HomeMy WebLinkAboutPermit Mechanical 1985-01-223r\CTL\
Springfield Utility B o ar d
ACCOUNT NO.AAo- o DElC)
INSPECTION FORM
AUDIT NO.
-
AUDIT DATE lo - 29- sq
rNSpECrroN oarrNov a? ,,rr9411 rNSpECrroN No.- TNSpECTED By
rNSpEcroN oarc{rtil ZZ rwe /OiD rNspEcrroN No. 2- rNSpEcrED By
CUSTOMER.S NAME Glexl lleer h OWNER'S NAME
STREET D.,g.z /Vo Du STR EET
C ITY STAT E
ar
o
Z IP CODE q
HOME PHONE
(NO. OF UNITS
LOW.INCOME BUILDING TYPE ALL MEASURES COMPLETED _- CHECK FLAG (O/C)
ME A SURE AREA KWH- SAVED COST IN CEN T IVE
fwrr,roows /44?
PATIO SLIDERS
WALL INSULATION
CEILING INSULATION./)enfr z/ro
0oot TNSULATToN 840 il / P7Z
DUCT INSULATION I
MAJOR MEASURE
SUBTOTAL
WEATHERSTRIP
DOORS,/WINDOWS /o
CAULK ING
SEAL DUCTS
CLOCK -THER MOSTAT
INSULATED DOOR
OTHER
OTHER
TOTAL
COMMENTS
u o
TOTAL REIMBURSEMENT
UzZ 4E/; fa z'rt/# f c T 4 z-A u,- t f ,F/4 cts
LLN
FOR REIMBURSEMENT 8Y,
URES APPROVED
DAT E
BUSINESS PHONE'lUt--?,?At-
j
>2.'