HomeMy WebLinkAboutPermit Building 1984-10-29
(
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Springfield Utility Board
f?':l~'1tt)
INSPECTION FORM
ACCOUNT Nodk\ - b ~ 'I '?tl
INSPECTION DAT~ ;:;;0 TIME 32/9
INSPECTION DATE.:::Ji::}1\J 18 TIME.3 pl'l'.
CUSTOMER'S NAMEC1\Ro\'1' (Y''-Gl \ \
STREET 3 \ <po '-H.'{\II.'~Ja...L
CITY , ~p~'\d
HOME PHONE ~i, - ,$\("ro
(NO, OF UNITS)
LOW-INCOME II BUILDING TYPE
I MEASUREJ_ AREA
Q, S/WINDO~S vnr J.itJ.,J
I PATIO SLIDERS
I WALL INSULATION
I CEILING INSULATION
I FLOOR INSULATION
I DUCT INSULATION
I MAJOR MEASURE
SUBTOTAL
~L: "'EATHERSTRIP
~'OORS/WINDOWS
)/lULKING
I SEAL DUCTS
I CLOCK-THERMOSTAT
IINSULATED DOOR
10THER
OWNER'S NAMF
,STREET ? 0
AUDIT DATE -.10-::)9-80
/ INSPECTED BY 2-0
?- INSPECTED BY 2b
H. I~, C. ~ Q
~ Cj 0 '7 - r'l ~Q/YlJ..
ZIP CODE Q'lI..IlJ 0
AUDIT NO,
INSPECTION NO,
INSPECTION NO,
STATF
OR-
BUSINESS PHONF
1
ALL MEASURES COMPLETED _ CHECK FLAG 10/C)
J KWH- SAV~D I~ COST 1- INCENTIVE
I
I
I
I
I
I
I
/J]O
5?Z~ 41
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I
I
I
I
I
VI1r /.,/VJt,,u
1fIgr- 4/".u;J
2,1/
'1/
I I
I I
I I
I I
--,- I
ILrOTAL REIMBLlRSEMEN~:----=-l I
COMMENTS' ,()~ 4.>")"r",,,/L;.1} - I/A ),4-/?~ f1? ~4~-",) kN77ty-=1
r7J .4-':'1","",<" .QFY'lb -,..,... / ~/'r, /<' JtJO-'- a./L4'T/h!~ ,<T-/.?yju-i"'A.(j).4r17;'
~,:>n ';'J<:'d/ Ar7;"..v / '<:, HJ/\-r- .<'-"Y"UA"A"A 7'n (V)().tr'.
I~O/;~'" <'77 ,-V~.v,. rr"'J f.?'07~-rJ;>--7 ()~ ~
. 1 J
f-.L "'3" ~ , / J,.,,. t.-4;f'~..,
I /3~f77McTln A:-b//r=~,) 6c,.-.1,4-Jc)4'_
I ,r
I
OTHER
TOTAL
/)~~ /- ('
XJ~/
INSTALLED MEASURES APPROVED
FOR REIMBURSEMENT BY'
I
JI
DATF