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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMEtiTS OWNER BUILDER DELCARATION
<br />I h.rhy rllirm und.r Fnlhy ol Frjury lh.l I d dcmnr tmn ltu Cdnktlon LatnE lj* for rh. lnlt'win! rc&)n (S.. 10:l l 5
<br />aurftr. .[l Prufdtxr C'ul.): A.y C[y or Gr.ry *halt htu6 r F nI ro qhdtur. .1r4. i.rF,!., d. ,l6t or EFn &,
<br />rrturm, rnr h [r Frsr..l$ Eq!rcr rrE .J'pl.r tu tuh Fmr h nk t .8r!, {r.mnl lhd lr or itE ! l{sEar riNd
<br />nr rhc Frvn$nr of rtr CoirrNror'r l-Mn..d t ? (C'lilprd 9, C.l:lftDm! elh Str.i 7m] of D'vntm -l of rE Busrs utl
<br />Pn,fcq$n\ Grr.) or rhnt lrorshc ncrcmorth.rchmnd rh.6ua! furt !lk8.d.x.mpr(!n Ary vk,hhn ol Serb. 701L5 6y {y
<br />rp!l{.nl rttr r Fml subj.rn rtr rpllElnr ro r lril n Mlry oa d mn 'h.r i'v. nunjrqi,lolll ($m)
<br />[41,. - .**, r,*.,*ny. d ny.r{'t,rtt w h,.3B it rrrs $k dnp..t{o.. qn &r llE urt.,l rrE tue ! B{
<br />d.,rl.d or orr.Ed ftr {t lse 7044. Bustr$ nd Ptuf.rrkrs C,rtc: Thc O'nrr&roir lr.n* ljw d&r Nl lrDly ro u tr*tur dl
<br />rh. I,qrny wh) h{illt or ulrnE rh.rtr.[l whr &rs \kh hd h'drcllot h.rclror lrw'u3h hn u h.t o*n.q!kry..1.
<br />l,nvrlal th.r rkh othmdi e rr doJal I dll.td t {l lt hoas- rrE hilluu * r+nEmd n sU * lu oE ).r
<br />ordhl'klrn rlt (re Builld * l IEF trE bont not Fov,B rhd lrd aE drj dn lu! ir oF t dr F{dy for rh. FrInEol
<br />-1.
<br />rr o*rr ol rh. th,Fd y, d .klunv.ly codr&lry w h lkrncd .o.rr.Lior t, o,{er rh Frj.lt ( S( ?o44. Burms\
<br />.d Pn*(rncodcr Th. (-o r_-k, r l,r.n* t,p Lks Dr r!?l,rooo*EorpmtEnyrhr I'uturor uqttuw\ rh.r&&
<br />rd *tx, (r'd rfdrkhF0FFw[h.ct' BrMir) l$nql Frur brkCod*t,tL..n*U*l
<br />I rmcrcnrpl !ndcr S.cl0n
<br />-.
<br />B.lt P.C f1t rhi\ (.c'n
<br />L^ir/",h.tt. q _@tirttnt\',,'rroN
<br />TIIS.ABAI]IJ
<br />I ho.h! xlltr n und.r |ihrlrv Dl |rrt,trv.trc olrlr kn[)q!ig Ll.(hrxrnn\:
<br />-lh.w.,rlwrll
<br />du. C.n'fEr. ol CoM ro S.lf-lniur rx *,t6' um+.n<.n, .. tmuld nn 5t Sdr.i !7(D orrrE
<br />tibor CdL, ft rlF Friillffi of llr unt for wnit rh. Fn ! !0.J.
<br />_l hrk sdl will tu:dr,r *0*.6' .otr{E.{lhn 'nrurr... .r r.quEn ny Ssr $n l7fir nt rh. L,hr (iiL. rot lhc Fno.rret ol
<br />rtr k*l lq whf,h rh( Fnd a anhl My urr6' N,rEna.n Dsr&r (uE ri F,l.y rumb.r e:
<br />IALI (.n'ryrh{ hrrE Fd",mB. rrrx pod r.tr*hEhrt,rFmn !r rnkr. I $rn mr .dpr,, ey rrre. ue,h-m
<br />$ as i) tNrm iuhjcd x, rh. *drk.r'(,trp.ns.oon hwr or crl .mE. rn! |sr rhlr iI l rhrLj ti.dm rlhrd lo llE
<br />*o*.r lr,mrEnsrnn ln,vnE,! ofSkrkrn l70Ooi rlr l2br Cdl.,I dsll. {i,nh*iih con{'ly wirh itIE Pntvissns
<br />WAiNING: FrluF k! eE kf,t rr d,qErrron (r,vf,Ic s unL*tuI. &i $rll .ubF r crPbF ro s6!d Frls r'l
<br />rn rn.i uf b ox hudEJ llFurtn d L.ltl{r).Ulo), rn .!rpn io rh. co< ol.oqEn{riDtr. i.mt.t 8 t,oqt.J fd rh.
<br />Serirn 1076 .l rh. Lrtrx C'rL, irr.Ed rd ,bfty\ rar
<br />PE(:TIEIIIAN
<br />Ih.r.hy ellrm unJ.r rxorhro( Il.rrury rhlr I n li..nrd unr.r F)vBrm ol Clu cr9(omft*i.8 w(h Selnn ?flX)) ol D*(on I
<br />ol rh. BuiF$ a [rr.$i)nsC(ri..! nylf,.,i*rintu ,'tr(.nl.llNr
<br />IaIIIASCTANIEIDIN{j.AIiIICI
<br />Ih.fthyNlltnuhdcrFn.lryofpcrjuryrh ( hcrc t r conlrrulr0n Lndi.3 4ucy ntr lhc I'.n'l!rMc. ol ihc wo n whKhrhriFrm s
<br />trskJ rS.. r09? C,! C I
<br />tJ Lr'! N.m
<br />-
<br />ATTII!:ANIDECIJAAIIOE
<br />I H'y .Iim unr.r rEn.lt y .l rErjury om ol rh. li)lt,*h! &(krr $nr
<br />D.frnntr)n P.rn lA\h.rlo! Norrll.6r!'n liedcnl RcluLronr ('frt 40, Pd6)
<br />_Rcq!r.d lr(.rdl 11{lf.crh
<br />-1.!n'Ir
<br />rhn 0E ,id.rrl cgrLrx,r F8.rilrn8 .rh.(os llmv.lN x rfi,lrlhl ro rht pnj.u.
<br />illf I Ld,ry 'hd I h.v. rcd rtu{ l}nrrrrr,tr lrl {n. rlur thr rbv. 6n,mrin tr ((llBl I tsr ro @r{ly,rh.I cry.rn coudy
<br />,nlm!! .fijSr.k Lrsr EUnE ro hdrtlu! roddrD[ 6l Hry.drsro. EFrcr*rrt ! olthn Cr, rir cody lo (ds !po.0E
<br />rh,( md[EdF!Fn, ror 6!FdInnoqEt
<br />Appli(ul or '\!ml Sirntrrtrrr D,r.: L lt.U
<br />t4[r N0to L"',
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulalion/Enerqy
<br />Drywall
<br />Ext./lnl. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL /'Zlta ELt<n e b, (Z)
<br />Certilicate ot Occupancy
<br />Notes, Remarks, Etc.
<br />-. h.tl .t4
<br />T-Bar
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