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CONTRACTOR -FIRM NAME
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ADDRESS
CITYICOM M UNITYISTATEIZIP '
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BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
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ADDRESS
CITYICOMMUNITYISTATEIZIP
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PLANS EXAMINER
APPROVE DATE
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APPLICATION FOR STRUCTURAL
ryRUCpULAL PERMIy
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FORM 284.208(11.81) INSPECTOR ,
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. 0
43
Final
IDA
Fireplace ' T.O.
P'
ADDITIONAL INFORMATION
_
l
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
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Final
Tank Pit L.Line
REAR OF PROPERTY LINE
P/l P)
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Groun8ihi3'Wire
29B Bonding
30 Fixtures
31 Service
32 Final
i 71 STREET NAME