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� <br />everetl ��5��°�jT'�N �E���d� <br />� O � �0 <br />Address-�/ %�y ou� — _S' ��-"�4 ��" <br />Owner �Jn.t.-c..�F�'c_%� C��� <br />Datc � �i 'S1%S-/ <br />-- _ i " ' <br />TYPE OF INSPECTION REQUtSTED <br />❑ BLDG: Pmt. Na. ��_�,� <br />❑ ELEC: Pmt. No._ ❑ MECH: Prnt. Na.��_ <br />------ ❑ PLBG: Pmt. Ilo.�,__.__ <br />❑ Hausing [] Mosanry � <br />❑ Foolinp ❑ Insu,atr n <br />❑ Froming [1 Grcundwurk <br />❑ Foundotion <br />❑ Sewer � �rYM'all Nailing � Ccmultot�en <br />❑ Fireploce ond Chimney � Raur�h-In [}-Finol <br />_._____ ❑ Scrvice ❑ (�Ihcr <br />__ __ <br />APPROVAL �--�'- -- <br />VIOLATION � PARTIAL APpZpUqL <br />____ _ __ __ __ ❑ CORRECTION REQUIRED <br />-- --_--___= == <br />❑ Corections listed below MUST BE MADE befnre w�rt, c„n be opprwcd � <br />❑ Wrrk lisled below hos been inspected ond opproved. <br />❑ Pleose eontoct inspecror ond ormnpe for oOPointmenl <br />❑ Was nat o61e to nerfarm inspection. <br />❑ CALL 259-8870 FOR REWSPECTION — 2q hour nuiicc rcquired. <br />/� Certilicote a( Cceuponcy shall be issued ond posted on the premises prior tc o;cupanc . <br />� , Y <br />���` s �`--- _ _� � <br />�. <br />�� <br />