HomeMy WebLinkAbout1214 Lakecrest Ct - Special Inspections/Field Verification - 08/14/20131. I verify that I have installed
minutes.
City of Fort Collins
Community Planning and Environmental Services
Building and Zoning Department
FIELD VERIFICATION FORM
JOB SITE (2('1 (.AOCef-5-1 C)J . PERMIT NO. ij 12-0
PRINT INSTALLERS NAME
INSTALLER'S SIGNATUR
=
v,j GA S " 1 1 r
(feet approximately) of gas pipe, tested at , S N1 FrF� pounds for
50,
COMPANY NAME f:.- C- I H ' {A
CONTRACTOR'S LICENSE NO.
2. 1 verify that I have installed (I' It W Ply KLI AO I.
which complies with manufacturers installation instructions and all applicable codes.