Polk County Public Schools, Community

Inspection Request Form

Tell us where, what type, and when you require the inspection.

Inspection Request Form

1. Job Location:
2. Building Number:
3. Contractor:
4. Inpector's Name:
5. Fire Marshal:
6. Fire Marshal's Fax:
7. These activities shall be inspected prior to proceeding. Check appropriate box for activity. Additional inspections may be required.
8. Underground: Electric
   Underground: Plumbing
   Underground: Storm Water
   Underground: Other
   Footer Reinforcing Steel
   Pre-Slab/Grade
   Fill Cell
   Tie Beam
   Termite Treatment (PCSB)
   Structural Steel
   Electrical/Plumbing Rough-In
   Pre-Roof Conference
   Pre-Rock/Shingle
   Pre-Wire Conference for Fire Alarm and Intercom
   Above Ceiling
   Sidewalk/Driveway Grade (Pre-Asphalt Inspection)
   Fire Systems, specify:
   Other:
9. Date of Inspection Requested:
10. Time of Inspection Requested:
11. Relevant Mix Design or Specification:
12. Concrete Mix#:
13. Slump:
14. Amount:
15. Date of Pour:
16. Time of Pour:
17. Threshold Inspection Needed Building #:
18. Contractor (sign) As Ready:

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