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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS O\T NI:N BUII,DER DEI{'ANATloN
<br />I lE-,* .lIm un& Fuhr ol Flury rhd I m .rf,pr tum th. CotudoR' I EG l.u fnr Ih< finl'hmt ltMn (S< 7(rtl !
<br />lru'nd !,rl Pmf*irn (o&) ny Ct!. or (oude $hEh EqutrB s rqn'l Lt ..Ntu(r. lhs 'nrF.L., LLmli9fi or tqnn inr
<br />strudue rhr lo ils isum., lts r.qui6 lhc qDlicM! lu !!ch Fnn lo fiE ! r'sn.{ nllmenl rhd h. or rhc u licosd l,urudn
<br />ro rh. Fovisio6 olrhc Co.mcror'i t-i.ds.d L.w (('h,gd 9. ( onnd.in* leirh Selion 7000 of l)ivi3ion 1 .lrh. Rcin.s tnd
<br />Pm fstunr Codc) o. rhr( h..r!h. ir ddpl rh6.froh !.d rhc hari, for rh. rllcs.d.rdprion Any vnndnr.ofsdi.n 70ll 5brmy
<br />r!91'c! foiaFonsubidrrn.lpgh.drroro\ilp.tulryofnoidorcrhMfi\.hrnrt.ddolld(lJool'
<br />-l.Bo*EorllEForEn\,nnrdnrlqcrri$.166lhcnsEoEFdn..trillthrtkudrnrl'sdE
<br />bN
<br />id*ldt or olT6.d ftr sL (sa 7o{t, t}6i|B xd hrasNB ( oL T}r c.drdm! l.rc.e lj$ &a B,r {'?l) ro M o{ffi or
<br />llE FrFi) trho hril&or nr{rp\6lhsqe ard *ho &Esh$! trn*lror hdkltorrhmuAh hB or lE otrnflplo!6.
<br />pr.r kl.d !h!r ru.h imFrErdr m Ln inradal d..r6dt lor s,. ll ho$66. rhc tlillog d irE o\ffil ii $lll snhin on. )a
<br />ofcomrllion. th. 01116 ltuild.r *ill hlvc rh. hr&n oIF.\ins rh, h. or $c dd ml tuilll o. ulp.s\. tn. ln]rdy ,or thc plrFe of
<br />L a o*d olrh. F.pdD. m.rcl6n.ltc6dr&rin* *dh l(aa.d.oitadod tu oBrud tlE Ford {Sa 71L4. B*ilE
<br />drl hokinCon Tn ( odrxloir l.Eos L*'66 nn 4lplt lo & o{E .( Forcny sha b!'rdr o. mpir'rd ihdon.
<br />dd $t 6drra rr uh tmF! $nh. Coddhn, kdB.d Fllld ro rlE (n rdoi3 ti@ t^ t
<br />,":-ju;li+
<br />OEII4BAIIqN
<br />I lE.by lmm un(k FEXy ot Fjur, oft oarh. tolkr* us <k<krd66:
<br />Ofh,.. d *ill minr.i. ! ( d,r(n. orcoMr ro sclr-l@i. rm sdt6' $iFd.n. s Frd.d ('. b! sfrrion t7@ orrh.
<br />Lltnr ('od., for tlE Ffrffic of llE *ori for utkh lh. Fri 6 ascd
<br />I ll.r. lnd will mrint.i. sod6 conp.Nlion iNurnc€, s r.quncd b, ssl t,n 1700 oalt I ihor (i'd., rdr
<br />'h.
<br />pdfot,M.. oa
<br />lh€ *ut fr {hich thi! pmil L! i!u.d My por*6 comto!.l ion iNlranc. .Mis Erd policy numbr E.:
<br />Ird'ayrh.'inrh.p.rformft.ofrh.so fortrhichrhrp..hn is &u.d.I .ll Rn orylo) anr r(vri 'i any'nMF
<br />$ I b tElrft 3ubiB-l ro
<br />'h.
<br />*1 6 (omFE{ion li*irf('rl'lom'r- md +R rh, ir! should b.(offi s!lr6'
<br />'o
<br />lh.
<br />$oa6' comrE er ioo p(n s(,n. ol sdrion I700 or rh. I.hr ( od. Lull. n,nh$irh conplr_ $nh rh.* Ir\ irions
<br />WARNIN(;: r:ailu. b <c. *ork6' comFri.lion .ordar. is unla*ful, e sh.ll nrbjdl M cnplolcr lo si'ninrl p.nalrls sid
<br />.ivil ,in6 ut b.n. hundi.d rhoM.d dollm (ll(x).(xxl), in addnnJn h rh..or of comp.Nlion. drmla6 rs pro\idcd fix rh.
<br />(ixL, d6d Md db.lEy's f6
<br />trclaSauol!
<br />I hcni' .mrm unds Fnnhr of rdrury rha I m [card u.d6 Fo\ isDn or ( haDrd !(.fnnnd.m! \ h sdron Totxrr ol'y'ilko 1
<br />i lh. h8indsdnd Pmlasidls(ir(|.. dd mylicds. h in tullforceandcll(r
<br />cl)!flauctloNrllDltcltill(}
<br />I hdcby rmd u.d6 rEnahy o I Frju.y rhd thd.n.iJnnoclirn lodinE !gm.y lor rh. psfomd.. of lhc sor! ru {hth rhB Ffli n
<br />Li$.il (Ss 10q7. Civ. C.)
<br />I a.Lr'r Nm.
<br />AITLI(ANfDICIJAAIIAT
<br />I tEtt\ afiinn trndc pdih! olpdjry on. ofrh.lollo\err d(ldarbns
<br />Drlnnhtr,n fdmirs Aslann Nolifi.driotr F.doal R.EuIxn'ns ( Iirl.,l0, Patr6l
<br />R.rtutr.l Ldto olMr'fi r.rr)n
<br />I cdifl rht lh. f.d6.l r.suLlirE csadins stEslor rmnll {. mt 4rlidnk h rha I,6F
<br />ff1.-n,,trt,,,..,.ua,t.qrlur'on,nlrdcrhdrh.rtrn.hrornrFn6condlr*laio..mFltf,nh.lt(nyrnd(-outrl\rof,-o*o-asror.ru"'.ro,,r{.iot!,ld.gcodrun-n.ddhqcb.vaurtn.rcEF6ddi;orrhkciri&J(-ou,ro016uponrlE
<br />ahov. mdln)n.J prcpdt for insp(rnn ru,pos
<br />^pprl.rnr
<br />or
<br />^*6r
<br />sisn.tur. X
<br />rmir* nrntrp;nrt: K Dcualz
<br />,,^,"'4r-l.z^
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />....r1 ^hltr{t+lJi\Jrlll\(v,)
<br />Certif icate of Occupancy
<br />Notes , Remarks, Etc.
<br />{
<br />I
<br />Drywall
<br />Ext./lnt. Lath
<br />I
<br />I
<br />I
<br />FINAL
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