12618_0002.tif i
43051.1db PROFESSIONAL FORMS, INO. 1- 800 - 537.0245
]B UILDING INSPECTION T
CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHE
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LOCATION OF INSPECTION
NAME OF OWNER CONTRACTO
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DATE INSPECTION REQUESTED TIME INSPECTION REQUESTED PERMIT N0 ;t 6 r g
TYPE OF INSPECTION REQUESTED: � Wit
r& Sg K CONFERENCE ❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL PARTIAL PASSED FAILED
COMMENTS: C Ci� �v�./ ❑
MIMMMMIN
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP El REMOTE ❑ WATER SERVICE PASSED FAILED
El PARTIAL ❑ ❑
COMMENTS:
ELECTRICAL: ❑ ROUGH N ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED
❑ ❑ El
PARTIAL
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED
COMMENTS: ❑ ❑
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PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED
COMMENTS: ❑ PRESSURE TEST ❑ ❑
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS• j
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INSPECTO c/'bt/,J DATE OF INSPECTION MADE: n ' (a T
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON By
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