835 (3).tif 15UILDING INSPECTION REPORT
CITY OF BLAIR WASHINGTON COUNTY OTHER
LOCATION OF INSPECTION-
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NAME OF OWNER- CONTRACTOR-
DATE INSPECTION REQUESTE, TIME INSPECTION REQUESTED- PERMIT N
TYPE OF INSPECTION REQUESTED: [:1 CONFERENCE El STATUS CHECK
BUILDING: F] FOOTING F DECK FOOTING FRAMING DRYWALL FINAL PARTIAL PASSED F4
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UTILITIES: SEWER TAP 0 SEWER El SEPK El WATERTAP Fl REMOTE El WATER SER PASSED FAILED
R PARTIAL El F-1
'�_ C�,
COMMENTS: . . . . . - - - - - .....
ELECTRICAL: R ROUGH IN -Ej� FINAL PERMAN SERVICEEI TEMPORARY SERVICE E] PRECONNECT PASSED 15Le
F] PARTIAL
MECHANICAL: R ROUGH-IN R A/C El FURNACE RADIANT HEAT LEI FINAL 0 PARTIAL PASSED FAILED
PLUMBING: R GROUNDWORKE] ROUGH-IN -2[- FINAL 0 WATER METER INSTALLED El PARTIAL PASS FAILED
C ENTS: PRESSURE TEST
CUPAN� GRANTED CONDITIONAL OCCUPANCY GRANTED
INSPECTOR DATE OF INSPECTION M E: )/77/ T
FAXED OPPD\BURT REA TO CONNECT SERVICE: 0 BY
HEREBY ATTESTTHATTHE FOLLOWING TEST REQUIRE-
MENT ON THE 2 PSIG GAS PIPING SYSTEM AT:
STREET
C1TY STATE
HAS BEEN MET OR EXCEEDED:
"PRIOR TO THE INSTALLATION OF ANY FUEL LINE
OR APPLIANCE REGULATORS, CAP AND SEAL
THE PIPING SYSTEM(S), AND TEST WITH AIR AT A
PRESSURE OF 10 PSIG FOR AT LEAST 30 MINUTES.
AFTER COMPLETION ON THE AIR TEST, INSTALL -THE
NECESSARY REGULATORS AND SOAP TEST ALL
CONNECTIONS FOR LEAKAGE."
CONTRACTOR r _ E
INSTALLER
DATE
Black Hills Energy
i
Improving) f with energy
FORM 48 -0151 (10/08)