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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O\INER BUILT'ER DE'(-AI'ATION
<br />I h6.by rmnn und6 p6ahy of pdjury rhn I er cr6pr Elm th. Co r.cloR l.rc€N lis nr rhc lollo$rr r.e! (s( 70r l 5
<br />UNins !d ftof*ion Csl€) Any Cily or ('oonry Nhich cqun6 . F6n to conerud. rlld, iirov.. d.nolirh .r qx, dr
<br />(rucl@. Fnr 'o
<br />tr! igsllm.. d!. rcquiB tlE {?ltar for 3(h Fml ro liL i srlNrt rdm' rh, lE or rh. ir lrc.B.n I'{ed
<br />lo rh. Fo\BbB oa r Conr*ror's l-koldl l!$ ((r!,prd 9. (iMtr'r! rdh s.<Fn 7(rrQ of rriri3i,n I olrh. aurr6i $d
<br />Itln*FnsCod.lor!nllEoislE6crmFrha.liomd,nrn.tsnn rh. ,lk*.d .raprioi Anr \irl,to..lsdhn?0rI56).n,
<br />ta4,lic. nr.lnn slbj<lsrhr.fi,li.dll.acivilpoah,olnornorcIhmfi\.hurdr.ddollm(t500).
<br />l. a ouE of lh. rn'F1r..r ny 6pLlc sith *ryB B rhd $L onFndion. \ill(h rh. \ui,n tlr rurr.6 mr
<br />ddrLd m olt6.d aor sL lse 7(!J. BGilN ud PilfNFB (i!. llE ftdr&1or'i Lt@ I r$ &E ml qTlt b & n{K of
<br />rh. rmF) I tn hil(h or nrm\E thdEn. dxj u lm &E sh urrt hrm$lf or hdslf or rlmorh h'. or hs os'h .mdo!c.
<br />provid.n rhar i!(h i!ryormr! e ml inrErld or olIa.d nn sk I I ho* 6s, rh. t(ildin! or nnF\ mr is r)ld { ihin on. )a
<br />of(.mpldiJ., rh. ( )\yn6 BliLti "ill hav. lh. hrd.i ofprolins rhd lE or s\. did nor hiB or inFovc rhc plopary tor thc pu,I.{ ot
<br />l.6ornd.frh. Fopair, er.\cGn.D (ont&ri.8 \ih hco\dl.onrdod r..odtud rrr Fr,r.( ls( 7l}l.r. &Bin6
<br />.nd Poisih ( ill,tc Th. C.nrrdkn\ l-icos. ks (h6 nor 6prly ro M otr n6 o, ForEny { ho bui lds or imntu r 6 rhd6n.
<br />and sho rodncrsior.u.h phl..rs I irh a Cdnldcro( t 1rcft.d puGuanl tolh.(onfactoa! I ico* li*)
<br />Ln.rmF un&r sdrion
<br />9g U) rql C
<br />ll!.! r \r\rx,\
<br />I nd.by amrm undd FDlrt. or tEjur, oftof rh. nrk qins &(l,mtrcc:
<br />I h,r. ri e 'll Minl'n ! C!i'fkd. orcolFr ro Sclf.lBur. r.r u!*c {omFEiir,r s p.or rl.d for !} sdtra r',00 or rh.
<br />I ihi. codc ror lh. Ffolrrrm. of rh. sort for *tth th. rET 6 is.d
<br />I h.v. and will nrinrrin $ orlds' &mt Brr ion 'n$ranc.. &\ r.nun.d b! S(hon r 700 of rhc l .strr aod.. litr rh. pdaoman(. . r
<br />rhctro for$l'(hrhi!Fn ir irlsun Nl) * rkEs'.onFa,k,n 'BUr c.cnrrddFl'.r numhd &.1
<br />l.dit lhd n rrE FloruNc otllE *ort tn$hahrhirrErmn i isucd.l3h.ll e.l mphr.nypc$n r rn) EdM
<br />$ a'o bGoG rut d ro rh. $orld mnpqaaF.lrrs of(.hfoma aId lsr rhd if I shouu tEoft tubrrd ro rlE
<br />e.116 6n{Eur6n Fyak\N .f sdion lT0o of rh. Llhor ( uL. l ilEll. fonlM irh $-Dly * ir h
<br />'hos F.\ niin3
<br />WARNINC f'.iloE lo su. rvorlG onpdldion coldsr t unla$tuI. and 3h,llsuhjd an drployd ro.innn.l pdahiG rnd
<br />cirl find up k) !n. hu r.d lhouend dollss (t100.00o).
<br />Sdri,n 1076 of th. Iilnr Cdq drcd anl dronE !lc
<br />ln. cosl oacomp€nsriun. dara*.r,! p(nid.rl lu lh.
<br />IJECIAAAIIA!
<br />I M! amm utoLt FEny.f Fjurr rhd I m I'ca<d undq rrcvlrn of Ch.rns I (Nmmnins trirh s..rirn 7u)(D of Di\ i.ion I
<br />ol lr. 86Br r.d PrctdioB ('o&- d n) l(* is in tull nn.r !'d GlI6l
<br />(altrBlcrl)t_l.l:tDlNc_aclit(r
<br />I hd.by afil"n un(lo lEalry o r tEjury rhar r hFc is a .oErrud i(!n ldd'ry ag6(, tn rhc rEfonnunc. of rh. s nrl fff \ ri.h {hs F nr ii
<br />rnrdl{s4 1097. (i\ ( l
<br />AffUTAdLDICIdAAUO!
<br />I lElt-r afrE u.ds Fnall! ot Fjurr oR of rll folhtrinB &r la irns
<br />D.nFliion P@n3 A.hGiM Nora(dhn Fcddl R.sulunnr ( | dl..1o. Prn6l
<br />Rcqut€d l.rrd orNotifi cati0n
<br />I cdify rhd dE f.rkrl (SuhrbG etading B&rd lEmvduc nor 4rlt bl. ro rha pmF
<br />I cd'ryrhd I ha. rdd rhi.rrlrotion !d nn.rhd rh. atn\c infnm,lhn ir or.d t asic ro $.rdy $ nh ill ( ( y ,nd Counq
<br />a^l'M(6 ud srsr.l.trs Elsr!u !o hu'lqnB conrur1'or dxl h6.by lurfiortu rc|t.r.darir6 otrhi! Cny dd (iiunryro dtd q{n rh.
<br />sbo\c mnrion.JpFFn) ror EpdrionptF6 n a,
<br />^pp,ron,m^rarsr,Er \Q0.e q Qg1 yc:zc ^,, 7' to- l1
<br />P@h(nrn.lpnnrr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing 9"'(lu {/w(P- PL4 /pfi
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Mason
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL o'ilr.t l1 a\$8
<br />Certificate of Occu pancy
<br />Notes , Remarks, Etc
<br />,r-,CA/d,cpa
<br />hr,,.o
<br />I
<br />.J '+Ck
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