractor R J PARINS PLUMBING AND HEATING I Category 440-Industrial-Interior Plan Value $7,489.00 Bathtub 0 Shower 0 Water Softner 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0 Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 FINWst Sink 0 Int Grease Trap 0 Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0 Toilet 2 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0 Res.Sink 3 Dishwasher 0 Beer Tap 0 Hand Sink 1 Urinal 1 Eye Wash Statn 0 Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0 Water Heater 0 Classrm Sink � Sterilizer 0 Surgeons Sink � Ice Maker 0 Deduct Meters 0 Site Drain � Breakrm Sink � Dip Well __0 F Prep Sink 0 Gar Drain � Wtr Usage Mtrs 0 Roof Drain � Ejector/Grind � Drink Ftn � Sery Sink � Soda Disp 0 Misc. � Fixtures Use/Nature emode existing restrooms '*check#36375 of Work Size Material Type # Conn.Type Sanitary Sewer 0 0 0 0 0 Storm Sewer 0 0 0 0 0 Water Service 0 0 0 0 0 Date 2J2/2006 Type Final Inspector Paul Wolf not approved NEED WATER CALC SHEET AND TO VERIFY CHEMICAL DISPENSING SYSTEM INSTALLATION DateTme requested: 2/?J2006 08:04 AM Notice Type: Telephone Number: Access: im-Parins 371-3397 Ready DatelTime: 2/2/2006 08:04 AM Requested By: R J PARINS PLUMBING AND HEATING INC Q Reinspect Fee Q Fee Waived ❑ Reinspect Fee Paid , �ti ' ' Plumbing Permit Work Card �8� � Job Address 800 S WASHBURN ST Permit Number 117918 �qTE ' Create Date 01/18/2006 Owner INSURED INCOME PROPERTIES Contractor R J PARINS PLUMBING AND HEATING I Category 4�t0-Industrial-Interior Plan Value $7,489.00 Bathtub 0 Shower 0 Water Softner 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0 Whiripool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0 Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0 Toilet 2 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0 Res.Sink 3 Dishwasher 0 Beer Tap 0 Hand Sink 1 Urinal 1 Eye Wash Statn 0 Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0 Water Heater 0 Classrm Sink � Sterilizer 0 Surgeons Sink � Ice Maker � Deduct Meters 0 Site Drain � Breakrm Sink � Dip Well 0 F Prep Sink 0 Gar Drain � Wtr Usage Mtrs 0 Roof Drain � Ejector/Grind 0 Drink Ftn � Sery Sink 0 Soda Disp 0 Misc. � Fixtures Use/Nature emode existing restrooms "'check#36375 of Work Size Material Type # Conn.Type Sanitary Sewer 0 0 0 0 0 Storm Sewer 0 0 0 0 0 Water Service 0 0 0 0 0 Date 1/24/2006 Type Rough in Inspector Paul Wolf approved w/cond. 'll be ready late aftemoonWrote correction notice to install shock stops on flushometer water Gosets and flushometer urinal.Gave plumbing contractor a py of nobce on jobsite.He stated stops will be installed on 1/25/06. DateTme requested: 1/24/2006 08:03 AM Notice Type: Telephone Number. tim 371-3397 Access: Ready DateTme: 1/24/2006 08:03 AM Requested By: R J PARINS PLUMBING AND HEATING INC Q Reinspect Fee Q Fee Waived ❑ Reinspect Fee Paid � " Plumbing Permit Work Card �28� . Job Address 800 S WASHBURN ST Permit Number 117918 4qTE Create Date 01/18/2006 Owner INSUR�D INCOME PROPERTIES Contractor R J PARINS PLUMBING AND HEATING I Category 4�.0-Industrial-Interior Plan Value $7,489.00 Bathtub 0 Shower 0 Water Softner 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0 Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0 Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0 Toilet 2 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0 Res.Sink 3 Dishwasher 0 Beer Tap 0 Hand Sink 1 Urinal 1 Eye Wash Statn 0 Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0 Water Heater 0 Classrm Sink � Sterilizer 0 Surgeons Sink 0 Ice Maker � Deduct Meters 0 Site Drain 0 Breakrm Sink � Dip Well 0 F Prep Sink � Gar Drain 0 Wtr Usage Mtrs 0 Roof Drain 0 EjectodGrind 0 Drink Ftn 0 Sery Sink � Soda Disp � Misc. � : Fixtures Use/Nature emode existing restrooms *'check#36375 of Work Size Material Type # Conn.Type Sanitary Sewer 0 0 0 0 0 Storm Sewer 0 0 0 0 0 Water Service 0 0 0 0 0 Date 1/23/2006 Type Underground Inspector Paul Wolf approved Date/Time requested: 1/23/200610:20 AM Notice Type: Telephone Number: TIM 371-3397 Access: Ready Dat�me: 1/23/2006 10:20 AM Requested By: R J PARINS PLUMBING AND HEATING INC � Reinspect Fee Q Fee Waived ❑ Reinspect Fee Paid