BUILDING. INSPECTOR RECORD
<br />SITE-WORK ID/SIGoATr-.\COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation rl
<br />Roof Sheathing 5l'ral Fo
<br />,
<br />.-\4(fi V
<br />Shear Wall /.,
<br />Framing /Dn/H /,/41////44>V
<br />lnsulation/Enqrgy lIa1/tf 'z/l /Drpvall Crll ltc Laf,tl-kr.Yra {t31i '1oc6
<br />Extfiff.Lalb)tlrl lr{-LuE6 ?)
<br />BrobtrC''oat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />t??"wFINALt0 /to/r.P /o-2
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.,
<br />,/
<br />OWNf,NBUILDER Df,II'ARATION
<br />Ihsd,,om,nunddp6ahyofFjurylhdIm.rmp'fiomrlE(odr*loEl-icrutwforlh.followin3.@n(".*.7(r1l5
<br />Busin6s dd Profdion Cod.): Any Ciry or (irunry which rcqutB ! nomil to (nnrud. .hs, in['ov( &rol$h or rq$tr any (
<br />nto(Ee Fir kr irs issuec., rL. rcquirB rh( arrJlicor lor such p6n'r ro filc r lisnqj rdffil rhd lr or !h. b li(as.d podrdr .
<br />to lh. Foritn'B 01tn. Conlrloir Lic.ru.d ti* l(-hqid 9, (-ommftin8 rhh SdFn 7000 of Drvirirn I or lh. BarN lnd
<br />Proisr8 ( od.) or th.r tE $.6.rstrp rlE.ton!d rlE h6B r( llE llks.d adFFn Anyvrhr$iolS..ri6.70:rl1}^.rn)
<br />rppli.s! ld . Fnn objdr rhr ql)h.mi 16 r cir il p.dhr or nn frE rhe fir. hundr.d dt,lla! (1t00)
<br />l. a o"F oflfi. prcp61y, or n' .nploys *'ith *asB a rn.ir rn. compcNlror, will dr lhc roll dd lh. nrur@ u nol
<br />i aLd or ofl6.d ad sL (Sc 7u4, Bcind sti Pbl*io6 c.d.: TrE co.rdols l.k.@ hs (t)6.n! qJply to D otrn6 of
<br />rh. FaFly sho h{il6 or !qnv6 rlEaG dd n no &E ech *!n hrulf or hBslaor llmu8h hb or h6 o$ mdo}s,
<br />Fnr lLrl thd Mh nnForlrla E d itdi.d o. ofi@d firr d. ll 1i66, th. hi,rCit d iqratld . -ld $ihh ok !6
<br />of@"pl'!rir dE Oxa Boit d "ix rts]r tlE h,rl6 ort'!\iC $r lEd!&ddrl h d or nip.oE th. FFry lm dr F,Fa of
<br />l. 6 osn6.f th. Fopary, dn€r.llsiv.lycof,trelin8 wnh Lc.nkn.onrdoB lo coNttud rlE Foj.d (Sd 7014.1]6rnB
<br />!'d Pst i{ Cod. Ih. Conlncnn s l-i.cuc lt* do6 nol arply lo e oq'r6 otF{rdr} who build! or imprord rhfra1n.
<br />Dd \h. .onb(ls aor r.h F)i<! qnh. c.dndo(r) lidBql polrd ro ilE (t'drdor-. LtN l.$,
<br />I m .r.inri und6 Stron
<br />D.t.: O*nd:
<br />$o{r(xRs,CoMPrNaarmN
<br />DICjJAAIIOT
<br />I hd.b .mrm umd pdulr, .f pdjurj .R .l
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<br />aollo\ os ilahri nN
<br />Ih.r.nd*'llmflMa(difrrrrofcoMrlos.lfIBu.l $orrd smg.nd$n. a Flrilal fn t', Sarion l7urolth.
<br />l,bor Corje nn lh. lsfotrrrcc ot rh! *o* lor whrch th. Fnn a i$u.d
<br />I h"v. .Id pill m.if,l.in so,t6 comFcslion iNurft., s rcqun.{ by 56l ion I7(n .a l h. t bor ('o&, fo, lh. Fn,n,mc. or
<br />lh. wrl aor shth lh6 FEil it NEd My *0116 omFsi,n rMtrc @i, il p.lty nuabq e
<br />I rdrfyrhd orh.pafo,rje..f rh. $orl lor *h(hrhisFmn i! n$.J.1sh.ll mr mploy sy Frsn r xymuF
<br />$ 6io bartr rbjEl b llE *$116 omposhn LusotcnifomE d +rllld 'rl nsuB h.@E et,..l lotrE
<br />nod6 amrmlion Ftrlib6 of S.clion l?00 of rlE Llbor Codc l Jdl, fonh* ilt sn0l! * nh lb- Fov6oN
<br />WARNI (; f.ilw ro Kuc *$rt(6 6mp.MFn orol8. 6 u.lrsful, .nd ih.ll sutld s dpbF to ainiMl FEtis anl
<br />ri\il lin6 trt ro onc hundrdl rhotr$nd dollfl t lfiJ.Ooo). in .dd n\n b th..oi ol conp.nerio.. drn+6 s proridd tu th.
<br />Sccri,,n r07(, ofrhr I aEn ( txlr. tr ncn dd
<br />DEIITI8AIIA!
<br />u.dd Fdr6r'nof(lEpls 9 ($mnrocm! sith Sc1$n 7000, ofDtrtr(r ltI hftbl amnn trn!6 pd.lry of p.rr!r)
<br />fl rhrln'str,cr\ntrJI'ofsstrN(intr.&d ry ltro$c N n l,'llli)r.. nn(l.ll..r
<br />6 1(A zeo
<br />I hftby dfm un& FElry of FJUry rhi tlE i r o"rrucihn ldldiB tsdy for rlr Ffo,rlm. of rlE nlrl h. {nth rhB Fmit i!
<br />irrEd (Sd 10e7, Cir. C ).
<br />l.cndeis Addr6e
<br />AIIU(AdLDECI.dAAIIIIN
<br />I h.dr Etrm unla FDir, of Fjo, om ol rh. folh{ inB d..hr.ri{in.
<br />I).mlirion Prmir!-Arb.$6 N.riliorion F.d.r,l R.suhtiotu {T lc40, P.n6)
<br />R.qund ktrd oaNorifi .dii.
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<br />$ h.ll( tt.nd (-,nnr)
<br />, dd ( ou.ryro 616 uF\. i
<br />I r6llt rhd rn f.dcrol l.lubrioE r.3edh* 8t6rr rm\rld..or la",licabk io rn! IroJ.d
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