1074_0002.tif ' PROFESSIONAL FORMS, INC. 1- 800- 537.0245
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SECT N REPORT
BUILDING o
ON COUNTY ❑ OTHER ----
CITY
OF BL
AIR
❑ WASHINGTON SHIN
GT
— I.
LOCATION OF INSPECTION
NAME OF OWNER'
CONTRACT
DATE INSPECTION REQUESTED
TIME INSPECTION RE ES
PERMIT NO
❑ CONFERENCE ❑ STATUS CHECK
TYPE OF INSPECTION REQUESTED:
a 5
PASSED FAILED
BUILDING: F] FOOTING ❑ DECKFOOTING ❑ FRAMIN G ❑DRYWALL El FINALE] PARTIAL ❑ ❑
t
COMMENTS:
t UTILITIES; ❑ SEWER TAP ❑ SEWER ❑SEPTIC ❑ WATER TAPE] REMOTE El WATER SERVICE PASSED F AILED ❑
❑ PARTIAL
COMMENTS:
ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑TEMPORARY SERVICE ❑ PRECONNECT PASSED FAIL
l
❑ PARTIAL
COMMENTS:
PASSED FAILED
MECHANICAL: ❑ ROUGH —IN ❑ A/C El FURNACE F1 RADIANT HEAT El FINAL ❑ PARTIAL ❑ ❑
COMMENTS:
PASSED FAILE);
PLUMBING: ❑ GROUNDWORK ❑ ROUGH —IN ❑ FI E] WATER METER INSTALLED E] PARTIAL ❑ ❑
❑ PRESSURE TEST
COMMENTS:
❑ OCCUPANCY GRANTED • ❑ CONDITIONAL OCCUPANCY GRANTED
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NOTESIREMARKS
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INSPECTO
DATE OF INSPECTION MADE:— TIM L---
FAXED OPPD�BURT REA
TO CONNECT SERVICE:' ON • BY
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