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i <br /> �o , � � <br /> NOTICE � <br /> c�ercn AND INSPECTION REPORT <br /> e �ddress–�, o ��� ;�� <br /> Controctor �-C� ��� <br /> Owncr <br /> Requcs�ed by � <br /> T�YPEqOF INSPECTION REQUESTED <br /> �6�DG' Pmt' IJ°'–Ll–�=— O MECH: Pmt, No. <br /> ❑ ELEC; pmf, No. ❑ PLBG: Pmf. No. <br /> ❑ Foctinq Framin <br /> ❑ Foundation � 9 ❑ Bronch Circuit <br /> ❑ Concrete Slab � ��a11 Noilinp � Furnoce <br /> ❑ Rough-In ❑ Final <br /> _0 FirePloce and Chimney ❑ Service ❑ Other <br /> �APPROVAL <br /> ❑ VIOLATION � PARTIAL APpROVAL <br /> ❑ CORRECTION REQUIRED <br /> ❑ Corrections Iiztecl below Mil$T BE MADE before work eon be opproved <br /> ❑ APPROVED FOR OCCUPANCY sub�ect to certificate o1 occuponty. � <br /> ❑ Work listed belcw hos been inspecfed ond opproved. <br /> ❑ Plcose contact inspeclor ond armnge for oppointmenL <br /> � Wos not able to per(orm inspection. <br /> � CALL 259.87d5 FOR REINSI'ECTION — 21 hour notice required, <br /> __��C/.�'�[C� � . <br /> - — O — � 7 <br /> � <br /> --- — �� — <br /> � — — <br /> Inspeetor / / <br /> ___==-1�.,� ` ,,._—__— Dot �J <br /> G �_ <br /> • 1 wns presenf durinp this inspettion. <br /> _ /` "�•� <br />