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BUILDING. INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS OWNEN BUILDET Dt:II'AiATtON <br />I h<.tir rmm und6 rE ahy .f Fjury thal I m .Gnrn fiom lh. ( ofltrlcloR- Lic.M l,u lor th. follotr iry rdsn {se 703 1 i <br />Bu!i.6r rnd Prol.sioa Codc) Any ( ity or Counry {hich i.qut6 r Fnil lo coNlrucl. alr6. in\,hvc. (Lmolirh or rfan dl <br />,tu.1uq Frr ro k isoeq !k .q!tr6 rh..p'lrsr Lr *h Fmi r, 6k a stn.n {dmr rh, lE o, rlE i! l,co€d rrdd <br />r. rlE F{\6i.8 of rlr Conrmr.i3 l-rni.d b* ((luFF c. (nmnftrB *ih Sdibn 70fii ol l)rirh. I of rlE lt6ms rnd <br />PmtNioB Cod.)or thd h.o slE ii.rmpi <br />'hg.noB.nd <br />rh. h.ri! nn rlE!lk3.d.(mdion An! riolrir.ofs.dni 7011 5b)u) <br />aprl'.rnl lor ap<rn 3uhj.cls lh. q,phca.l lo rcivilp. hrofnol morcllM fiv. hund,.n &116(1500) <br />l. f,t orE of rhc FrFdr. or mt mrlo\6 $ nh $.{6 a rh.n en..DmFMion. \nl(h rtE sGI Jn th. eeR i mr <br />dorlGl noF6.d r.r sl.156 ?Or.r. BBilB bd Eor<ioN (-o& llE (tn.ror'. 1 rcc 1,tr (iEFt q'plrhdorEol <br />tn FrFrt $lb trrli or inporG rlKEn dn {h. .IE kh $nt hm(lf or h€rlf or rhiDqh h6 or nd o$n mphrc. <br />,rov'dqt rhd suct iml'ovoEfu 4 mi orEd.d or oftsql for sL l( h'q66. rlE tlildirB or inFor@r r $ld s irhm on. \6 <br />ofcompl.lhn. th. (tuE lruiH6 *'U ha. lhc b{d6 ofForin8 thn h€ or .n. dd ml trild or iha,!\ c 6. I'rlIEry for lrt [{rr{s ol <br />L aorMofrh.Frd!). m.r.lN'v.h.od,arnls trnh ltqEd codndm <br />'o <br />odtud ilt !1.F (s< 7044, ar6Is <br />t rr FDkix Cod. Ttc ( onlrrlo. i I icru Lrs &6 m' 4plr 'o <br />u otrn6 of Fopd) *ho buil& or inprc\6 rlt!6r- <br />d sho ..iM! for 3uch FsF3 wnh. co.rdo(i,li.qed prNM <br />'o <br />rh.( ontdor'3 Lkd. rr*) <br />I m.t.mpr u.d6 sdnin <br />D.l. ()i.d <br />non (rrrl. ( ont Pr!rslTtoN <br />DECIIAAIIA! <br />I h6.hr.mnn und6 lEnalty of pqur! on. oirh. folkrsins d..ldal6ns <br />In.anu'illm'nr.in.Caliau'.o,coM!'os.lflcuEaorf,d\d'mmp.luFn.ap.lviLdf.rblS€rrn17(x)otrh. <br />t hr ( nk t rh. Ffortlk. of llE *.4 fq qtkh !h. Fmn ir isu.d <br />I hrv. $d will m.'nl.in wort6 .omprulion iBur.n... a r.qtrn d b, sal ion lU00 of lh. L.bor ( od., for lh. Fnrm ccof <br />rh. work lor {hich lhir pcnit i5 iN.d. My work6 .anp.Ndion iNursc. cMi6 !d rolicy numbo m' <br />,*, : Atwrlo+-t Zst'Lr-L <br />pu,,,rNumLq - WLSolhUkl- r\!tr6. ' tt/t/tTt -/' <br />I c.nitr lhll in rh. Frloffi. of !h. wort for whi(n lhir pann ir su.J,I !h!llnol mplorayr.r$n in sy nmns <br />$ B (, tE @ st d l. th. e&6 $nFui'on L$r olcdirou &d lar rhn iII rhould h.c6mc autid ro rrr <br />{0116 srFBrio. trs6ioa oas<rFn 1700 ofrh! l!E{ Co<k I idL rurhtr nh Nnply $ih rb.r lh.lhEwARNlnc Frlw i. Kac s{*6 comFMhn nrlarg. ir !nl.st!l. .nd !n!I sbF d ot'hrq b oihul FEhi$d <br />civil fin6 up lo on fiund.d thousnd 'lolls (1100.0(x)). in.ddili,n to rh. con otcomp.Nli.r. &trus6 a prorid.d tor lhc <br />SNrktr, ()?6.f(l[ I rLn ( ode inrusi itr(l Au*- <br />I hd.ny imrm und6 rErdh, of pdjury lh.r I m licaral und.r provirn,n ol( i.pr6 9 ((.mnrftinB $irh Sdlion 7000)otlhkion ll <br />of !h. A6in6 Md PofaioN Cod., dri myl'.mk ir in full forc. nl.lTd. (+L <br />larf r? <br />q737,L <br />I Ar;L <br />cotlla.l]IJtall[tDllglcErcr <br />I hd.by rffm u&r FuXy ot Frury lhi lhsr ir r otdru.lior L.dinS .Stry for lh. F {l,lr],E of rh. wort hr *trh rhB tE tri . <br />suGJ {Sr 1097.C8. C ) <br />l.ndcr'! Nm.: <br />AIIIICANLDESJAAIION <br />I hdrbt .lrm undd Fnllly ot Frjury on. of rh. followins dEtuat ift! <br />odnohr ion P@n!.Arh6lo! No!fi(.l6n r'.ddl l.*!br iors ('I nt {0. Pd6) <br />R.{un.d tdra of r*ri6cdir <br />I cdiry lhd ihc f.d6rl r.SuldioB r.gddinB abdd rdmv.l rr. nor .p!,lkabl. ro rhn pmja-i. <br />llU . d'fr rh, I hn. Eat rhB arplkd n. rd <br />'!rrc <br />th, <br />'tE <br />.t rc ihnnnFn ir .ord I i*G !6 comply snh .U Ciry !.d ftunr! <br />drdiMkd Jt sri. I^! clr 4 ro hiildn* ( odtud n( .'d hqttr x.lr'Bc '+.srir6 o f rnir ( ny ..d co6l' r. ard utFn rlE <br />e.Lah \. ,Inr k n.! F,,p.n ) l, { 'nsF r <br />'.,n ry$,s <br />nr,rr,^ - n" rrrr nr*\rfi*rr, <br />P.rnrfaun.rprinr,: Y- / tn, \UarP. <br />1la-rf r7 <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 />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Qgpuly Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />FINAL //r//9 I r///14/ <br />Certificate of Occu pancy /77 <br />Notes, Remarks, Etc. <br />_> <br />I <br />I <br />I <br />I <br />I I <br />I <br />I <br />I <br />I