HomeMy WebLinkAboutPermit Building 1985-1-28
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Springfield Utility Board
ACCOUNT Nr:2k.f', - oaq {;XJ)
INSPECTION DATE /-2.8-8~
INS PEer ION FORM
AUDIT DAT~
TIME ;rOD INSPECTION NO,
INSPECTED BY 2l:>
REINSPECT ION DAT~ TIME
CUSTOMER'S NAM~f2i)t0 Me(jo.E.+
ADDRESS IQ35 faJl?IJIP{.LJ
ZIP CODE
HOME "'1 ~
PHONE n-t{;;c.R
LOW INCOME
BUSINESS
PHONE
(NO, OF UNITS)
BUILDING TYPE
KWH SAVED
PREVIOUS INSTALLED MEASURES
I
INSPECTION NO,
OWNERS NAMF
INSPECTE 0 BY
SAI\.J\Q.
ADDRESS
STAT"
OWNER'S PHONF
ZIP CODF
ALL MEASURES COMPLETED
CHECK TO O/C
PREVIOUS REIM, TO CUSTOMER
IAQ SUETOTAL
I MEASURE
I STORM WINDOWS
I PATIO/FRENCH DOORS
I WALL INSULATION
t.CEILING INSULATION II ""OED
r!). FLOOR I NSULAT ION
I WEATHERSTRI P
DOORS/WINDOWS
I: CAU LK I NG
SEAL DUCTS
I DUCT WRAP
I CLOCK THERMOSTATE
OTHER
TOTAL
AREA
,
Q6o!l
96.np
COMMENTS:
.I
1
I
I
I
Ii
llNSTALLED MEASURES APPROVED
FOR REIMBURSEMENT BY:
..
KWH
au
.2D~
111/.00
r
~ TOTAL REIMBURSEMENT_J
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I
J
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/-2,8-8j I
DATE:
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