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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O*d-lruilds tkljrhn
<br />I h6.l8 rmrm und.r p. h)ofFlurvrh.ll.ma.m ao,m lh. Comndo.t' Lrc..r lrw lor rh. ro|hrrs r6sn tG 70l l 5 Eum6!
<br />rn P.oG3ti'r Co{t): Any Cny n Cosiy rhkn Eq!i6. Ff,I to o6l,!.t, .td. op.n\.- d.nrlirt or Ep.r r} nruclu.- FDr ro L
<br />Btur...lei Eqni6 rh..ptlr...r 6r.(h Fn r., Iil..,aEd tl.r.mnr rh.l h. or !h. i! lE.Md puE6r to rlE pm$tio6 of rh.
<br />( ontldor ! l-r.r.{ Lt* lCh.prd e, Conr*rnt enh Sdb.70@ oaD'vub. I olrh. Burn6!.nd Prol6sE6 Cod.) or ihrr h. or
<br />rhc B.\mF rhscnon md rlE bBB for lh. .llcr.d .\.mgh. 4., viobrionof sdm 70!l 5 by.ny.pploln ror. pdrn 3ubj.n! $.
<br />rpplic!.r ro i cnil Fulry or nrn ooc rh.n liv. hudrcd doll6 (1t00)
<br />l.B o*ndofrh.pmpdy. or trrr.!rrloy.6 *trh *.s6 B rh.'r sk .onp.n$non. *'lldorh.*or\ rnd lh.nru.lu.tr nor nfld.!
<br />or orl.r.d forsl.( Se ,o44. lru(.6! .nd l"of..(onrCod. Ih.Conr.dor s I 'c.G.l.r* do6 nd rpply ro in osns olrh.plop.ny
<br />*ho bu,ld!or improv6 rh!r$n. .nd wh! doo ruch worl hirElaor hcMlf or rhrouh hDorh.rown.nrploy.6. prolid.dthlr su.h
<br />in,'rov.n.n( e. nor if,r.ndd or oIld.d lor i.l. Il hor'.rd, rhc buildrs or r pu.m.nr G $ld $irtr on y6rof.onpl.tio..tn.
<br />()sn.FBuildcr will hrv.lh. hurd.n oaprcring rh.l h. or3h. nol build or impror. for rh. lurlrot. orsk)
<br />l. B ownc. of th. prop.ny. .m .lchrir.ly conhdiry * irh lic.B.d conr.doR r, .oNrrr rh. pk er ( s?. 70.14, a6ir.ss .rd
<br />Prcf.sionCod. Th.Co.t.dor'r I f,.nr. tr* dod nor rpplv ro r. owtur ol pbpdy *h{l bo'ldro mprovB rh.r@n. rnd *ho
<br />co.t.dt aoi ruch proj<B ! h. cont..ro(r l'c..i.d pu*unr rorh.contrdori LE.nr t,* I
<br />l!n.r.nfl undn Sftiin
<br />ll oRl(ERs ('ontPE flsaTtoN DE(-L{Rnrtoii
<br />I h6.b) .mrm uDd.i p.Mhv.Ip..lorj oE.rrh.lolLf,rt ddlar.rio6:
<br />I hlr. .r]d ] ill mint.in . Cdific.t. of ( i'6.nr to S.llJ B!r. for mrk.B' .oflp.M!.n, a pro! d.d for hy Set bn I700 of rhc
<br />lrb.. (t'd., for rh. !.domnc. olrh. w.rr n *hrhrh.o.mit n i!.u.d
<br />lhrv.and w'llnB'nu'n rorlt.r. (onrn.nilon rnsu66c.. !s r.qutr.dbyS(ronlT.xrolrltlrtrr(od.,fo.rh.p.raom'anc.oarh.
<br />eorl fo. *hrcn rhs p.rnI B Es!€d My worl.('conlEnston
<br />'nsurmc. caric! rnd poliry.rnrbcr i..:
<br />PdlicyNunbd: - _ErpirB
<br />(Thir r..rhn E.il Dr b..onpkr.d ifdE p.rmn ii for (rE hutxtril dolLa Ill0Ol or L.)
<br />I .di6 rhr ii rh. p.rfolrffic of rtE * lt fn lhlt) rhi. Fni L i..Bd. l $rll d nt,b .nr F$. 'n .ny MM6 io a ro
<br />tqrm rubrd !. rh. Frl(i ' omFierK(LB otl.Iroa!. rnd isrd rhl 'll.hould h.otu rubld rorlE*o <.'
<br />(oton urFn plor6pd oasrrr. 1,oo or rLL.h(, cod.. I rhrl. lonhr iG mmpD rdh lhor pm,rrrntr,.,( h" znrue1 {/,/\WARNINC I'lur. io Rtrr. worl.r' (ohp.Brl
<br />'on
<br />(or..g.
<br />'r utrl.wful. rnd thrll ilhj-l t. .hployd b oniMl p.@h6..d.tri1
<br />nn6 up kr oE hundrd rhou!(l dolho (ll(ll,On).n iddilirn lo rtc con ofcomp.E lx'n, dlss.r r rroriil.d aor lhc S.ction 1076 oa
<br />rh.lrhor Cod.. 'nr.rd .nd .norEy i f6
<br />ll(j;lIr;DllNt&!(lll8:iDlcldrrllt,!
<br />I h.r.by rfln'n und.r lcnihy.t n rtury rh.r I rfl lic.ns.d und.r pmvEion.f( hipr.r 9 (co'nn,.',c,ns tr (h S.Clrn 7(X)0) oIDtrri()n 1.1
<br />rk llurn.s!rnd Pror6rod (td...fld nD I'cctrsc r tr' full forc. aM .O.cr
<br />@4?/+21 fl
<br />I hd.t, .lfm utd.r Fsnr.lpnjury rh.l r
<br />sudt (Sa !09?.Civ C ).
<br />n kndins .3ft1 ror fi. ll<rtotunc. or rh. tr ort r.r * hrh thi! !.mn n
<br />l.na( ! N.m.
<br />APPI I('A^I 'S DECLARA IoN
<br />l).n$lii.n Pcnnirl^lb.nos Notifi( ion t.d.r.l R.Euldi.tu (Iir1.,10, Pd 6)
<br />R.quir.d I-dr(.rNorii<.rion
<br />6td I ltra ro.ohplv *irh
<br />tF*ir.r,vq oarhn ('ny !d Counly lo 6rd upon lh.
<br />?* 16.wc3
<br />,.drb rhry h. ,.ddl rcBUkr hnr Erudrnr lbdror rm.\rl m .or .npl'..b
<br />y( , .-'rr/tr , t,.,- '* upr*.rrn . i.r. rh.r rh. rb... inrorurion i!
<br />dle,ftl.nd Srd.lrsr 'Gl.'nr rn b!'ld'ry c(Ertudrr. rrld hq.by rurho@. rtbo,}6'nn d FoFn! ro, mFdrnpuFs z /
<br />o,,/.".o-,,n 0Z1tg-s4 -a t t/.
<br />r.\Z/,,.",, G?t4-€r4 4a ,Z/
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subfloor/VenUlnsul
<br />Roof Sheathing zrlNi't ilt 13+
<br />Shear Wall J
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />FINAL b /!/!+5.Dr4Uz v((
<br />Certificate of OccupSnty
<br />Notes, Remarks, Etc.
<br />m[-lnsp€cnon Forms\Bu ldrng-lnspoclrcn Record do. 03 31 06
<br />UFER Ground
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