MECHANICAL INSPECTION REQUEST

 

FOR THE FOLLOWING TOWNSHIPS:

BLENDON, FILMORE, LAKETOWN, OLIVE, PARK, PORT SHELDON, SAUGATUCK

AND CITY OF ZEELAND

 

 

TO:  JERRY HOLWERDA                  FAX/PHONE (616) 554-0325    DATE: __________________

 

 

FROM:  COMPANY NAME _______________________________________________________

 

FAX # _________________ OFFICE PH# _________________CELL PH#__________________

 

 

OWNER / BUILDER:  ___________________________________________________________

 

PROPERTY ADDRESS:  _________________________________________________________

 

CROSS STREETS / PROJECT NAME:  _______________________________________________

 

 

TOWNSHIP:  ____________________________ PERMIT # _____________________________

 

 

TYPE OF INSPECTION:  (CHECK ONE)

 

MECHANICAL                                      ROUGH-IN _____________ FINAL _________________

 

MECHANICAL FIREPLACE                 ROUGH-IN   _____________ FINAL ________________

 

MECHANICAL REPLACEMENT  __________________________________________________

 

OTHER _______________________________________________________________________

 

 

PREFERRED DATE ________________(CHECK ONE) _______AM ______PM_____ANYTIME

 

SPECIAL INSTRUCTIONS: _______________________________________________________

 

KEY LOCATION OR METHOD OF ACCESS: _________________________________________

 

 

NAME OF PERSON REQUSTING INSPECTION: ______________________________________

 

 

Due to other inspections it is possible that an inspection request may be delayed.  Indicate if you wish to

be notified of any delays.  Every effort will be made to make all inspections in a timely manner.  Fax your

request to the number above, at least one working day notice, before you need an inspection.  Thank you

for your cooperation.  If a fax machine is not available for your use, I can be contacted on my

Cell Ph # 292-8658.

Avoid re-inspection fees by being prepared for the inspection and access to area for inspection.