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BUILDING. INSPECTOR RECORD
<br />OWNFI AU I LDEI DEI,('ATATIO
<br />I h.rcby ,lTum u .r lrmky of F!!r, !h, I m .r.n{r lon ih. Codrar,n lldr trw to, rlI n'Uoung Ero. 15.a 7(}!l I
<br />Bu.ftrs art Prn.sir Clrlc): Any Cry .r (i,unry *hrh cquml r Fyn. !, .rn{tur. Jtd, tn{r)v.. d.m)lsh or rF( ry
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<br />t' Ihc pNvsx'nr.l rh. C nrra(nr's t-EneJ liu (Chnpir 9, Comhctu'nt w h Sdtrn 1(XXl ol Drvtron .! ol rh. Il$'n.s mJ
<br />Pnntsi{,ns Cotl.).r rhlrtrorrh. s .r.m!r rh.rln,n ,nl rh. brsi! trrhc rllcScd cxchltt,n AnyYi,brirnofSetsnT0 l.:ihylny
<br />,ml(!nrttr1lxmi\uhj&rirh..ml(rnrr('rdv'lp.n.hyoffr)rnrtr.rhlnlivchrnlrcJJollsrltul)
<br />_1. I owr ol rk FrFdy, d 6y .mploFi , h wrtd a itrtr r,L co,r{ENrrn $d] n} {E k* ,n tlr (E@ . n{
<br />d.rlldt or ofl.Gl ld d (Sa ?l!,1. Au!E( .rd PNfc(irnt C.*: Trr Cidtukr.. trqr t * &Er Bx .pply ro r ocr ol
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<br />nnldal rh.r rkh nrn,wd! c rr lroldl r ollie! rq eh ll, h,kE, rh. l! iE n inIFErr, r. r,! wirh- (m Fr
<br />ol@r9lrntr 0. O*8. Aunkr pix rEE rtE lnikn ol Fovin! [E rE or t r drl Bn hri! d dtr]t rlr ln,Isy r* tlr F4Ds or
<br />WORXERS' COMPT{SATION
<br />DECL/TSAIIO!
<br />! hcrchy..lnmu rr p.n,hyol p.iuryokol rh. n,lr,win8 d&Liahont
<br />-t
<br />h.E .,n *rlt m'nrlin . Ccnifr{. ol Cotr<nr h S.ll lNrd rd krl.li !tmFnr.l{4 .( IFrvd.d tu by ser nn l7(x) dr rlE
<br />lrtor CdL. ld lh. Frfiffi. of llr k,lt ln *trn r,r psn'i r rrhi
<br />L .\ o*kr ol th. Jf,)JEny. am c{.lunvcly (,nlrtur uS * h li(cortl .ontrn)F t) odrucr rh. lnrJcd 1S... 7l!4, Itu\ims
<br />[rl tn,t\rrn CoJ.: fhc Cohkrroi i Ltr.nr. l.rw dds frr apply t' r .wrcr ot pn,IEny who $u Jt .r ml'ruv.s rh.rcon.
<br />.nd wlk' !.dr.ct ntr !u.h l'nFn * h. ConrBro(r) hcnt J tonlrn( n'rh.(i, r*ktr'!t$nrE*)
<br />lenilyrh.t h th.IErluNEr ol rlE *orl hr *hrh rhu p.rhd n nreJ,l th.llml c.q'loy lny Frq,. mantlMEr
<br />a' :\ b h.{'m uhFr tu rtr hrt6 oqrnqrir Lwr of C.lnrmq. n l.crh.r ral rh)uu t(oft '!bFr brh.
<br />hrl6 o'qrnurr,n |ftrv(..! of Sdr'. l?(U ol rrE btr* Oxk. I O.lL lonh*rh rlr'l,ly *!h rlr( Pi,v.bni
<br />I n.r.d urLr Sdrx'n
<br />IXr.: Or r
<br />_.4 &PC ldrhF.trg'n
<br />_l t:v..,n *'ll Erd!6 *ork 6'mn{l..qlnn 'nrur.k.... rcquftJ ty Seu,n l7m olrlr l,h* CixL, ror ItE Fn(J|!lrn..r
<br />rh. sor[ !,tr *hkhrhFlidxr tr r n lrt lr{Etrqrtn frur.R. (!mr .al F)lly ddEr m
<br />cprl lrcr un lr'.m hu lrcJ rhouqnl ddl6 i
<br />S.(rr)n.1lr76.l rrr lf,lxtr(irl..'nrcr.{ ftl
<br />hrlr rn iill't'F n, (rmrol FDI- rnJ
<br />nqrn)n. irE3.i !s t ovdd nr rh.
<br />az/nrl t ot
<br />PECTAEAIIO!
<br />I lrEby .ll m unLr FMty or Frjur, lhr I m [.nd uDi.r Ftrvs,n ol Clld.r 9 (d,lmmo8 wrh Setnn ?mor ol t !F{n.r
<br />ot ih. Burm! Dl Ptuf.{bnr Cdk. ltl mv 1...( I m tull foN .rn crler
<br />c4{6€s+a
<br />trftL.\ N,m
<br />-
<br />rax$alcraNltlllllti-&{iENJ
<br />I h.rh, alim ud.r FDx, or F rt rh, rrEr tr. Lr'.{uhn knlns rrry nn rE Fifr,lfu or rrE krt in *nrh rh! F.o, s
<br />r<u.drSe. !ur7,crv. (.)
<br />APPI ICANT DF(]T ARATIoN
<br />I h.rd'y.tim udcr FnrltyoaFruynk ol rh. n,rrrsn8 &{hrdirrl
<br />ttm'lni'n P.rnril^st {o( Ndrlrrrnn f.1kr.lRquhrbns (Tnk,l0. P.n6)
<br />R.q!nd lnrcr or *rd-!rnn
<br />_l !.drlyrh{ th. f.rllnl rauhlnnr E3rrJrtr3 !+rn.!Efrrr:lrrc mr qitlrrbk ro rhs Pn'J..r
<br />l.cnrly rhrr I hiv. r.xJ rhtr rpplrrrtrr Jrl irr. rhrr tr,i r\! trc.t.l {IlN n) lo'ntly wnh rll C yrtul(i)unry
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<br />,h'v. mnltrrBd pn,p.ny nn
<br />Applic.nl o. l!.nl Siamtu
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Ve nVln su lat ion
<br />Rool Sheathing
<br />Framing
<br />lnsu latio n/E neroy
<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 />Engineer Final Report
<br />Flood Zone Certif
<br />d.,hn)Qt )FINAL 6-1rq 1 a)
<br />Certilicate ol Occupancy UII
<br />Notes, Remarks, Etc.
<br />Shear Wall
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