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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE rE(srG.COMMENTS OWNER BUII-DER DEt-CANATloN
<br />I hd.!, nmm undd l,6ahr of t€llry th.l I m.r.mr lrom Ih. co ra'iod l.icre li$ for rh. f.Uotrins r&n (^.. r(ril J
<br />llusnBr a,xj l\ofNnn (i'd.): Atry C y or Counly shrcn r.{uir6 o Frnil ro contrucl. .h6. op(re ditulch or rqu !
<br />dtu.rfr- F, b n] Bum.. ,'I$ r.qun6 rh. rpplK r for such Fmir ro fiL a sun.d lllr d {hd h. or 3h. ir li(dE n !u$ad
<br />lo lh. Furtn6 ot llE Co.lrrlm r LE4EI L.$ ((lEI{d 9. ( omnmrns tr irh SRlrn ?(xxl oa l)v'r'o, I or rh. In'sin<i ind
<br />kordi,m( o&)or ih.! h.or3h. n.rmF rh6.non dl rh. bdr" ntr rh. ilkt.d.rmprbn Ant\i.l ionofsdrnT0ll 5 b!.n,
<br />orplmnt for . Fnrit suhjGc lhc qplic.nl lo . cn il p@h! o f mr mn. rhr. lir . hodr.d &,llG (1500)
<br />l.N.$ndolrhcpNFnt.orny.mploF6\rhwi!6ar(h.rrn..omFrdn,n.Glld.rtlE\('*ddtlEslulNan{
<br />i'rrdrLd or orqd nn sb ( ss 7or-r. B6mBr bd tmf*nrnr ( od. lt. (i drtrdor s t.'(d* l.a* d.6 nd q'rl) ro in o\ ne' or
<br />rh. F)rq! rn) &rilll or ans.lr 6 thdon. dn * h) dE sn \!Il hr6.l, or h<*lr or rhnrush hir d nd o$n mt lo) c,
<br />provkl.d rh.r such i' Fovffirr a. nn hEial oridd f.r ek I( lxJs6d, rh. boiLlnB o. lrFm.ffi i $ld *ilhi. oE 16
<br />ofcoDpknn, rh.(\'n6 Bui& willhau.th. hlrdo ott'ovrr+
<br />'hd
<br />h.or slE did x txih or inu.or. ttr rmF' lfl llE ru4$s.f
<br />L a o$rd ol rh. pr.pdt, dtr.rcLrn.l, .o rdina $ irh li.a&d co r&16 to 6drud rlE FoF (S< 7(rl.i. &*l|B
<br />ad hoi3rir Cod. Th. Contrlcrois l.i(.e lrw do6 nor irply to e own6 of FoFd y *hn buildr or impr.r 6 th66rn,
<br />..d $ho o fts tu 3u.h Fojds snh . ( o d rls) li.ft{.d pdRud rorh.(i.lr.dois l}.N lir).
<br />I rnr\c ir)r tr J.r S{trri
<br />D.r. oi.d
<br />wonxres' coniif, .s^rroa
<br />IECIJSAIIAT
<br />I h6.by rmrm un{,( p6!l'y of pqJury orc of llE followinS .l(Lr.lioN
<br />I hlv. rd sill inhh. Caiifkd. or(olgr ro li.lf-|M.. l s.rt6 onr.Mion. B ,rcv'd.d for by S.dion 1700 olrh.
