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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE rD/srG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing J <lhlt a eq,el>(iz-
<br />Shear Wall
<br />Framing
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />itrtr,flrr..FINAL r llsltr' I (tD-.
<br />Certificate of Occupancy
<br />Notes, Remarks, Elc
<br />OWNI,:R BUII,DER Dlll,('ARATION
<br />I h6.1, rmd rndr Frlrr {)lldirtrt thtr' I dn.r.nr r'mm rn. (in rift)G l.{an It$ for Ih. nnh$in8 rcasn (Se7(rllj
<br />ausinGs rnd ProfNion ( .dc) nv ( il, or ( iuly tr hich rqunB ! Fnni! ro .onitud. tll6, if,IP.or c. &nolsh or EIBn anv
<br />rrrucruc rior ro irs is! c., d$ rqru,G rh. qlilrd for iu.h Fmi h fiL. sisn dslslod rha lEor !h. b li.a*d ,6uan(
<br />to th( Fovirn'N ot lh. (\hl,id(, s I icosd I is {(]I!I'lq 9. (.dni.i.rn8 sirh Setnrn 7lI() of Division I or rh. Busmsr ard
<br />PnrrBion. cod.l.r rh6i h..r3h. ir.r..rfl lhdcfrom ann !h. tErir to.lh. lll.sd crotlion Any \ ioldion of sdi.n 70! I t bt anr
<br />rmlicd.! for i tcni rubdlslh. np?n..nl lo. (nrlpmhy olool tu . rhd nr. hundn6l dollrs (!50o)
<br />l- ai osn6 oflh.r'6tBrt. or mJ mdord sirh s.86 8 rh.r $1. rcmFsnrr. \r ldJ rh.$.lt at lh. dMuc b ml
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<br />or conplni.n, ft oh 6 B{'kld ril lsr. tlE h,.kn of rrovrB rnd lE o. slE dd d lnild or uqror. fi. Ir.Frt for rh. FIFE oa
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<br />I m.\.mn ufrlcr SerF.
<br />D.r. O.r.r
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<br />I h&. rn {ill Mi.rm r (-cnifr.r. of( olmr !. s.lt lBur.Ior rn d'.onFMi.n.6 FoLiLd for b S€li.n l7(xr of 'h.l$or cod.. f.r r h. rEfotrllft. .l rlE tr on fu. sn(h rh. rmi 6 isu.d
<br />I hrE lnd u ,ll E'nrrin tr orkd' conFud in iBrris., s r.rtu".,.l h! sd tr,. 1rcr0 {a rlE Iitr,r A'd.- fo, rh. Fromft. ol
<br />rh. trort tor shf,h lhi Fnn ( N(d Mt rorld' comFM'o. '6ure..{ir nFlli.vnunta&
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<br />so.I6' .onp6r nr F)rn$N .f S.ciFn 1700 ot rh. Irtfl (i{c. I rlull, fon hq nh .oopl} *nh Ihs p..\ tnB
<br />WARNIN(; r-!,rur. k, cur. sork6 comFdhn m\dr. n unLnf!1. ind lrull ruhidi d dploF ro aiminol FEhi6 ud
<br />.rrl l_'ncs uI n) on. hu rlr.il rhousnd
<br />s(rsn ]t116 lrh. rrh, rn{l. rnrad
<br />I,ll(x,r. rn iddrn,n r,, rh. cost (,r.o6t Nrion, d.m'3d 0s Ford.d for lhc
<br />,,.,", //-/5:2ot.7
<br />I hGby amm und6 rEally dl p.rl,rt rhd I @ li.dr.l trnln F,,ri,ion ol( hqnd I (rommocins {irh s..li.n 7uD)oaDi\ision I
<br />of rhc ttusin6t ond PNrFroN ( (d.. Eri trry I'cds. tr m rlll r.r.c ed .iY(r'H@7-/f/5-ZotP
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<br />is!.n (se. l0e7. ('ir c )
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<br />AIPI"I(A!TD!g.ABAIJO!
<br />I hoq,afir und.r ,6alr] of Frury oft .f rh. folh*
<br />'nA
<br />ddlf.r onl
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<br />R<tun.J lnls of Mr'tHrkm
<br />I .dia) rhd rh. lqLrr l+uh'ra r.*rd'nr 6h..1n rnho\ rl a. kr 4rlicabL lo lns FoF
<br />kr. dn n.l.lh, 'h..h)r. mfonniFn. cord l.xr<r
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<br />'\x_Lo.&
<br />o $nplr *ih ,ll Ciry and Cou.l!'rntC r lrd ( ou.h
<br />'o
<br />ora uF. dr
<br />^,LH5 A/7
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<br />lnsulation/Energy
<br />I
<br />Flood Zone Certif.
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