|
BUILDING. INSPECTOR RECORD
<br />SITE-WORK OWNER BUII-DER DEI-('ARA TION
<br />I ho.tl} .fm nndd Fulry oa Fjur,- lhd I dn .ropl IF,n rh. Contadou' Li.6s 1,.* aor ltu fdk wrs ra$ (se mrl :
<br />BurinRr mx, Piodion Cod.l Atry ( l or ( oudr $hi.h r.qrn6 d Fn'l lo cotr< ru.!. .hd. imFor.. &noliih , rqen rn\ \
<br />'lucir.. F b ! suM...h.' r.q!t6 rh.4'plrdi f.r ruct F ro6k!3r8nndmr thdlior{E6lt..d F,gma
<br />ro rh. rovBFN .f rlE conrrrror'r l-i.6sn lrs (Chrpld 9. (.nmtr,n! tr{h sdirn 7000 ol DnFlon :r ot rk ttlnns md r
<br />Pn'fRrhn! ( od.) or lhrr h. or sh. is .(mpl I h(.fr.m dd lh. hdri. for rh. ilcr.rl c\mplion. Any viLl ion ol Sd i.n 7(rr I 5 by otr,
<br />dprlicrnr io.6Fmir rubj..lslh. appl,ca lo a.ivilpdlhyolnor mor.rnnn nr. hun&.rl dnlas ($500)
<br />l.s o*Forrh.FoFly. n) .flplolc $nh $.aG s rhot $k comFsi){ *ill {tr .snl,n ErtElE. ,
<br />'nrs.d orolfq.dr{trsl.(saTolr,Itusi6mdltlfd'onr(o&Th!Cod..dorsLtoFl^&EnoltpplytoMo$ndof
<br />lhc lr.Fsiy wlF laild! or trnFov6rhdotr &d sho do6 .h $tt hims.lf or h.elf or rh$lah his or fid o{n dploy*,
<br />pror id.d rhd ech inlrlromli G ml f,loiLd d oilaal ld sk If. hos6d.lll trildin*.r in9r.rmr i! eld tr hhio od !@
<br />orcdrrllrm troIE B{itt trnl h.tr llE hr&o orFo\n€ rhi L or sh. dn d hild or lr{rrt lh. FrFrt 6. tlr F.lE ol
<br />L d.wndoarh! r.tcry, Mr\(lusilcly conrrsdin! sirh li.mr.d..ntddou ro sNIrud lh. Fojdr lsd 704{. l](Nn6s
<br />a.d p[liarnCo& l h. conrrddr'r Li.ak I rf, Jo6 nol ,rFl, lo & ou n( of roFd v $ ho buil4! ot imrroY6 rhddi.
<br />sd sh. oddit rch FniRlt{nb r (i)nr&ro(3) iic.ftd puEud kr rh. Conr!.1ori La.e l^ )
<br />li .\.mpl trnd6 S(lFn
<br />Drt. Or.d
<br />ll{}R|(t Ls' ( oilPE'{s,lrto\
<br />DECIIIiIIO!Ih6.t'lmmu r p.rllly of lE u,) on. of rh. rolk\! inB dalr oN
<br />Ihlr.,rjqillruinhinaCditr.olcorer6s.lllmEfm*0116cohFtdi.n.BForidairorbySrlionr7m.frhi
<br />t h" (i{., for rlt F6ffi. ol rlE Ntrl fG utth lh. F n n iq.d
<br />I h.\. .nd s ill mlinlm mrt6 conpd6 nt iNura..., s ..rlut d by Sal N. 1700 .l lh. ktmr cod., for th. F
<br />th€ *ork for * hirh lhir pcnil i! isu.d My *0116 .omFslhn imurmc. ffi6 &d Frla, numbd ,.:
<br />c* ,I,J,LLI! ry:lq 7]lrl!,k EZ! cE, cF cA ;FoPl't*/t^)
<br />poricyNumbd: r !lA1 :t-c,D ':oQba t2 p11*,.,, ' Ct lq]1 t/z-<, t Z
<br />I cd,$ rhar in rh. pstolMNc olrh. *orl for "hi.h thn Fnil ir i$u.d. I rhlll mr .nPl.y a) rs$n in e) nmE
<br />$ s ro lrt m !!t'l<r h rh. ert4'snFErni Uss of Crhloma ald.8E rhi irl ,rult b.(6ft tubd h ilE
<br />*irtm omFNronl,rofishN or S.(! on l70o of rh. Lrtnr ( ork. I Ctrll. fodhqnh omtly tr nh rh.* Fn\ iri'N
<br />WARNING: Fliluc k, Ku. so.ld compdsrion cov@!. i! unl,wtul. md sh.ll subi.ll d @phF ro 6inin.lFoitiB sd
<br />civrl li..r up ro on. hundr.d tho(und '10116 (i100,000). itr iddnion ro ih. coJl of comlEBtion- d!6!86 d Prold.d lor lhc
<br />Sd"o. 1076 otrh.lifl code f,'6d .rd drolB s fc
<br />-.
<br />q/za I r1
<br />DBCIIIdIION
<br />I ls.h.t rltm und6 FEty of lt rury rh, I m kqB.d udd Fo\ ipn offtrptd e (rsm.Ifiin8 rnn s<(hn 7000) of oi\kion:r
<br />.I th. ttLriEr nl lt fNn)6 Q'&. ntd hv lr* i! h loll f.rc. tn dld
<br />{u*b, L-L,.i,ithtr-w qs z-t qQ
<br />u.Nt-Ttzu (7 t Od1/zq
<br />rcXSIBUCIIOIIEIDIIC.AGEICI
<br />I n6.r,y.rm un& Frty of lErury lhi lls. n. (o.ntudao. ladr8.gtr) for llt Frl)lrll,N of rlE *ort tu *hi(n lhB Damir .
<br />e.d (sa 1097, (ir (-)
<br />Lnd6t Nmc'
<br />AITLI(ANLIESJSAIIII!
<br />I hdn, rnm r.dd pa.hyoaprjury onc oflh. tollowin8 d(lirdbn!:
<br />D.nolirio. Pmir3-AJb.nN Norilkdtion F.d6.l ReuhlioN (1 irl. 40, P.n6r
<br />R.qurcd tdroof NdiftiiE
<br />I .e1rly lhat lh( f.{sal .csuhrn,'E r.sTdi'r8 &dBbs rmov.lac nor.p,rl,.oLrlc lo lh's t'(,jNr
<br />I cd'rythi I hs.ddrnirlpdklnnidrd.rhd llE.ln\. hrorndhn n.(tld I .3rcio 6mph trnfitllCnvlnd( ounr\
<br />ddDr6 ,nd srdr. L$. EldirE ro t!'ldinS conrDdiJr sn tdcb rultFp. r.F.sdn 6 o I rhis Chy md Cou,r_ ro 6rd l+nn rri
<br />abor. r6non d propoly rr Gpslk,n
<br />Appli(r.l o. ,186l Sisnrhrre
<br />DATE ID/SIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lt4asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />'o(ve.)FINAL 7 zV-/ts J.Jc,fa't
<br />Certificate of Occupancy
<br />Notes, Remarks, Elc
<br />+
<br />(Jr.-rxj A^,DX4:;)/'.)
<br />ilaq L1
<br />Set Backs
|