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BU|EDTNG- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COM,MENTS Owl!ER BUILD}:R DEII-ARATION
<br />I lgd, rmrm un<k FuIy r'f Fj!r, rhd I m .rdn$ fi.m rh. (i,fldou' LE.* l!* fot rh. follt)sing r@. (ai< ?lrr I 5
<br />Boosr !.d l\ofdion ( od.) Anv Cily .r (irunty efii(fi r.qutr6 . Fnn lo .onrltucl. tha, nnprove &mlish or rqitr d,,
<br />sro.ru., rin ro tu isue.., ltso rcqut6 ltc lrDlic&t for euch rEmn ro 6L a siSnul ltdmol lhd h. or sh. i licd!.rl tutuml
<br />ro rhc I'trrlioN ollh. Contkror's Licolal tr* (ch4ta 9, ('ommif,s *iih Scrri 7000 of Divirirn I of tk B$indt lnd
<br />Pmadtr,B Co&) or th.r ri or.n. n.rdF lnddrom sd r h6s to,lh. rlLscd.i6npiiD Aryviolx[nolsciion7011iequv
<br />rml(dn{.lEa shGBrh. @lEd h !t1\,1n@h).imr mF rh,n nr. hun.H doll6 (ttorr
<br />lHf-. "-"" ",,r.**,,.*., -rr* "***-*,hd $'cc(mras,bn. * riro,h.uoit a,rr !h. rME B toi
<br />idod.n or olIdal for sl. (Sa 7044. BNins ad Prcfsioc ( odc lt. Codrdor3 l](N bs doe n 6pply ro d ownd of
<br />lhc Forsly *ho hil& oi nryNc UEon nrl trlrr .ti6 tuch srl hiB.lf or hs*ltut lhNush hir or hd om mployc.
<br />orovikd rh{ iuch invroemts e rct iddrjqj s olls.d for sl l[ ln$-6, $. tlrlljin8 or ulp.!\ffi i sld Inhin on. ]6
<br />ofcon{'k.( rtE (xc rtlrlldd $il h.\! thc hrLldr of Fori,ts llE rr {r lrE dn d h,ld rtr ,r9.!E lh. ImFlt for llE purlr& of
<br />l, {r .$ n6 of rfi. prop€nt. m .rclus'v.l} colnr&1!ry {irh l'.4!.J u@cloB ro ()Blrull lh. F6jd (sd 7Or4, EN|K\
<br />ud }\Dl6[. Cod. Th. (iJ.lr0ciols Licmlc ! -rs do6 nor a,'rly to e osnr o f !n,pd y *ho huildr or improv6 lhsdrn,
<br />a.d uh) conlr..1r lor 3uch Foj6ls w h d (nnkrlo(O li.sts d ptrRd ro
<br />'h.
<br />Conli&1ois l,ic.@ li* )
<br />",,,81a lN,t
<br />DrclaS IlQx
<br />I hn.1,y allirn o.dd F.nhrofFjury on. orlh. follotrTs d(l6rlnr6 J
<br />I h.rc rn will n,Mnn r cdifd. of CoEd lo S.ll'lM. fm wrt6 6mC6!di)r s Fo\iLd tor t? S6rirn lToo of ih.
<br />rrbd co&. for $c Ffolrle. of E *ut fd whrh E Fnn . irsrd
<br />I hrv. lnd * ill nai.roin ".116 comp.N.tit'n rNu.srcc. s r.rtuurd by s<r i0. t71[ of lh. L.hor (i ., n]r lh. pdaonnfr. ot
<br />rh. trorl tur *hich rhii pdmn i! i$u.d My*.rk6 comp.Ntioa msure...rid,rl linily nuDb6 ec
<br />r{it** *****ms,r";**:r*l'r;'.r,n, *t-t r*l:'*m* **-
<br />srl(6 otrrp.@rion pmrsnrN of Sdln, l7q) o[lh. t bor (td., I tulL fodh*irh co'nrly $ith llrs Pro\ ilrd
<br />WARNINCT f.ilE ro sq. $ort6' mnFMs. o16rS. i! unLtrtuL ad ih.ll lut t! o dPloF to antriBl FubE ud
<br />.iyil li6 up ro oE hun .{ rhour.d (lollc ( t loo.om), in ailn nn ro lh! .dn or rimFdio( d!f,us6 s lro\ rl.rl ntr rh.
<br />Sdr6n 1076 of rh. tlbLr ( dL. mr66 {xl.hlm'
<br />,,.,.. * {ll lao t7 ^,,..",,- T- '-r Lilll-ulrtl).Lt! (x)n
<br />Dr.( I \R \ I lr)\
<br />I hd!6y .tr@ uidd Fdt ol Fiury lhr I m licoE d ur& FDvai'i of clr4G e (@Mitr8 *nh Sqr., 700{, of Dn hion 1
<br />or rh. BeB &d Prol6i6c Co.rq rn ny ltre ir h tull fore ,n .lIEl.
<br />CAIIIBUqIIAd..LEIDIICICEN}
<br />I h6!6, .,lrn und.r Frny of Fju.y $a lhd. ! . coiintucrio. brlrU .3fty for llE Ffo.rr@. oadE *dt ft,r wni.h thi.t IEs a
<br />hru.n (sc :1097. Civ C.).
<br />t6dd ! Ndc
<br />dffucaNtDEgiaarl(}t
<br />I hdd, .trm undd F.alt, of rflury o.. ol th. following d.clsll k,rr
<br />Dc'nolirnrn PcmitlAsb6lor Notific ion Fqidll Rctuhrions ('lill.40, Psn6)
<br />Rqurcn lnl6of Mii6{rm
<br />IL]FI.-/r,t'",*
<br />t"toa *ul!lbB r.*sd,n* sbdo!,m,\.r,. h{ a,prk.br. r' rhE pmxd
<br />I lll ;6!, n r hd I hs'. Md lhtr .ml'carhn drl srd. rhd rh. .bovc hnrmdior is coocl I isrd ro onpl, wirn lll Cily 6nd counly
<br />ordi6an.6 md sr . ti*! Eldint h b!
<br />rbov. nEtnn.d p.opdy fo Nr,..rion
<br />ilditrB connrucl ion. rd hschy aulln'rn.i\(olrhls(ir'ad(iutyr{,ctrrd trtrrrhc
<br />Appllo.r or
<br />^sar
<br />sisrrlE X
<br />Pm,i,ftn.mc(pritr,): K p{6pfk 1 ilo 6 /ill n
<br />Set Backs 9lr (1 ,44{r1 )
<br />Forms/Steel/Holdowns t7 A4qfr)
<br />Ereclion Pads
<br />UFER Ground 9 t z..a 9 )
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathinq to /:.? Ltnr i,
<br />Shear Wall )' ..r, l.;tt r2/4
<br />Framing . a\4Jv l\12
<br />ln s u lation/E ne rgy It-r <,/4r0,
<br />Drpvall I .r*ls4V <
<br />Ext./lnt. Lath a,aqc|z
<br />Brown Coal/A,{LAa.A ll ll /tt /t l .z \>f4. i.ed* 8\
<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 4,h L*.\f<1
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
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<br />/14/n,, t l,?-tn K
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<br />Vo/tt 5 )
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