<br />Ldor ( od.. lor rh. Ffol1re. of ih. rdt ao strth rh. Fnr a isu.d
<br />Jr Ur. .na *itt .,inr"'n *o*6 compau.r ion iEurm., s r.qun.d by s(xon :r7oo or lh. lrbor ( od., tor lh. psf6ne. .f
<br />llE s{il for f,hth llfi Fhil ir isrd My worl6 onFdion iEumc. cair !d Flty.umb6 E.:
<br />c*l. c:l ?n,\ t.,f (o
<br />t^1"!b01,Lc1-[. l- tg
<br />|..nift lhd
<br />'n
<br />rh. D.rfomaE. of tlru L for $hih rhi! rErmi! n ae.n.Irh.lld mrlor r$ 6'o b.<omc sut ..r to rh. wori(d'.onp@rion l$i otcdironn. Dd.sErha if I 3huld b. om iutidt ro tlr
<br />$nrlc.ontEqrhnpluii66ofsario.:1700orrhcl-ab,(bd.,I.hatl,lonh*irh.omplywirhrl$*,m\irn,N
<br />WARNINC Fn[r. io w. $0116 onFdhn 0\6+. b u.l!{tul. Ed 3hall 3ut1d u altors lo mmtul FuhE od
<br />ciil find up lo o* hun&aj lkrsd &,llc (!lm,mol, ir dlnio. h th. cd of comFNlrcn, d.nu*6 !s,r.\'d.d nn th.
<br />Sarion 1076 olth. t lEr Codc. ntrd.n ud 0nonEy s ac
<br />9ro - rt
<br />I lE.by rrm undd Fn,lry . f pdjdry rhar I m [.d€l ddd thvirnrn ol chdBd q lcommdcing $ irh s..1irn rlxxrl ol lh isi,n l
<br />ol rh. BGmd !.d hrt<s'oN Codc, !,1 ny li.mc ir in fult ror.. ad cfrEl
<br />t,i..Mchs I
<br />,,,., 5- lgr-J
<br />1t1tlt,"K C fr
<br />cqrilauqro l,lNDllclcE!(l
<br />I hd.by rfift un&r Fahy o I Fjw thd rlEc i$ oirruclr. lddor ,Btrr lor rh. pnfol:l@. . f rh. *. tu \t(h rhn Fnil ir
<br />BU.d lsa.10e7. Civ C.l
<br />l.ftiE s Nrn.
<br />APPLI('ANT DE(-LAIt ]ION
<br />I hddl}'rtrm undd lEnlhy of Fjury oft of th. nnhsin* &<ls.ri..3
<br />l).mlilion Pmit!.Arislo! Notilicdion ldr6.l R.8ul{ion (TnLl0. fd6)
<br />R.qutat ldtd orNdilrdi,n
<br />I cslif,_ lhd rn f.i.ralr+lhthN l+rdin3.rb6t\ rm\nl d. nd 4rlicnbL ro rhs prord
<br />I cdrrfrrhrl I hrvc,qd rl'is aDpli.arion s.d rdl. rhlrrhcahrv. inlomalrn 6 corrr li*rrlosnpl) *irh 'll cnl
<br />ddmft6 md Sr.r.IArElirB ro hildi.S coinructnn. d hscby ldh.rtc rqn6dnar^< orrhir Ciry ud ( oonrl ro mla ol[n rlE
<br />.h,'. lEtirEj FoFny for iBF.rrion FrFs
<br />^rr-*-n*-,.,,',*.[ {b o',. !-1o-11
<br />Pmrr{n.n.(p'r.r,: Clrt, (3Oll4
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads . A\.1r[\
<br />UFER Ground
<br />Subf loor/VenVlnsulation /)
<br />Roof Sheathing
<br />Shear Wall t)'r'1,/t'.
<br />Framing WI ,,4,
<br />lnsulation/Energy l/)t 7t tii'i,
<br />Drywall
<br />Ext./lnt. Lath )
<br />Brown Coal -T ll 1lL]
<br />"W
<br />w
<br />Mason
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />I I I
<br />FINAL
<br />Certificate of Occupancy 1
<br />lYotes, Remarks, Etc.
<br />r4 I 1
<br />I t-u
<br />\,r-il
<br />SLAB Floor
<br />vlH yl/
<br />ltr'ill,1
<br />bl1..5h]lil4v/w
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />Flood Zone Certif .I
<br />I
<br />I
<br />I Wk*
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