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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.. COM;JIENTS OWNET BUILDEX DELCAIATION
<br />I h.rchy .llrm urkr lculiy {, Fqury rhi I m .\.ry'r ln'm ilE GffrlA' lrm* L* l[ ih. rdlo*!8 cri'n rS& 1!l!l.t
<br />)r Any (Iy or L',ounry rhrh rcqu@s r Fmr ro Lon(dd. rlra. rrwoE. iLn'hh n, rFiry
<br />qruururc. Frtr k, (s rsu cc, rlo rcqumr rhc.!pl(r.r ntr lurh lrmrr k' fi1. r slsdJ { .ftnr rh h.or sh. 6 lnrn\ql Pusuul
<br />l. rh. ln)vndnr ol llf, cohr.(M'r l.r..sd rlw (chr0r.r 9, Commfrmt w h Se-.lnr ?ul) ol l)rvBnrn .l ol rh. Blnfts ,
<br />Pnrr6rk,ni Cut ) d rh{ lE d rlE ..r.q{ ltRlrun.nt rlE t'.!! lor rh. .lLS.n.r.n{,lFn An,vlLlr'nofserrn70:ll5hy.ny
<br />.rrpl{n ftn r Fm( .ubFli llr .|',l.rni n, . .'vrl I'.Nlr y dr mt mE
<br />'h.n
<br />I rvc hBrtul &nb^ I s5{rl)
<br />l, .s owkr ol rh. F'Fny. 'r nry cnFl,rlc( wnh sr3c! !\ rh.r oL s,ntlEnqri'n. edl d' rF w,xt ,rl rtr (ME n n{
<br />d.nleJ or.ll.rctl lor qL(Sd 7lH{. Bo$tu\!anJ P('i.$n)ns a'ol.: Th. (i,htr(ttr'r L.cn.c lxp!(Er {ag,lyhMown.rol
<br />rh. pn,pc.iy lh' htriLh o, irqn,Er rh.frr. ml wh' d(*\ \kh u, him{.ll or h.r(ll or rhn'u*h hr or h.r trn cmpk'yc.{.
<br />,m)vrl.d rhd rEh mtln,vcmdl r B{ rrcnL{ or ollsd ntr eL l,. h*rq, rtF h(illiry N uqn'tmd Lr 3Ll w[htr otu Fu
<br />ol.oltIlLrDn. r,r ()*Er B![].r, l hzk rrx hxLn ot I'l,!u! rhr tr or {r Jr] nn ttul}l c rtF'( rh. In IEIy [o rlr |xrlr,e o,
<br />L rsowxrorrhr Flxdt. rn.(hhr.ly.odhdnr uih lf,cnral ( rxt{\r'on{ru(r rh.,ror( rsd 7Ol.{, B !m$
<br />r Pnlflxq,n(,ilc:'fhc Conrrr.tr'i l-k.ns. Il* d(r! nor lplly ro rn rwnri o, IlroFny who tlurlds or mpnrvcc rhc,.on.
<br />rtul who ( nrld r ntr .uch fnrr(k q( h r Conri$'nr, lcn<cJ pu^urnr r) llE Conlrrttr \ Lrcna Ir* )
<br />I rn.\.n,1 trnnr S(!ir
<br />llrEf,E8S.:CAU8EltArr!IlEclltaA[q!
