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BUILDING. INSPECTOR RECORD
<br />SITE.WORK ID/SIG.COMMENTS O'\,VNER BIJII,DER Df, I,CARATION
<br />I hd.ty.ilm u d p.nlhy of Fjury thi I m.rmp nnnih.(o ..c1oE l-ic.E lrw for
<br />'hc
<br />rolkNi.s r.u]n (S( 70.115
<br />lr$'E! .rd Prorda. Co&, A.r' cir) or cent shrh Equn6 . Isn, ro ..dtud. rh6, inForc &elnh .r E.n &r
<br />3rrudd.. Fnr b ft cue.. &o Equt6 lh..ppltd nn sucfi p6nn h nk r vsi.d cddMl lh, lE.r rlE i! licded p{Bd
<br />Io th. I'nvn$6 of rh. C.nta.ioir Li.as.d l,r lchlpld 9. Codmftins $irh s*lio. 7(x)0 of Divnion I of rh. lllrr6 Md
<br />rrcfdi.nr (-od.) or lh.l lE or 3hc i! .rcnri lhd.6os ed rht nci! for th. .lk8.d crnfln'. Anyviol.ti,.ols4iion 70rl 5 bym)
<br />amli.. for !Fm( $br6lsirr rt?lkd fu.ci\ilp.nrlt, ofmt mElhr fir. hui<L.d &llo3lli00)
<br />l. 6 oM6 of rh. t oFrly, or my 6plo)6 wilh w.g6 s thn 3r. .onpodi.n. will &) llE ssk &d rlE tfflw i! mr
<br />i oi.d d olrdd f.r !L {Sa.?01,{. BBi6 bd Ptnl*ioB Cod. Th. aonr.doas Lic.B l* &d tol 4,tlv lo u ornq of
<br />!n. p.q-lr *l[ ht*l or insD\6 rhd@ rn * h. dB En solt h'IElf or hs*lr or tkough hs n hq o*n @Plo!t<
<br />F.liLd tld I.t mlh'/lrEc R mr insi.d s oFEld t r sL lt rn*Es. rlE tlitldB or inrs\qrd 6 $ld *ahitr.N )q
<br />.f6sphbn. tlE ()$16 D{ilda qill h.v. rL hi.dor otFDvihs rh, h. or rlE dit ml hdd or ir,[Dw lh. Fol6y ro. E lr,rrxof
<br />l. 6 o{E otrh. F.r,cr,-, 6.rclNn.ly c.r.*rins snh h.dB d cod,xl6 ro coldntl 'li rhFd {Sd 7(}11. tk'6
<br />ind h!toBm Codc Thc Cont&tri Li.6r. l-!w do6 mr lrply lo s os nd ollnoFny $'ho build! or imprcvd rh66n
<br />lnd who.ont6crraorlucnprojdrwirhr(t'mr!.to(rli.6kdpuBu.,rltoltc(i'nrr..1or'tlj(mtrs)
<br />I m.rmpr urd- S61io.
<br />Direr Ornd
<br />\t oRt(ff\, cdn, PF\sa rloN
<br />DESJf,AIIIT!
<br />I hdcb .mrn u.&. polhv ol FJu! om ol rh. follo* m* rktktar 6
<br />I h.\.&dwill mlinr.in aCditurr.oa(onhr to S.lf-lNUr. t sorls conr4dion. s F.rid.df.tbyS-mnr7(nof(h.
<br />Irbd (ixj., an rh. Ff.lM oaln Nrt ror *nrh rlE Ff,n it isu.d
<br />Ihav.i sill Elirt.r *'oit6' (dFqihn iMR.. 6 r.qutr.d qu Sdrnn .1700 oarh. t t{i Cod.. for lh. pdfo.Irt4. of
<br />rh. "srk nn shkh lti p6nn i5 is6l M, wort6 comF6dion iBurMcc cdn6 ed Flk, nunbd &€
<br />-\.* okr\e t!\\^d.
<br />P,,ri"yN,,.b-,14 Llll q o L o I tltT
<br />Icslrfyrhlrinrh.FLlmft.ofrlrr.rlfo.trhthrhErEnnLsu.(Iin.llmrqqh)u].,F$nin:_maB
<br />i 6 ro iE om slbid ro lh. rdtd ooDasrnn hr..f (-.lilomi{ drd qar tlin 't I 3rruld heoft 3ubcl lo ll!
<br />vo.ta' .ory,6sl ion pmvisioN ol S.(lDn .r 700 of rh. lrbnr Cod.. I drll. forrh*nh omply s irh lho* Pmvnio*
<br />\* RNI C !-.ilurc l. sd. worl6 omp.reior m\d8c G unl,s6rl. sd 3h!ll tubj.rl D @doF !o 6inin.l Ftrltts ed
<br />cril fi.6 up ro om h!'iH
<br />'houq"d
<br />&lhE (1100.000 !ddni{,n ro rlE cor of coEF@iio( d.mB6 a pro\d.d aor rh.
<br />Scrr. 1016 .l rh. l,hr ( o&, mrdd rd
<br />t)t!l!!rc1
<br />I heby.mm undq polhy olFrury rhd l6 nGE d lnld FDvlioo orqurrd ekottllffihs trirt S.dni 70m) orl)^iri.n 1
<br />of rh.lruinsmd ltotdiod(i'd., &i m,li.e n in flll aoEc !d cfid
<br />ri.*.cr"* t!--JQ
<br />,",,\z fl411
<br />(aIIIBIJCIIAI.LIIDIIC.ACEIIa
<br />I h6.by rnh und6 Fndry oa Fjo.y lh.l lhq. n. on!rudnn hndins.*fty for lh. psforlre. olrh.$.rk aor shi(h ltis roni n
<br />isu.d (S( !097.Cn (,
<br />AITIICANLIEqJAAI]O!
<br />I hnt'y dfm u.dd porhy of Ffjury orc of lhc i'llowios &.hdion!
<br />lrsnolirrn Pmnr-Art6ros Notili(.tio. f'.ds.l Rcsuh tuni (Tirl. {0, Pd6)
<br />_ R.nur.d tddof |i(rifdir
<br />I .dily rhd rh. t ddal icsubxoN rcsrd,ns 6rb6ior roov.l rc not .pplic.blc lo lhi lr,,id
<br />I cd![ rnr I hn....d rnir.pplid6. in rd.tht {lE dnr. irfotunn a cotu I t*E!o ompl] $(h nll Cir)..d (tutrrr
<br />rtiltty rnd (ounr) to ai6 !,En llrdn hdcbr .urri,E. qr.ddN6 or
<br />SEue,;r v42cl
<br />-,. oltqltll
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorA,ienUlnsulation
<br />Roof Sheathino rL-?D-t7 .I .CJn Y r
<br />Shear Wall
<br />Framing
<br />lns u lation/Energ y
<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 />Flood Zone Certif
<br />FINAL -3- t(
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />DATE
<br />,,,,'ilrq ln
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<br />r.k.* Numqr aSrrR $3,--rX&"l.Qd-W@E-
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