MS-2010-00039_0001.tif 43051.fdb PROFESSIONAL FORMS, INC. 1- 800 - 537 -0245
INSPE BlUILDING
CITY OF BLAIR ❑ WASHINGTON COUNTY
El OTHE / � rL ��} c,
LOCATION OF INSPECTION
NAME OF OWNER* CONTRACTO
DATE INSPECTION REQUESTED � L l -� [ TIME INSPECTION REQUESTED- PERMIT NO-
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE El STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED FAILED {
COMMENTS: e ❑
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
❑ PARTIAL PASSED FAILED
COMMENTS: ❑ ❑
ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE
E] PARTIAL ❑ PRECONNECT PASSED FAILED
COMMENTS: ❑ ❑
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED FAILED
COMMENTS: ❑ ❑
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL l
❑
PASSED FAILED
PRESSURE TEST
COMMENTS: ❑ ❑
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCYk GRANTED
NOTES/REMARKS•
o c A go
CAILIL-
INSPECTO DATE OF INSPECTION MADE: TIME. / d t it
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON
BY
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