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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.-coMMENTS OWNER BUILDER DEII]ARATION
<br />I hd*t rlfm u.d.r Fshy ol Frrorr lnl I m erdrrl fion rh. Codr-loE l.t@ l!* tor th. follo*inE @. ls( 70rl t
<br />B{sire lrd Profdion C.&) Any C'rv or Cou,ny *nah rcqund . pad to Ndtud. .na, u,9rc8 ddnolth o. qtu ur
<br />ltDcruq Fnr
<br />'o "r 6ieq .!a rapta rh. .ggltd for s.h Ftur tu 6k. rryEl ml fir h. or 3h. i! lkq&l lEerln
<br />ro rh. Fo\BioB oldE Conrr-rq! Lro*d h*' to!.$s 9- Cotrl]rem8 *nh sdi). 7cln ol Dirisior I or 0E BujtK .nd
<br />Pllt*ios Co&) or rh.r lE ( !E u d.!4r rlEtton ad 0r b6n to, 0E .lLS6l ddFiof, Any riold.I olsdirn 70.1 I t l, uy
<br />rrplkrd ao. r Fnir ebj<1r rh. rptlkd ro r .i!il p.Mhy ol mr mr. rha nlc hsdr.d dou6 (1500).
<br />l.6ouF.alh.rroFny.{rmy.d9hr6*nh*a!66lh.rsL.omFMxr,will.bilEsortdejth.rndr.EL!
<br />i.roddr orolh.n aorsk(s( 70.1,1, tllif,B Md Profdiom Cod. In. (-onrr&1oii l.f,ru lju'd.6 mr @ply b d osnd ol
<br />th.I'spdy {ho hoil& o, uqmv6 rhsm {d uho dG $.h *! h'ms.lf or hdsllitr rhouEh hir or hd osn mFl.rcq
<br />Fovidcn rna such improrodls e ml inldxlol or olIald aor el. I i ho*a6. rh. t!'ld'na or iryrorffir a! $l'l * ihin on. ta
<br />of.otupLrioi. rhc Ownd lluildc sill h,vc rtE htrdft of pmvi.e $d h. or sh. did nor trild or ilnltrorc $€ Ftpqiy lor
<br />'h.
<br />puIl,k ol
<br />I, s o*c oarhc F.pd!r. m.r.&n.1, coddin8 *nh lcden codr&1oB r' $drud rlE rsj..r {Sc 70r,t, tr6hd
<br />dn Ftrtusr Cod.:'lhc Co .!.loir l.ic.M ljs dc mr !f4,ly ro d o*na ol FoFnt e lh hilrt! or inprcv6 thsor,
<br />sd sho 6dM. for ru(h F.F. $ h . Co do(s) licdEal poB@ to !n ( odrdor! Liw tl[)
<br />I mdmF u*ld sd'nin,..E-l-( gitl
<br />I hscby n,Iirm und.r FdD ofrdjury or orrh. rollotrTa
<br />I har. dd will n.in!.h . ( .nrfi({t. o, ( olgr to S.lf-lNur. aor sorld' comFBd bn. a Frwti] for by Salon uul or I h.
<br />trho. (rod.. for (h. Ffo,Ifu.. of rh. $!rt aor
<br />"'hich
<br />th. pan il b isucl
<br />I hrve and*illmri'rla \o,l{1 .ourNali,)n'nsurancc.asr.rlunl{h}S(rtrn:17(X)rirhcl-ilxJr('ode.inrh.P.rnnn,3.tfl
<br />rh. \ork frrhichrhl\ pc.nnr i\ i\\u.J My\orkos (,npdrdrtr$ i',su,ni(c.mb d F,li(t ntrnrbs dr
<br />l.di&rhdrnrh.Ffo.mft(ofrh.tr..Iforf,nichrhi.Fn Bss<II{ulln opl,yt,) F$n inu} muE
<br />. d ro bqoft etitr ro rhc *dtd .oniFdio. h*s of (ihlomq dld .*r rha rt I nslE b.ror $t*<l b rrE
<br />qo.rd comFerh. Folts6.l sd Fn 1700 oarlE bbor ( odc I JEll. fonhs'ri ..npb u nh lho* FrBioG
<br />$ARNlitG: tniLr. lo s6. s.ko omrqEdnn coro4. ir u.Lstul. ,.d .ttll .ut al e o?lorq lo oinin l FEhE drl
<br />(srl lir6 up ro om hu,l,.J rln,uend d.llE itlo0r00). i. dd(ion kr rhc.oi ol.omFNrion. dams6 ar provd.d (,tr rh.
<br />\dFr 1076ofth.llh ('.d. ddd md drol6'Jls
<br />-,;Q rt.9.r'r ^..,-Y-- M)\,114-7'' 'r-rcensroc0ffitluFDE(',I-AiA tlol\
<br />I hd.b, amnn und.r r6all, otrEr},y lhd I m licq&d unda Foision ut( hlrrE'r (Nmtu.,ns *irh Sdion 70n0) ofDnir(n l
<br />oa rh€ 86'8 ed h6a6t ( ('.&. &d ny li.@ a in tull foB. !,ri.flca
<br />( oNsrRucTtot't LEtnrtc acf,licl'
<br />I h6.by rltm uRId FEhy of Frrury lhd rlEG i! s odru.lbn l6x!,'r lsny lor rh. Fn ll14. of
<br />'h.
<br />*ort tur *hth lh! Fhi 6
<br />i$u.d (Sid l(r97. civ c)
<br />ASIUCANLDECI.EXAIIA!
<br />I hdd, alrm u.dd roalty olFJUrt on..arh. aolb*i.8 delsr'ions:
<br />().molilDo Pm r'A3b6lor Norili.arirm tq,@l R.gulatio6 {TnL 40, PM6)
<br />-R.qun.d Lnl6 of f+difrdirn
<br />I.di6 rh,
<br />'h.
<br />f.J.nl rc3uLtnB rtx diu 6tdos r6o!d r. hrl4,r'habr. b rha pn,Fl
<br />I .dift {hd I har...d rh6 .rtlt.ri)n rn nrr.'hd th€ ltr\. rnlolMFn ! cotr(1 I asal
<br />ins cordNdiotr an h6.t!.dhrut r.Fsrdr6 df
<br />o@.lply$nh C , ltrl Coutrr)
<br />rhi. Ciry &d Cou''
<br />'o
<br />6rq qr'. lrE
<br />*l" La*.2.ott
<br />Pt-ta r [.9GuYEr,
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drylvall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif.
<br />FINAL ?/24//8 =K,n a,tu'hd
<br />Certificate of Occupancy 7 \Jv v-
<br />Notes, Remarks, Etc.
<br />:
<br />.d,Bn.6.rxl Srar. l-d\r
<br />.l-rt 6r6n.d Fp.nr- lor
<br />UFER Ground
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<br />!z/14 tu6r /hoc, 7
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