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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O\T NER
<br />'tIII,I'I:R
<br />DELCAR.ATION
<br />I ndrb arm undd rE hr or rEJun rhd I m .@lln lirm !h. coffi6' I k.e l,r aor rh. tolh*rns lien (si( Tulr 1
<br />B{iins ail Proacson (.&, An! Cn} or Coudr qhkh rqur6 a Fn'l ro oMru.1- ihc. imForq damluh nr qu ur
<br />itudu.. Fir h nr isum.. 68. rcqunB th. q,pliui tu ruch Fnn ro fik .3i8n n nd.tmr rhd lE or sh. i! li.d&n pumd
<br />lo rh. Forisiod of rrE (i,.k(ror3 Lic.ns.d ll" ((tutrd 9. ( omtrins *ilh Sd!'i 7(x[ of Diviion :l of lh. Bn.,n6! .nd
<br />Phf6r.rCo&)orrhllh...!h.i!.rmptfidciinmmdrh.h.rn6rIh..lks.dcifrrl(n An,liol,rionofsc.lhn70rI5qulnt
<br />.pplica for a Ddmi luhl<B lh. .ppli..nl to s civil ,.n.h y ol nol morc lhu fir. hundr.d (()llm ( t5oo)
<br />l. s oMd olth. ForErr'. or hy mplolc whh w.*6 s rh.ir $1. @nFNrion, will & lh. sul ! llt !d\xrq. k mr
<br />ltrqd.d or otrdcd tor !r!. (s< 7(x4, Bdi,B md Pr.l6ioN ( o&: In. Conlrrlori l.E@ liu' dE .or drply r. u o$F of
<br />rh. FoFty $ lF h.il& or irrF.\s rlEor tn u rr .lE uh *o* him'.lf or hc*lld rhh!8h hi. ( hq osr dph\6.
<br />F.\itdrhd*chinqm\rEd!emlirqndnofiEldl-i].ltlo*EEtlthlildl,I$i,4miildi!!B{ntun(r)@
<br />orcnl9lrbtr dE O$G r}rild. $ill hn! rlE hrr,a.f F.irtr fir lE o. CE dd Dr trild d lrgnrt tlE F!Fi' fo. E FrFa.r
<br />l. s o\n6 o f rh. FoFny. m .rclusir.ly rod,e! m8 r nh li.msd cododoE nr .odnrud
<br />'h.
<br />pro].d ( sN 701.1. llNtr,B
<br />Ll hlEsi{ Codc: , hc Co.k.ctr'r l-icas. L.* dod nor $tl) b d o$nd o a rop.n r r ho bu'l{s o mpm!6 thdanr.
<br />dnd sho .o.rhds for sr.h Fnj..r3 with a Codm r(r) licm%n puEu.l rorh.(ont.dois l-i..M hw).
<br />I rm clonnr trtrdr Sn1(n,
<br />SONXFRS' ('OnlPENSATION
<br />DEClJA61la!
<br />I hq.b' amm undq Fullr of FJUr! ok of rlE follo$lu tL<l,trioB
<br />I h.r. di will minllin ! ( 6lific.l. ot Congl to s.lt lnrurc f.r s ork6- snFM tun, !r Folit d for b s<rti 17no or rh.
<br />l.hor Cod.. ror rh. Fnnruc. of
<br />'h.
<br />RorI for which rh.
<br />')chi
<br />n isu.d
<br />{i h"'. ona " itt .ni.' o- " nrlo (ompartrDn
<br />'Nur.nc., er rqunal b} setion I7(nr ot lnc I ihor Cod.. lor ih. pdfom.ncc of
<br />lh\ trork for shEh rhr n6n'16 su.d M! \o'ld'c mpour'.n 'tuum..cmq Erl Ir lict nunh. E.'
<br />9"14r€ Fv.t ?
<br />4lt tltL ..,"- o t/uy'r
<br />l.diryrhd i. lh. Fforuk. o[rh. s'oil fo. trhrhrh't p.rn
<br />'r isudl l idl nor mrh, !n) p.Mn in &y nDF
<br />s Bro hc.ft$U.d 'orlE${ 6 smFtsdion Eu'r.tc!lifom'!. dd.gElhd itl rhruld t(om lubi(l rotlE
<br />tr rt6 (omF eiion Fovirio6 of S.dion 1700 o r th. I .bor ( od.. ! sl6ll. lodhsnh .omdy s h th.s prortio6
<br />wARNINC FlihE x' ruc *ortd @mF.srion sv6*. ii unla*tu|. ud rhdu lub.id u @ploF ro simin.l pcEhi5 ond
<br />(tril fines ulr t,.n. hutrL!'(l rlntrsind dollam ($ll)0.1)l)()). h rddni(rn ro lhc o rrflsxli,n,. d.ma!6 r'.1klr,l la' rh.
<br />a Z 7.
<br />DICIJ8AIIAN
<br />I Fq\+ alTm unln FMxy ol Fjuav lh, I m h.qej ud6 Fol nhn oach,ll. e (omffii.! N nh Sclnn 7flrl I of Ih "Fn I
<br />of rh. BBiIB dd PrclBr6D cod.. ald mr lkG ir n tull fora.d.,Id
<br />t1
<br />I (cnsc( Lassl ,l ./
<br />",,, Qzr/n
<br />b
<br />COIIIA!(IjAIi.LIBDIICIGEICI
<br />I h€.t'-t .rm un:t6 F!h! ol Fjury (hri !h-. i3 . ..drucr hn lnii.g lgft! lor rlE Fr(!lrm. of rh. r o t1r$hichrh!Fni 6
<br />i.s.d tsd 1097. (-ir c r
<br />l..n&'3 NM.:
<br />AITUCAN[IIIiCIAAAUA!
<br />I hdd1v.trtrib undd Fn.hy f rEjury orc ol lh. lolloainr dsls nrns
<br />l)qnoliltoo Pmns'Art6l6 Notfi.d6. F.ddal R.!uhnrN (rnk{0, Pd6)
<br />R.qun.d l3l6 or Mi'li.di.
<br />I .d ri ih, rh. lald:l l.luhl oB E3edrr atEl.r rm!\ !l & nn +pli..bk kr rh6 txor<(
<br />I (dify rhar I llr. rcnll rh6 itrnl
<br />'.arnrn
<br />arn sr.r.rha' rh..trtr. r l,gan, comply s h all Cir!.n! (in'nr)
<br />artrd ofth'r Ciry dd Cou.ly lt, flrs ulnnrh..r(l'tranc6 and Sr rr I nq\r.hinlst,ln"lLlir!
<br />iu. r.ottrn.d lt(,!tny nn mtaltr,
<br />,\mlicrnl or ,\gml slxnxrtrrr
<br />fuaeo-
<br />^
<br />t'fL 44,*
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<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 7/7//r lftl94
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />Forms/Steel/Holdowns
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