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c� <br /> ���«„ Iwsp�CTION REPO� <br /> 0 Hddress n �� <br /> '� i % <br /> Conimcror � <br /> ( � "Ti� <br /> e <br /> Owner / <br /> 3/ <br /> oo�� <br /> TYPE OF INSPECTION REQUESTED <br /> �� ❑ MECH: Pmt. No. <br /> ❑ BLD�: Pmt. No.� �G: Pmt. No.� <br /> � ELEC. Pmt. No..��� � Insulatiun <br /> [] Mosonrv <br /> � Hausi�q � Froming ❑ Groundwork <br /> � F����g Ccnsultatinn <br /> � D all Nailing O Finol <br /> � Fourdotion pugh-In <br /> OSewer Scrvicc __ O Othcr— <br /> FireD�a« o^d �himney ❑ _-------- <br /> qpPROVAL ❑ PARTIAL APPROVAL <br /> ❑ VIOLA l�' CORRECTION REQUIRED <br /> � Carrectlons listed below MUST BE MADE LcloraoV��k can be oDP�a�� <br /> � Work listed below hos bcen inspected and o oPn,menl. <br /> � Pleose coatact inspe<tor ond arrange for a0P <br /> � Waz not ablc Io perlorm inspec�ion. <br /> � �qLL 259-8870 FOR REINSPECTION — 24 hour mticc requircd. <br /> nc sl+all be issued a�d posteJ on the premises p��o� ro °CYP°��y' <br /> A Certilico�e of OccuW Y <br /> qll. l.A <br /> Oit/ rl��� <br /> tJ� �,e� s <br /> �'�r�i,✓ �� <br /> ..1� ----__ <br /> 02 � <br /> a, w � �f-- /- / <br /> InspKtor <br />