<br />I hcrcby rlttfr u.d.r pcnaliy ol pcrjury orc oalhc n'lllltrr lelu.lbns:
<br />I hrv. rrn*,ll Ei.lrin . C.ndi.l. ol Co.r nr SclLlnoE frtr wo (a .oDFnrrior I ,n'vrLd tor by Sdr$n 1700 .f ltE
<br />lrtb. CaL. k* rlr FrflllM! ol rh. m* td *nrh rlE Fmd ! .iBrl
<br />_I n rc,nJ wrll nBnrrr eorl.A' romFnsarnn Drn,.Lr. r rcquml hy S(r(n r'7llo nl rh.Irtxr Cid.. fo. rlE Flofu! ot
<br />I,tr Phkh rha lrmn tr Nrrd [ty
<br />$ASe
<br />(arf,r .r{ IDlrv nun$.r
<br /><sr5.{)lLL<6a-
<br />I (cdrlvth.r mrlr tErf.rmB. ol rh. !.rt f,tr *hrh ihtr lr.6rr r Ftu.J. | \hru ftn m{tl,v:hrFra,n n.nymnrr
<br />q, arn, t-(,nr {'hFr b rh. krt6 (,ft{rn\dkm L*r ol ( rl'lnft'a. ul '3N rhd n I rrruu lia{nr \ul'Fi io rlr
<br />woA.^ ('n,Fn\!ron fn,vr tr'n\ nl S.rrtr|n 1700oi rhc Iihtr (ixl..I slllll. l')n h*nh.r'mply w hrh)kpmvtrr,ns
<br />WARNIN(; r',rrurc l,) s.-.ur wtrkc^'(mlcnsalion.ovcrurc r\ unlirh'L ind sh3ll \xhirr rn.nrl(,)tr l dmnal p.u!$ and
<br />.Nn incs up r' orE hundrd rhou!.nn nollei (SlG).lxX,). rn .nd rn n, rh4 .oi oa.on0.n\ri('n. dnro8c! .s ln)vdci li). ih.
<br />I c
<br />IIE(IIBAIION
<br />I hcfthyrllirnont]rr fndlrydl Frurylhd I am ldn(l!nd.r provAionoi(h! c, I (Nmmn(tnf w h S.LrIn 70tD) ol Drvrk,n I
<br />ol rhc F!{tr.\\ ! Pnntsonr(iilc. d myh.nk ^ m lull nnr inlcllcd
<br />n
<br />4< zay'('(r\\tRl ( I t()\ t,t:\t \t; \r;l\(1
<br />I lErchy i,rtrnuBhl FnrtyofFrrrry rh.r rltrc !. o ulr,n LBliry rl.ty rttr rtE Frfolr:4..l rrr kxl ns whrh rhs Fld.
<br />Brkat lse .l{197, C,v C)
<br />Lc&rr N.B
<br />lf,r .r\ tlJr.\
<br />A.EIJ.IIANLDECIJ8AITA!
<br />I Hry .flim !d.r rEnrty ol rE |Jry or ol rlE folb*h, &! lrnron{:
<br />D.mhr,n P.mrr^\6.10r t{dt,.jir leLEl RquLtrn (T.h rto. P.n6r
<br />Rcqu Ed l.rlc. ol f*rifE.lin
<br />_l.cn'lyrhrrlrr.Jrrrl'.!tlnlnn\(8!rdrpart$rxr.nr,vrlmturipplllhlci,rhnpn,F.r
<br />I {mty th:l I hr\. r.ad lhir +tlr.ron.tn (dc rl r,x rlr,!. rnturndx,n n cMd I .!E ro (r,md} *!n.ll C.t rBi !_ou.'y
<br />utlEMr.,n Stn. llvs rkry 16 tu jry.!tr(BlrD. .d lErr,y db@ qr.(dr'kr ofuh'! Cn/.,n Coudy ro. dqb.dr
<br />JIxn. h-.nrrtrf,n |nlrnv,,, m\tidtro trF'r(
<br />Apoli.nnl or A(tnl SiAnilu
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Rool Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsu lation/Energy IDrywall 21,2 )anttv /,/z/tq ,'YH'q
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonr v
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil
<br />FINAL 9-?7'r t //c l"/o
<br />Certif icale ol Occupancy
<br />Notes, Remarks, Etc. /
<br />q 4
<br />t Pb */24 '4k 6
<br />6c..t
<br />'e a
<br />a-(JU (/
<br />Subf loor/VenVlnsulation
<br />lv.Str9-.a.-;^Elts1r9
<br />9s Tob
<br />T
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