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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDEN DI;LCARAI'ION
<br />I h.rcby afrilnr undc. Fnalry o, pcrjury rhir I lnr cxcmnl r'roD rhc G).rrrron l,iccn\c liw f rhc lallo*iDs rclv,n rscc?il.ll5
<br />Aurircss lnd Pi(nl\sun Codc): Any Cily or C.unr, shich reqdncs ! Frnrir t, .oinru.r, alrd. i'npft,vc. d.nhli\h or BpdI rny
<br />srructrrc. nrdlo iis issurncc. :llso rcrturcs thc E pli...r lnrru.h pcnnf r, fitr r si8trcd sarctrEnr rh h.or shc is liccnscd pur{r{nr
<br />ro rh. povniotr\ .frtr Conrr.ttr\ t-i..nscd ljw (Chrprcr t). Con,mrn.ing Nirh Sc.rion ?(rX) of Divnion I of(hc Bu(incsi rid
<br />Polt$ioD\ Codc)orrhrl ltorshc hcx.Dr0l lhcrciorr.d rh.ldsi\ ld rhc,ll.Scd cxcnUiotr. AnyviohtbtrofSccliofTl):ll 5hyrn,
<br />ryrlicanr foru pcnnir suhjNlslhc apllicanl l{, !civilncn.lryoinor nmrclhrn iivc hundrcd dollin ($500)
<br />-1.
<br />$ oNNr of Ihc pn,Fdy. (tr nr! cmll{ryccs *nh *rec\ rt rhctr v,l. drnp.n\arnJn, $ill do rhc $olk tnrl ltr sl uiure ir frn
<br />inrcfrld or olltrol lnr salc (Ss 7lst. Bu\ircs rnd Prolcs\ions Codc:1hc Conurtn \ Licctr* l-,w d{Es nor rpdy h rnownor or
<br />rhc pn,trtry rlx' htrild\ or inlfl(lws r)rm[ rid who d({s skh $o* hi'n\rlfor h.Bclfor rhr.ugh his or hn own.nlroy.cr
<br />ptuvnhd th r \u.h i'ntnx!'L-nh aE mr idc {d otcRl ,or $b lf. howc\rr. rhc hlr ih ill3 .r irI}oE.rnr is $ll wirhn o'E Fa!
<br />oi(onrDlcrt)n. rhc O*ncr Burllcr sillhrvc lh. htrrd.n of t'(,virs rhxr h. or \hc dxl n.r huik.r nnpr.rc $c !fu|irly rot rhc |ur!)\..,
<br />_l.rso*Nr.lrhcpn)pcny.rr$ch'sivclycotrkcrintqirhli.cn\cl.onnNusk,.on(ru.rrhcpmlccrrSccT(I4l.Br\in.,\
<br />rnd lh,li\(ionCodc: Thc C.trhr.r.f\ Li.c sc Lrw dnc\ nor r|ply b m owNr of |x'p. !sho htrrltlsor i'npturcs rhcrcotr.
<br />rntl sM .ontrx.l\tur\u.hpr)lc.r\\,fl \r'.!n\.,l f u^trrDr n) rlr (,'nt.'.rtr \ I i..n\. 1 rs )
<br />I anoxrml unddrS..ri(i
<br />"*'€/ql $
<br />\f()Rht,lls' ( {)tI,l:N\\ Ir()\
<br />!].!].lL.!J!!t!!^
<br />Ihcrcbyrrrn u Jcr Itrirlry.l t)c'jLtrtotrc orrlr lnlk,{i !dorr.rr(na:
<br />I hirc ind will un air r Ccnni. c ol C. $irh S.lf lrtrrr ntr $o'kc'f .o f.trlrridr. r! prorid.d i, bySc.no.:17{troilhc
<br />t.rtxr coil.. firrhc pcrlornunrc orrhc *ork lu shich ilrc pcirnn n isucd
<br />-t hnv. rni pillnmi iirvork.n-.omncn\.Lonrn\ur.mc.r\rcqunclbyscdidrt70l).lrlrLjhor(ndc.li)!rhcIlcrfonutrcc.f
<br />lhc sor k ,nr which rnis Fnnir is isucJ Nlywork.rJ.o |En\dri(r n$urrDcc.lnlcr Dolicytrurhcrnrc
<br />l.cniryrhrr i'r rhc |r.rr{tr rrncaofrhc (ork lor shichrhi\ p!nnir is i\srn- I \hrll nor cmtk)rrnyIc^on in xii ntJtrrcr
<br />qi .s tr, trcotrr rubjc.r k' rh. "lrkcN conpcnrdtun lnE( ofCalintrnr. r0d rgicc rhd ifl slFtrld blconE suhFd to rhc
<br />qllkcF.onl|kn\illotrln,vi{ioDsolSccriorlTmorrfulihtrc(xlc.lsrnll.ldh$irh.otrfl!wirhrlx,{prcvnbns
<br />li^RNIN(; lril,tr. x, .c.tr'c *ork.ri con,p.n\rri{r L lnl xnd \hrll {'hjccr r rDrnlt,yd' t, di'niMl Finhi.\ d
<br />n, rh..o{ olom|cn\rr(,,,lJn'r!.\ rs tro\trlcd i.tr rhccn'l linr\ trp ro.n. hutulr.d rh.u\r do
<br />,,",". a/1[rr
<br />IESAAAIIIIN
<br />I hcahyrfllrmlnder penllryofFrjury rtur I am liencd undc. provhion olChanrcr g (con,mmin8 rirh Strk'n 7000) ufDivkid! l
<br />ol lhc Busircs\ lnd Pmrisions Cdc. ! myli.cn* ir ir rull ror.c dtn cli'ccl
<br />caxiraucrroNtlllltlc_&arNlr
<br />n{'.rliscc l(r7 Civ C I
<br />i lISlIl;llNL[IiCl,llnIIl()N
<br />IlEdrynlllnnu.dcrNn lr,of prrjrr,ohc.f rhcn,lbsingdeclrarnnr\
<br />D.on)lilion I'cnnil! Ash!sros Nol iornnr lidcrrl Rcruhrnnr l'lirl.40. I'an6)
<br />l{.qLi'*i lr(.r.1 N.rillcari,tr,
<br />I ccniryrh Ihc radcralrcguh i()NrcBfllingish.iosrcnrivtrli,cnorafllicnhlcrorhnprc/c.r
<br />l..rrilt rhrr I hr\r r.r(lrhi\ nff nnrut(rrcrh rh.rbovc i .rmdi( r\.or.cl lrercclocorrdysirhrllCirr d(i,uiry
<br />ordinrn.cs rnd Srirc Llws rcldln8 ion.nRlh.rcbyiurlvri/cEnrcscnr iv.sof rnnCiryando,unrrrocnr.ruF)nrhc
<br />rlxr( f,rri{nrll f(rrn\ lor i'^
<br />Appli.rtrl.rAAetrt Sil$nl f/</ rc
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/lnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />ln s u latio n/E ne rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Nilasonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL Ftb -t1 ?.L?,
<br />Certificate of Occu pancy
<br />Notes Remarks, Etc.
<br />FrDncs
<br />Pool Fence
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