HomeMy WebLinkAboutSpecial Inspection Electrical 1983-12-7
Electrical Inspection Report
PW-13
(Rev. 3-78)
726-3753
WIRING INSTALLER
ADDRESS
ADDRESS OF INSTALLATION
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DATE /2-J-Jl3
TYPE OF STRUCTURE
USED
HEIGHT
WIRING METHOD: NON-METALLIC SHEATHED CABLE 0 ARMORED CABLE 0 CONDUIT 0
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POWER CO.
. ADDRESS
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OWNER
CHANGES ORDERED
ICITY OR TOWN)
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COVER
. FINAl
INSPECTOR
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. ACCOMPANIED BY
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LOG SHEET
INSPECTIONS
JOB LOCATION:
JOB NUMBER:
DATE RECEIVED:
OWNER:
OWNERS ADDRESS:
. CITY, STATE, ZIP:
PHONE:
TYPE OF INSPECTION
COURTESY (Renter Request)
HOUSING
OCCUPANCY
FIRE DAMAGE
REFERRAL FROM OTHER AGENCY
DANGEROUS BUILDING
NUISANCE COMPLAINT
ZONING COMPLAINT
OTHER
INSPECTION DATE:
INSPECTOR(S) :
OUTCOME:
1ST LETTER DATE: 1- r; -BY DEAD LINE: /() - ~-r? ?
COMPLIANCE GAINED: YES VNO DATE: /tJ ~ /;2.-??
NOTICE AND ORDER DATE: /O-/2-!f3 DEAD LINE: //-)2--'&--3
COMPLIANCE GAINED: YES NO DATE:
REFERRAL TO LEGAL PROCESS:
CITY ATTORNEY NOTIFIED:
COMPLIANCE DEAD LINE:
COMPLIANCE GAINED:
YES
NO
REFERRAL FOR PROSECUTION:
OUTCOME:
DATE FINALED:
CERTIFICATE OF SUBSTANTIAL COMPLIANCE ISSUED:
(SEE OTHER SIDE FOR ADDITIONAL)
( NOTES )
P 329 '965 102
~lECIE~~lIFO~ CIE~l~IF~1E1O MA~l
NO INSURANCE COIIERAGE PROllIOED-
NOT FOR INTERNATIONAL MAIL
(See Reverse)
SENT TO
Decaro's Upholstery
STREET AND NO.
439 Q Street
P.O., STATE AND ZIP CODE
-~ci-]:l.gLi..e..l-d-,-0P. 9747-,7
TAGE S .2()
CERTIFIED FEE .60 e
en SPECIAL DELIVERY
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~
a: RESTRICTED DELIVERY e
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...
a: en ... SHOW TO WHOM AND e
... ... ... DATE DELIVERED .75
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.lS.55
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE, AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES. (see front)
1. If you want this receipt postmarked, stick the gummed stub on the left portion of the address side of
the article, leaving the receipt attached, and present the artiCle at a post office service window or
hand it to your rural carrier. (no extra charge) c"\) _
2. If you do not want this receipt postmarked, stick the gummed stub on the left portion of the atldllBss
side of the article, date, detach and retain the receipt, and mail the article. . .r..~~ I
3. If you want a return receipt, write the certified-mail number and your name and address on"a;~ltrn .
receipt card, Form 3811 , and attach it to the front of the article by means of the gummed end9 if:sRace
permits. Otherwise, affix to back of article. Endorse front of article RETURN RECEIPT REOU~~T~o
adjacent to the number. ,'0"'.
.
4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, i')
endorse RESTRICTED DELIVERY on the front of the article. "'""If
......"
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If"(!jfllrn
receipt is requested, check the applicable blocks in Item 1 of Form 3811.
6. Save this receipt and present it if you make inquiry.
"'GPO: 1980331-003