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SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Sleel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing lt tt t1 ,l/4tdr,
<br />lnsulation/Energy t\t,lt7 /'rArA)
<br />Drywall u )P[-a4 "hd)rgxoac*zoatvtlr€Ext./lnt. Lath d A h" r wcd
<br />(prown Coat )rL 5.wxr.t .tg-{fiaW-4cal+T Ei6x L ,4.ur@'l,tl*rc4 lron
<br />Pool Fence t
<br />T-Bar
<br />Handicap Req.\\9 FAh0q )
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL t-1,44(t\,
<br />Certificate of Occu pancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />O\{NDN B!II-D9T DI:ITARATION
<br />I hs.{D rllm (nds rF.hr of lEiur} rtri I m crmpl hrn ltu (!mr!doE l.ic@ l.!* nn rh. rolhNi.s,den (s6-tolll_i
<br />Itusin*s ud PNidion (od., A.y(nt or (ird\ $h(h..qund. p.rhir h sdNr. ahd. imFo\.. ddn.lkh u r'qn Mr
<br />nrudue F h is sumc, .ls r.qun6 rh..rplic. lo. such Fmil ro lilc i sisn.! ndmt lh.l hc or !h. it licdi.d nlN'arn
<br />o rh. Fo\ithB nlii co.tdoas l-rd<d li$ l( lqrd 9. (i,mmft6l. tr hs(i6n 7000 of Dnishn I or!h. thsinN.nd
<br />Profdions Co&) orrhd tE.t si. is.rmpl th6cf.onmd lhc b.ri! tor rh. .ll.s.rj .\mpl i.. Any \ioklhnofsRrior T0rl S ht u\ '
<br />lrth.ur for , Fnn rubJrl! rh. rp?tulnl ro r$rlp.rull' of ml m'clhu lir. hundr.n dollei (15ft1
<br />L 6 o$F olrh. FnFn), r, mr mphrc $dh r.86 B rh.r $,.(onpdsr$n. srlldo lh. *ort dd rtu nMG is Ft
<br />nndili.d orofiq.d lor slc(S( 7{}4J- lt6inBr and Pn)r6tK (ii. l h. C.tu'liois I Kd* It\ rh6.or q'r,b rodo*F.a
<br />rh.INFn' $ltl hildro. imtmr6rhqon. ed *ho dE s!.h s! hnnsll or h6*l rrtr rhhtrlh hr .r hd or n .mpht.d.
<br />flovi&Jrh.!suchinForffirRdiod.do.ofi6dfty$klCbr66.$.tDiti'l\8orimt,rffi6$HnihinG\6
<br />ot $q'Llra ltE osr6 Duius sill halt llE hdo of rro\ins rhd lE or r\. dd mr tuiU or imEo\ c lh. I,.poly for rh. N4r\q ol
<br />L s o*E of llE FIdr, m .\clnsiEly (od&1i,! $ nh !c.cn (odr&1.6
<br />'. codrud tlE tmrd (SR. 7or'r, &!'6
<br />r.d h'r6s Cujc: Tfi. Conlrtrtoir Lrcor. Liw do6.ol lpplr lo & o\rn6 ofpnFny\h, buildr ni iiprovd rnts..
<br />rnd $h. .oinBt.lM 3u.ft FF! sdh, ( odn<ro(r) l(ds.d Fl'@r ln rhc (-offid'3 Lr.M l,*l
<br />I m.r(mtx un Lr sdi,.
<br />l).r. (hnd
<br />woRxFIL,i' ('i)irPENsa] toN[!lldrlar.&!
<br />I hsctly imm un,lcr pcnallyolrEjuryorc oilh.lL'llotrl.3 dRle.ti('B
<br />Ihrv.a *illnEinrain.(-dili..t.ofa.lshtlos.l{.lMr.litrsorl6..nFr3,k,n.!r Fo\rHrorI^strrnlr($or'h.
<br />b&tr (irL. for rh. pqt(ffic of rh. \.rl for Nni.h
<br />'h. Fnd n slal
<br />t ha\ c lnd tr 'll minrarn r ort6' c.nFxar nn 'Nu..ft.. .\ raprcd hy S(l Fn 7(roffrhclnhorCod., turh. tdfnnnM.. of
<br />ltu \or! ror$hichrhis pcnil n is{d Mr \{.k6 omltuion ier .cffi ed rblE) numhd t.
<br />Prl'rv N!'nha l:\nrr\
<br />I cdrli r rnrlEp<nymm..lrhrtroillor\hrhrhFlE,rnRrn'ci.Ishrllnoronpl,,\anj'ts.n'nxn\n,rnn.1
<br />rdom. nn,i6r r,r rhc wo,k6 comrEeriotr llssotctrl'aomin. aad +re rh.r ,rl rh'uld rr.om suhj(r k) rlE
<br />.onFBrku I'.vstr6 of Sdx,n.r7 rofrh.l.tnr(irl.I drll, fodh\ih rorll\ ([hrh)kIn,\ishns
<br />lrARNlNc l'oiltrE to suc \rrl.R'.omr.nsir)n co\.E!. is unh\ful. { d sh.llsrhid mrh}( lo rimiul,Euhs,nd
<br />crrl fir6 un to om hoD.ir.d llFNnd d.lln (ll(xr.ur0), in .ddrNn h lfi. cost o, comp..srion. d!md{6 i3 tnfidd a.r rh.
<br />Sr-.rn,n 1(176.flhc t drtr (od.- inrrsrrnlrrrl6 s f.1
<br />4/a/1L
<br />DECIdBAIIO!
<br />I hd.try .rm un<16 Ful, ot Fjury lhil I rn ldrcd unda lnrvnDn ol Chop'd T (c.mmnL in! $ irh scrion 7000 ) of Dn ision r
<br />of lh. BciB dd PmtdibE Co&. En mv li.M 6 in full forc. rd.fid
<br />RlL't1
<br />o /2'1
<br />colslatcl,lqx.LftDldlilcrdcr
<br />I Hry nmm und( rtn.ltyoipsjurllhd thqE ts ! NNlrudion k dd8 rytry for lh. Fn,rl11m. of rh.$trl aor snrh rhs Frnil ii
<br />sud(S( 10e7.( ir (,
<br />lnJd'! Nm.
<br />AIITKANLDI;CIj8AIII!
<br />I hod, t8'm uid6 ,.n6lly of pcjury oG .altu rouotr ins delurtion!
<br />I,.rFl'rior PmnrArbdo! Nor'lic.rn n r.d.r.l R*ullri.nr ( I irl..&, Pm16)
<br />R.quFl 1..1r6 of N.r,ftai
<br />I cctftthd rh. ftddrlr.suhtiotu r+,d'n! shdrosd.vAle. nor.tlli..bl. ro rhis rniNr
<br />IcdirylndIharcradrh6applicarnn.ndst6rcrh.rrhcdr!r.intof,ldiooiecotrarlalraro(onplysirhlllcnr,dcounr!
<br />otuIBN6 ud St.lc L.n s ELritu n' h,ild'q co'Elr!.lnr an lE€eL rdhortc rcri6crr.ltr 6 or rhE Cd, ed ( .um) r. dr6 trFJ. rh.
<br />alxtrcnraton.d m,p.nr fo, r:XAppli.inr or ,\96r SiE ihrr.ganh .{ f((A:{r"(il,,
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