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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNDRBUILDIIR DELCARATION
<br />I hschy oii unds polhy of Frjury l hat I m c\.!npl to'n lhc Conlradou l,icw li* ror lh. tollowhE raym (Sr 70l l 5
<br />tlNindr trd Pmidsio. ('od.): n, ( ity or (iru y shth r.qun6 ! p6mn ro co6rtu.l, ahd, inprov.. n inolish or Ep.n dy
<br />slructurc, FiLtr lo trs ilsuncc, 8ls r.qun6 lh. at{,lic..l for such p.nnil lo fit s siSn.rl sldmfll lhol h. or s& i! lico*d puBuml
<br />b rhc F,r isi,)N or $. cd.kr(rtr 3 t.ic..ed h* l( ha d s, (irB'n.('ds wirh sdrion 7000 of Division I of Ihc sosin ,a and
<br />P()ics\6ns ( od.) or rhar lE o. sh. rs .r.m rhd.lio sd rh. barB lor rh. all.*cd.rmplion Anrv'oLtionois.(ion70ll tb,-any
<br />dDpl'.er tu itdrh rubJdllrh. iplrl'cur ro !cN,lpcnalryot.or nor.tho fivc hunddd doll&s I l50O)
<br />l, $ owna ofrh. pro!.nr, or my mFlor6 wirh $ds6 6 rh.ir $L.omFnsrion, "ill do th.*o adtErrulEbmt
<br />mrdrlal or o rsal aor sl. (Sa 7tB.l. Il$iflB3 &d trro tBiore ( ode 'llE Codracror's Ltrlg k* &Jd nor a!?ly ro d .snd ol
<br />rh. F.rdy tr lD bil& Dr nnrova trEq'q s,rl sk) dE sch *.rI hi.r.lf.r h.mll or rhrou8h ht or ha om.nplor-.d.
<br />Fovd.n rh.l ru.h impro@rt G frtr hrErl<j n ofiadl fu sL rL k)s'ds. th. tlruus or iryrcvmr ir sld *nh'n onc ra
<br />of compldr)n. fi. (h n6 lto,rLr $ ill hr* rlr hd, of Fovin$ rhd rx or slE dn d hild or inFor. fi. FDFiy aor th. F!.!os of
<br />l. sosn6oflh. I,ordr, m€tclusrElyconr&1ru $irh ltrds.d contra.loE ro cotr(rud rh. Fo]<l (Se 7041. rIErc
<br />,nj t\trbrnn (id.: I hc (irmr(ttr t Lic.nsc l rw d(B nor appl) ro e o\ nq of propd) \ h. brilds or inpror6 thdm..
<br />lnJ who co.r&1r aor luch Foj.r1s *trh . (-.dtu1o(, li.c.{ puB@r lo rh€ Conhcrors Lkru taw)
<br />I m.\mrr unii6 scron ,B &P( forrhnr6n
<br />laa5Eaa:lautfdsarla!
<br />DES.AAAI]A!
<br />I hd.by .m.n u..k Felr, of Frjury oft oa!h. folL$qr .t cltrati.N:
<br />I hrv. ni s,ll mmrri. r ( diakri. of coMr ro s.la l.U. for *nk6' comFMi... a F.yiLd aor by S.clion !700 of !h.
<br />lltrr cod.. ftr rh. Ffolr1@. of rh. s6lr for trnth $. Fon u i$dj
<br />I hav. !.d wrll n.i.ui. r orld comFMrion iBurmq c ratun.d br Sd ion 1700 of rh. t bor Cod.. for lh. psfo.lMc ol
<br />rh. rvt lor *hth 'hi Fmn n irord My $0116 comFMion iNrm. cdis .d polty numbs rc
<br />I .ct'ry lhlt o
<br />'hc
<br />F lolrjac of rh. $o,r for *hah lhn Fhn n &.d I !h.ll mr qtpb, m, F$. i. sy .lm
<br />$ 6tobdomubFroth.ro 6'omFsbr L*s ofcdifo@ di +r 'hl itl nrub t com $ti.rl to llE
<br />rsrtd' $mFsioD FnvirhB otsdirn l7m of th. trEE Cdte I ltElL tdhsnh of,pD wnh Br pmtiiioB
<br />WARNINC lalur. ro s@ mrt6' omFsion or6.s. is uLs{ut in 3t!I $tin e @plo}E ro oioinn !d.iE td
<br />.^n fin6 u, lo oE nu!&.d rlr'6nd doll6 (tloo,ooo). i. rhion ro rlt on of codFaaion, drMs6 6 Flra.d 6r th.
<br />s.nn. 1076 olrh. Ltor ('.d.. idai, nrd rri4- ! fc
<br />4p9!o.l:_
<br />It(EllfIIlo&rSA(IqA
<br />DECIIa^IIAT
<br />I hd.b.r rmm uD:!d Futt of FjuD rh, I m lrdei urld Forision of CIEF6 e Goffiing rnfi Sdior 7000) oa DdsFn !
<br />of lh. BdI6 od ProlBr6 Co&. d ny l.6E 6 in fuu toc &r, .lTdr
<br />(allrf,I(rtotr-LIlpttclcEr(1
<br />Ihd*D frm untd Frr, olFjury rhd tlE. i! ! 6dMi,. ladi.e +d) for tlE Ffollrle. of lh. sst 6. r'hth tha F$a s
<br />'s.d (sd l(,)7. cir c )
<br />ar8u(Arl.ttEg4aalla!
<br />I hdrbt lfm un& Funt ol Fju.,' om of 0E folr,q ins rL.llrriiorc
<br />lloml't$n PoT s'Arhdror Noriliclrion Fd6!l Rqubrir6 (Inl. {0. Pu16}
<br />Rcru(d ltlrE of Ndi6.d6n
<br />I (d
<br />'fy
<br />rhd rh. tddrl r.*uldioB EBEJmB abGros rmo\ al e nor edtlbk ro rhis Fol€1
<br />, .qt,it
<br />'h!r
<br />I lu\. rdd rhB rgrli.rnon erl rr. rhd rfic !tr\. rnromahi i3 cotu I .sc io .omply tr nh rl1 Ch) ed Counrr
<br />oidf!ftB ed srrr.lr*r Eldins r. ihiiB.oNtudiotr nd hd.hylurtbrizr.FMdn6 of rhn Cilyed Cou ylomraupontlE
<br />a&,\c 'MlNo.d prupsrt fr Np<10o puIB
<br />,\rpri$nl or ,\Bdrt stn.ltrn
<br />Set Backs
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />ln su latio n/E ne rgy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handica p Req
<br />D uty Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL )-L-t 3 ')/atVa 7v-)
<br />Certificate of 0ccu pancy
<br />Notes Remarks, Etc
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />I
<br />Ext./lnt. Lath
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