HomeMy WebLinkAboutINSPECTION TICKET - 06-00184 - Madison Memorial Hospital - AdditionINSPECTION TICKET
❑ Bldg. -'A Plumb. ❑ Elect. ❑ Mech. ❑ Fire
Inspection Request Rec'd By Date I I 00
Req. By 1' iii Z, d4ROl?!.LWrr Phone No. 522- 4qJ
Project 06f d IS6Y\ OYIP DOl1'4 Permit No. 06- 18 Ll
Address -SD c VnA1I7
Inspection Type _f RAgh in — Ih wA l l p f l- mA i In it J
Day/TimeReq. /Y,O :#nURS
Inspector's Report ❑ Res. ❑ Comm.
INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y ❑ N ❑ N/A
INS TOR'S ACTION
APPROVED
❑ C.O. (FINAL)
ACTION REQUIRED: _
❑ DISAPPROVED
❑ NOT APPLICABLE
❑ FINAL
❑ DID NOT INSPECT
Signed ry Inspector
Rec't Act; owledged
White-OKce Copy Fellow -Jab A, RliNc-Inspecror's Copy