BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER Dt:LCAITATION
<br />I hq.by itlm uidd F.rlt, ol Frllry rhd I m .rmpl tum lt. Co,'ln.1o6 l ic(e t $ lor rh. follD*lu r6n (5<.703 I 5
<br />I]6hd r.d Prof*ion Codc) Any Cily or Counry *h'ch Equn6 r Fni! ro codrucl. !llr. nlpnv.. &f,olilh r E?an M,
<br />sNdue ,rhr to n! ilslee als r.qun6 lh. rpglicd for 3u.h Fmn lo 6k s sisndj rlltoal lhd h. or th. ir li..nrrl PuRu.,ri
<br />ro rh. t,.!i!&B oa E contEroii Lkcrrd Llw (Chlpls I, Comhtritrr rilh s.dion ?00o oI llrriri,n I olrrt Butio< tnd
<br />lY.l<i.B C.&) or rhlt tE or dE B.r6nfl lha.6ontnd lh. ta3B lor rh. .lk*.d .raFirr Any rDu irnofsBiio^70.rI t q(tny
<br />q,r,lEer tor r pqm sbjftrs lh. .p?li.mr to . civil Fohy oa mr m.. rh.. fir. hundr.rt <loll&. (ttm)
<br />l. 6 osG of rlE p.ordry. or ny dtplo]6 wilh rrs6 6 riti. $L ompanirn, $iU & llE rfll td llt ide ir mr
<br />lid*ldj q ofrq.d fo. !.L (Sc 7044, asiB dd PrDf6i,o6 Cod.: TIE Codr*t( 3 Lr.e h* dE d {tly to u.sE.t
<br />rlE F,Fry rts hril& d inporEllE@ td uho dE sh wI hrell or h.*laot rlNur.h hit or ha o*n d0lot€,
<br />F.!!d.d rhd sh rqorglEa G rd ndn d morH trel lt lb*6r, rh. b([t!B or nFoffi ir $U rrhd * !-
<br />rlolplar!\ tlE (xc &rildd wil l6E tlE h!&r o,FotitE fir lE d J,c dd br hrild c ntm* dE [n'IEr] tu 0. F po.. ot
<br />L s o$M olrlE F!Fy. m qcl8iv.ly rclu*rll€ \ nfi Ucq!.d tdrdod ro odM llE ,mF.l (S< 7ora, adl6
<br />.,rj hlbin Co&: Th. Co.t.io.3 Li..e b*.k!6 mr.!oly r. M osna orFop.nr rhd b(ildr or inpmrd tfidor.
<br />sd who offi! for sh FoFr! *nh ! Co'in ro(r) li.r!.d Intl:d to th. ( .tu(d t Ltae lr*J
<br />I dn.rmB und6 Sdon
<br />D.t. _ 0r.6
<br />l{onl<rqs'cotrlpi\s ildi
<br />DEC|dAAIIA!
<br />I hd.6y .rm ui.!d Frlry of Fjury oE of llE folloEilg d6l&IioB:
<br />I h,r. drl $ill mi.uin . Catiararc of CotMr ro S.lf-lNur. aor *r&d .onFdb.. 6 FuiLd for by ^*l on ]7tu ol lh.
<br />I lbor Codc lor $. pcforljrm. oarhc wrt aor *tkn rh. Fnn b isu.{.
<br />l hr\. rnd $,ll rdtrtri'n\orls.omp.nsarionrnrtranc!.asr.,tur.'lNS(rr)nrTixrrfiltl..lit(oJ..n{rh.tEln,nL'n!c.r
<br />rhc $'l r' \hL h rh'r ffi ntr s Latd€d il\ s.rh6'.otr,m'un'R-'r!. utr'ki .u'!l r li\\ trtrn't{ .rc
<br />t'42,,1&..1 &*,rb {r+,n*,_,-
<br />rl,(.,,n.,a1 LtbaF,*QT- t/ub,.,*',3-/ -E
<br />I ccn'ly thar io rhc pofom&.. ofrh.{orl for shich this pdnn is h,ued, I shau nol onpn,y any rdron rn tny m4f,.6
<br />s' I ro h..ohc subjd to rh. *0116' compcnralior la{s ol(alifomi!. ud a{R lhd il I rh'uld b.{om. robjcl to llE
<br />*orkd' ..mpne'io. porisioB oasdlion I700 o f lh. hlsr Co!., I shlll. tunh$'lh (nnplt * ilh tt e lrolili.N
<br />WARNINC l;.ilur€ lo su. *ork6' coopdsllnrn .ovfts. ts unl.*ful. Md shdll rubjer u @pL}s lo m,Ml l-Bhs dnd
<br />.'vn nncs uf' lo onr nundr.J rhouend dolles (tlo0,omr m rd.ltr./o rh. sr nr(mFNrnn. d.trrad a rn\ikn r.v,h.
<br />fuuts(tion 1076 olrhclab.rCodc, inrdd Md alo.e*t aG
<br />r.rt r r. r,i r rl.i i/-r riri r rlr
<br />trtr l_tRI I (r\
<br />I hdlt y !lr@ udd Frny ol Fiury lhd I m liilE d ud.. Fovirbr of CtuFs I t@ffii.B * nn sdioo 7o0o) ot l)lvirhl l
<br />ol dE auitE ud PrDlBioG Code dd my li.a ir i. tuU aorc -d .,Id
<br />t-7
<br />I lEdry drm o& pa.ty of Fiury thr llEr L r o'dndnn bdits tdy l dE Ff(tE. olllE wl6r sith lhB FD. a
<br />i*d (sa 1097. civ. c ).Lo& r Nw
<br />Aftu(aNfDl:gJaalla!
<br />I hsrt'! .trm und( Fn!t, of pdjury om o{llE tollosr8 d.cla, io(
<br />l).tuhNn P6mili-Atbdoi Noi6di.n F.dsal R.8llarirB ( lnt t0, P[l6)
<br />R.rr!!.d l.ll< of Mnifi .{ion
<br />.h'v. nrflliondl nftrp.ny lor inspcdion
<br />dd Cdu.ryb dn6 ulr nrh.
<br />E >o-,t,1DIli(rnl or ,'\t€nt Silnilurr W*S
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Fram ing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif --,arrrEhEArrrr..-
<br />^ ,)nlo
<br />FINAL 5Li I r "'-
<br />Certificate of Occu n 290,556, 667
<br />Notes Remarks Etc
<br />8.43
<br />u,,8'3o't1
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