Field Inspection Form (Fillable)
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10 Date Submitted ______________ Johnston County Inspections Department 309 E Market St Smithfield , NC 27577 Phone 919 989 - 5060 ? Fax 919 989 - 5431 ? Burned Structure ? Moved Structure ? Other_______________ Fire Department Name ___________________________________________________ Property Owner Name ___________________________________________________ Contact Person _________________________________________________________ Contact Number ________________________________________________________ Location of Structure _____________________________________________________ ______________________________________________________________ Office Use ONLY Inspector’s Inspection Report Date of Inspection ________________________________________________ Inspector’s Comments of condition of structure __________________________ ______________________________________________________________ Repairable ? Yes ? No Engineer Certification Required ? Yes ? No If yes , give description required ______________________________________ ______________________________________________________________ Permits required ? Building ? Plumbing ? Electrical ? Mechanical Additional information Approved to be Moved ? Yes ? No Approved for Construction ? Yes ? No Condemnation Required ? Yes ? No Inspector Signature _______________________________________________ Please PRINT Name Page