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BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS T'WNET BUILDER DXI,Ci{iAIION <br />! lrEhy rotn !ol.i FNxy ot Fruy lMr I d .r.mpr iNn rh. G)nrr-ts' L.nt L.* ntr rtt lolherl E.$n (Sa?o.tl.F <br />Bu{n.ra .il Pnrr.$iln Col.r Any Cny or (l,ur, whirh rcquN\ r Fn lo uon(ru.r, rli(, ,mpruw. dcari.h or (p.! dy <br />(Brur..Inr r{ rr! !m!, ie' htu6 rlr r@ll.rr lor rkhFml ro,ik.s'rEJ {{.ffir rhd lEf l,i n ll..nGl rM.d <br />h rrE In,vRmns ol rhc Conk(ror! I-(.n$J t:w (C'tEF.r 9, Conmfr,rs sirh Strnn 7ux, or Drvnrcn I .a rrE ButiE{ d <br />Ptui.sbnt Cnt r ,r rhrr rE nr rlr n crcn{i rnc{rcm .rl rh. h..8 ft, rrx dLra.t crctl|llon. Any vbl,! i;li ot S..hn 10J I 5 bt .ny <br />.tplf,.nr r .Fmn iub]e.k rh. rpdf,d b 1c'vrlFExyo(nn frE rh:n rry. hoalBl !rolh.. tl5r ). <br />-1,rio*frofrh.F{Eny,qmy.iphycr*i*.3.\8rh.(tL(r,n{E.{lrn.,l&rtI*dtrnttEiuiEnnnd.nhl oroll.EJ ntr el. (Se.7044, aurtr( .nd Pr.l6s.nt CcL fu Co.rB-rd'r l-NM L.q doc! trr 4?ly rlt - o*tr dl <br />rh. m{Eny whr ho !ror ut{s)E\ rh.N)n, u]*ho tti! skh k'* hrm(lfor h.rcll orrtNUSh hc orh.rown cnl,|l,rc!, <br />nrovr.lJ rhd q*h oli.rd fr !k ll, lt,ffi, rlE h{ltlur r npowr,r n $ll *fi{ oft Jtr <br />of onpkrrr. rlE Oqk. Burllcr v l h.E rlE hr{.n ol F,vDS ttd lI or \tr Jll Bn hu! dr utInrE ilE F)F y ntr lh. F[Ire ol <br />-1, <br />arowE.olrh. Ix,{rny. .h c\.tunv.lr.odBr ms * h lt$n{rt o frl,,F b coninri rli Foi.ar (Se. ?04'1, Bums <br />!n Prri:rir Cod.:1h. Conh(ttr't l-(.ns. b{ dtr. R rt oly b M o*n.r tra ltroFd, who huilJs or ihpn}r.\ rh.rd,n. <br />r l who $ntut lt".uh F)Frr qrh. Codran'l!) lx.nkJ po^d h E Odt*k{\ LEtr* lrw) <br />_l rf,.kmpr uDLrSeln|.- <br />!lrll&!Il!a <br />I h.r.hy alltrm un'lcr n nrlrrol p.!!ryi <br />I h.v. .rn *!ll dlxu r C:.d'f..r. of (i,itd to S.lf-In uE rd kds' onlrnd rr.. .t |rtrvrLd nn h, Sarn. lTm ol rh. <br />tltxtr C-dc, r,tr rhc ltrlomM oI rh. krt ftr *hkh rhc ,Emnr ( Ks!.J <br />_I hlv. rnl *rll tuor.6 l d.F ..n{'.n\:ri 'n mru,iN.. ,t nqlu.J hy S( I ir l7(Il ol rh. Illr, (ixL. f(tr rh. ,rnor'rrfl. ol <br />rhc volktur whrhlhr F.mrt,s,srucn My *o, kc^' Lomptn$r ('n nnrdRc.atrrt anJ Fnry itnh.r e <br />P,,lEy Nu rr:- <br />llcnnyn r m rl* ncnornL'tu. ,n rh. work ntrsh'(hrhrt[rnnr rr snrJ llhrlltroi chpl('y !r',lihdn inrny mrnn.r <br />q, rir)tno r luhFr n,rh. *ortd\ u,.Irnq(ir Lu!.1('.lrn'mB. r rtR rht( 'l IlbuLl li\onr suhF! r,rL <br />* lt.r ru [.n\rr i,n pn,!tr('nr ol S( bn l1l(, ol rhc Ljh{ (irje. l fill. lt,nh*ih (nrrly r rrh th'{ Il^rr rn\ <br />lv^llNlN(; l.rnrto r' (urc wtrkcr! .{r,Ftr\.(i,trr uov.rrlc,s unL*lul rtr(l\h111\uh,c.r r".hploycr to dflir FtrrLi\ afr, <br />.n rrr !! ro or tudrd rhouqtn JdLr (tl ,ri,(t. J'lJiIn !) rl* (o{ or <br />piud <br />d-"t" * F""n"d r"' ir" <br />srLrrr rori !,r rlr I .,rrn ( qrr <br />I hrty rlnn unk, Fu!yol Flllry I uuLr Ftrvllnof C]lFd 9 (ollmEu! w h 54r..7UI), o! DFBrr ] <br />or ilr htrna\.trnl llotr\j.'tr (\nt(. rnl tr,! l..d\r tr trr I',lll!tr(c arl.,trr <br />Lic.nr. Chs: Lktn.c NumtEr: <br />E(INSTIUCTI(IN LF-NOING GE!iC} <br />I hcEhy allirm unl.r Enalryoln rjury inai rh.n 6 !.r,n{d.r.n Lft.ths l3.ty fitr rh. Frfomftc ol rh. M'd n, wh.h rhl( rE nr s <br />t(kd(se ltDT,crv c ) <br />APPI ICANT NF('LARATION <br />I hdrtry.nimuftLr Fnrlry.l pcr/r, ft ol rh. loll,P'ng &tL r Dnl <br />D.nr,lion P$h[s^\h.st r Norrlirlrn'n F.d(rxl R.3ohrn,n\ al'tL40, Pd6) <br />_R.quftd tdrq ol U<rlfurrB <br />I .!n y rh, rlE r.&nl tluh.B E8sdr8 .rlErhx teDv.l r r, {Cl..hk trt rhrr Pmr( <br />ndlnrr.thrr rhcllr)!. orlorn,rrtrnr r(rm(r lr8(t r,(.mply wrrh rll(\ryrnl(in! t <br />ria rFe.rrtrwr ot rhrr C! y Dl C <br />)l/\L <br />Z <br />Forms/Steel/Holdowns <br />Ereclion Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulation/Enerqy <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 />Enqineer Final Report <br />Flood Zone Certif <br />FINAL tc ln l,a fur€ lo, <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />t dLa\ A!l..li: _ <br />Set Backs