HomeMy WebLinkAboutPermit Building 1985-1-10
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Springfield Utility Board
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INSPECTION FORM
ACCOUNT No.3'l{r) ~{n~ / !5IJ,~~
INSPECTION DATE\)?C 18 . TIME
INSPECTION DATE-fu'\ ID TIME
CUSTOMER'S NAM~
STREET qJ..lI4-ql-\{" 1\\,
CITY C f\b\ I J'\r,
HOME PHONF
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INSPECTION NO, / INSPECTED BY
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INSPECTION NO, 2 INSPECTED By-.20
OWNER'S NAME LM_Qj~, ~). S,b9.p;DcI
STREET P. 0 &'>L 8,")110
OE'_ ZIP CODE qj 4Q..1
AUDIT DATE ID-18--B-f
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AUDIT NO,
STATE
LOW-INCOME
(NO. OF UNITS)
BUILDING TYPE
BUSINESS PHONF
ALL MEASURES COMPLETED _ CHECK FLAG (O/C)
MEASURE
~'i /WINDOWS
PATIO SLIDERS
I WALL INSULATION
I CEILING INSULATION
I FLOOR INSULATION
i DUCT INSULATION
I MAJOR MEASURE
SUBTOTAL"
I WEATHERSTRIP
D00RS/WINDOWS
I CAULK ING
I SEAL DUCTS
I CLOCK-THERMOSTAT
INSULATED DOOR
AREA
L KWH- SAVE~L .
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INCENTIVE
COST
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OTHER
I OTHER
I TOTAL.
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INSTALLED MEASURES APPRO'VED I './0,,; A.. 1 ----:.b~ '" "..
, FOR REIMBURSEMENT BY' ~ .
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