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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE tD/stG.COMMENTS OWNER BUII.OER DEI,CARATION
<br />I hcah, lftun un'l.r pcnrlry.l Frjury rhir I smcr.r{ fn,fr rh. ornrrcr'r' Li.cnr. li* Itr rh. bll,'*in! r..q,n (S.r?orl.s
<br />auio.rr d k l.$u (in l: Any C y .r a\unly whah EquEs . Imr !o $n{orr. rhd. it{nrE. d.frnsh or EFn uy
<br />(Nrur.. Fr h ds iisB!. .l$ rcqur rlt qlPl.5r kn rNh Fmt b lik r iBmJ ntklmt lh.l lE .r {r ! lid<1t F ad
<br />tr rh. F)v6$nr o, lh. Co.tarlri Lr.rd l:* (Ch{d e. CohmEb! *.rh Sd!r,. 7m) or D'vM'. I of
<br />'lE
<br />BlrFrs .ti
<br />Pn .sons C,rj.) or ihll lI or \l! s cr.n r rh.i.irun r*l ilE h.tir for rrE ,lk8..l .r.mF"'n. A.y vrLl m or Sfrri'n ?0.1 I 5 hy my
<br />rmlMnr ror. Fm rubjccrs ih. lmlMnr t' ..,!n FNI y.l nor m'E rhn livc hundF,i J U$ (5500)
<br />-1.
<br />$ owrolitr rrFnr. if, ny.r|)loFt * fi B136 r r&r $k qnIddDn, hll U' rlEsrt. j rlr {dM tr nn
<br />ui.nlal or o(.Eil ftn sL tS( 7044, Burm( rnJ PiDl6rxDt Gxt : Th. (i'dr&1ir'r Lros L.a dxt nr rptl, ro o orEr of
<br />rh. pn,Fdy wh, hulUt or E{n,Bt rlEBn ui *h,Jr!shs,* hrnkl, or trtulf or rhn,t3h hn M h.r own .mphy..1
<br />pn,yd.d th.r ruclr mn$Emdt s ml i.rcd..l or off.rBl |,tr qL ll hrkkr, rh. hiLim! or nqmtntnr i\ g,Ll wirhrn m ,!&
<br />ol.o,rrLtin lh. owmr audh eO h.w llr hnbnorF'vB8lhrl lrornrJd nn h!! or qrE llt F{dy ror E FrPror
<br />l.asowmr.lrhcpmpcny..flc\.lusvc,y.odrlcr13wtrhlr.n{J(od.nn(,Llhnrudrh.r8*(rsd.7Or1.Btrrfts
<br />jnd Ih 6\rh(-' .:1hcC.ntrrttr'sLr.n\.lnwdocltr.rllplyr,) rn.wn.r olln,peny wh, hui[r or
<br />'m!n,vcs
<br />rhcrcon.
<br />ind *tu, $drrk lor luch lr'j..r\ *nh , (i'.im(k,n, lrrn{J Nhuanr n, rht conta tr\ L.cne lrwr
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<br />B &PC lorrlt6 E:rn'']. . . L--n-]tl)strt.8ffi.t**.,tr*^
<br />r!I!,r talro!
<br />I hrw rd wrll mm.jn sort.n corp.nr.rDn 6surc. .r squw{ I'y SsrDn l7{x) or rlE L4r, C*,., for lll Frfulm ot
<br />rh. knt ld rh.h fin Fm, ! siud M, kita oqEnrrir $llfur (.rr.rn F,uy nud*Er e:
<br />PolxyNutrlEr-_E\pE!
<br />I..n,lyth.l h rh. FnnmLr of lh. *ork ntr*h.hrh lErmrr n EtkJ.l \tdl ior.hfk,y lny lEild. m.ny m..mr
<br />y' !\ b b.u,tu tuhirr ri, ih. w,rk.rs' un{Enrdr D. hwr or c,hiomia. lnd ryN lhit ! lh)ulLl tr{om h).d rorh.
<br />biGF L$qEns'xrn PtrvM,n. or Sdtin l?(x, ot rrE L.htr ({rl., I {!ll. ri'nh*irh ohdy *'rh rtrre llnrr(b.t
<br />WAININC: r:.'lur. ro sE uxls .ql{rneinn.r83. ! unL*aul lnl ilull iuhFr o drrbFr ro silul Fflrrs l
<br />.o nnci uI n' .E ,rudrat rbusrl &lls (tl(D.qx)). o a inn n, tlE con of.orqrnerrun. im!.! .r Fotrl.J lor rrr
<br />I trEh,drtrmu cr!.n.llyolJErjuryrhllI16lErsnundcrFr,yN[nol(]hr.rI(..mmnc,n8whS..rnn?dD)orI)wrM.!
<br />.l rh. Busft(ail Pot.s$n{C, c..rll my lf,c.E r m tullr,trE lllclrel
<br />artutANfl)lcltt8Aua!
<br />I lsrhy ]lrm ud(r p.Mlt y of p.rjury o* ol rh. l,,lhwmg tLr l,nr xnr
<br />ftnrn[r,n Pcrntri.A{Edo\ t& krix,n tr&al R{uLlr,nr (lik10, Pd6)
<br />-R.quu
<br />l.rrcroaMrnir n
<br />_l cdifyrhj th. f.d.rd rc3ulrlnnr Eg.rUu!.rtErr rcmrvJ e
<br />'r
<br />r0Dl..bL ro rhI lh+.r
<br />96.n,ry rh.r I h.E Ed 'hr..n r.rpn 'nt {.r. rh,r rlx tlnt mlold$n s ()lBr I .!ra h.!q,ly wih.tlcrFrt C-otnry
<br />onluBr aol Srll. uwt ELro! ro hrildrS con{orri)n, lrl h.Ehy rlihtrE Elxr*nl.xv.r ol lhis C'r, raj Cordy t, .nl.r uF,n rrE
<br />ah)r. nrnllrtr'l I'r,p.ny ntr rn\i.rrinr *YLexrAppli(rnl o. Ar.nl SirBloE
<br />t/'\c^ Y'\ I (-Sc-r-v ? Vvtot A
<br />,l/r o (r1
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsu lation
<br />Roof Sheathino
<br />Shear Wall
<br />Framinq €/t q /t s M/a
<br />lns u lation/ En erg y
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />Itrlasonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />FINAL E tlal rq tss(r? I o?
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc.
<br />i
<br />I h.r.b! rfrm uhr.r tEflIy ol Frory oE ol rlE follos6! &.Lnt.m
<br />_I hrv..fll wrllmrnr.in ! C.nfsrr. ofo,nk.r b s.lf-lnurc lbr workcn (mlEns.ron..! Fovrtcd fi, bySorDn lrc() oflh.
<br />trh, CdL, fu rlr tEf(lirlmr or rh. *ork tur whirh rlE Fmr ( ssu.d
<br />S. bn.\076olrh.lihr(ixl. d.r.! anJ xnorhy'\ 1..\Lc<
<br />l.E.trt Nunltr
<br />Ihl.:- Conlftdor-
<br />(.ORSTRU('TIOIT LENDIN(i AGENL-Y
<br />I ltEh, rrr(n unj.. Fd!, or F Jory rh, rrFR n. sn{@.n kLlbt.!cEy ror llE Fnolrrm or rh. urt for vhrh lh8 Fm B
<br />FrucJ (Sd. .!097, Civ. C.).
<br />Lcnl(.r N.tr:
<br />T-Bar
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