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��j � iJ��J�S��' �.'� ��' ' �L.��'�Iti��' <br /> �� �� � Date: /5/(•� Permit: � � �Q� -I <br /> •�?ioH;�!'c;�7�r <br /> --� -� — <br /> " ' Contractor. <br /> Ov�mer:_ `�� �tA� <br /> SiteAddress: O. �yQ l ��v �Q, � <br /> TYPE OF INSPECTION RGQUESTED <br /> f_L[CiRICAL BUILDI�G MECHANIGAL PLUN3ING <br /> ❑Temp Service ❑UFER�rourd ❑�roundwoddSlab ❑GroundworlJSlat <br /> ❑Groundwodc �Footing ❑Rough In ❑Rough In <br /> ❑SIablConduit ❑Foundation ❑Cciling Grid ❑Ceiling Gnd <br /> ❑Rcugh In - ❑Structural Slab ❑OK to insulata ❑OK to insNate <br /> ❑Service ❑Praming �� ❑ Rooitop LJnits ❑Water Service <br /> ❑Grounding ❑InsulaL'on ❑On���rricel rincl <br /> ❑Ceiting Grid - ❑totedical Ga; <br /> ❑Dry•.vali Nai�ing ❑Flu;nbD�g'rir��i <br /> ❑Electrical�Inal ❑Shear iJailing GAS PIPE <br /> 61TE WORI( � ❑Raof PJaliing ❑Rough InfServir,e Hot VHater Tank <br /> (]Fooling tlrains ❑Ceil�ng Grid ❑Re(ri3ention ❑ Rough In <br /> ❑Roof drains ❑0uil�ina Fina! ❑G=_s?iac;-��.I ❑'r;J�Y t'inai <br /> OTHER OR CONSULTATION;__ �j`l'� % `1 1 // 7 i <br /> .�i_�-� 1�-�L�;_�1 _ <br /> ❑ APFROVAL ❑ Pf�RTIALAPPROVAL G;hlqi_(1P�i-!'ON9,LTF�ISPL'P.f171T <br /> ❑ OK F'OR T.C.O. ❑ CORRECTION REQUESTE� <br /> (� OI<FORC.O. ❑ VIOLATIOiJ �._� <br /> ❑ UNABLE TO PFRI=ORM WSPECTION: <br /> ❑ CALI(A25)257.8681 �'J4 Rci�S!�F_;'iDf�1-26;-,ou:natica vequir�N <br /> r s�� d�.�__ - -- - <br /> se�,-��a�; , - <br /> �- - <br /> ; <br /> inspecior.._______�� _._____ pafe:`___ _ <br />