NO PERMIT NUMBER (2)•
1. L �O
1 e
2. DATE RCD
3. TIME RCD.
•
4. READY AM (
a PM (
C
AN 1 16.
1 SP FV
TYPE OF
SI�CT.
6. AREA
Q
7
7. INSPT. MADE
TIME
DAT
•
6. AP ROVED 1
DISAPPROVED 1
1
9. REMARK
•
T
INSPECTOR
•
WHITE - FILE
YELLOW - INSPECTOR
PINK -OFFICE
480.871