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�,��,.,, I�d�PE�'T���! RE�O�T <br /> �. <br /> Address�� ,-�«l����=s�Ss�2=.'L___ —._ _ <br /> / � �- _ <br /> Ccntmttor���tZ..y— <br /> _.���7 �Owncr �v'�x' — _.- <br /> c j f� <br /> - - �,«__ �7�?I - - --- - <br /> TYPE OF IPJSPECTION REQUESTED <br /> t OLCG: Fml. Na___—'-_-- ❑ MKFI: Pmt. No.—_.___.—.--- <br /> i-� ELEC: PmL No.'_—.____.___ �PLBG� Pmt No_-.S ./ 4-C.----� <br /> ". H:using �J N.asonry ❑ Insulati�n <br /> ❑ Pooting ❑ Frominp rl GrounJ,. ��'� <br /> (J Foundoticn ❑ Dryw�ll Nailiny ❑ Ccnsulta�� i� <br /> �; I .icwcr �Rcugh-In ❑ Fir.ol <br /> j7 Firc0la[c and Chimncy ❑ Scrvicc ❑ Olner_'__. . ___ -- —'-'_ .. <br /> _ ____ _. <br /> _:_-._'—______ '___'___'_..—_______'__--__'—.- _ - <br /> �j, APPROVAL [� PARTIAL APPROVAL <br /> ❑ VIOLATION ❑ CORRECTION REQUIRED <br /> —----- -- _ <br /> ❑ Ccrrectirns lisled bclow MUST BE MADE bcforc w%�k eon bc opp��-v�d. <br /> [; Wcrk Lsted belew has bem inspected ond approved, <br /> ❑ Plcasc contoct inspcctor and ormngc for appointmcnt <br /> �� Vlas no1 oble 10 pe�tarm in�pec��:n. <br /> [] Cl�IL 259-d870 FOR FEINSPECTION --- :.4 h�..ur nobc,.• reqnhr.'� <br /> 4 Cr;lilica�e of �Cwpancl' shall be issued ar,d pcsted en thC premi5e5 pri�r fa c:cuponcy. <br /> . _ �J._ ..___<,.'_ <br /> In�.�,.,:ror�'S�CL�':l_ . � `.1' �� . ._Datc_��� /—��" <br /> :�- �= . <br /> �-�'� <br />