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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER AUTLDP-R DEI-CAN TrcN
<br />I lEElry .ffm uDLr FM!, ol p.rpry rhi I n tktpr ftom rh. ConrLr6 Lttu t:w for rlr inhwu3 E.$n (Se 70)1 5
<br />Aunnclr rln P,uldrd GrL)r Ary cny or Cdnly *hrh GtuB . Fn ro L$mBr, 116. rtnt, JnnBh or EFr uy
<br />{turuE. pmr b ,! Biuhr, .ls Equ6 tlt '9di-rr ld rsh tEmn b 6l. r r'!Ed {.tcdn' th, lE or dE B lErcd Fii.lr
<br />n, rh. Fovs.nr of rh. cinrrG r LNneJ Ur lc,qrq 9. C.,ntrBr! * h SdrE. 7Om oi Dr!,n t or llE AunE$ ."d
<br />Pnr..rins ColG) d rh.r ll r th. Lr .r.nii ih.i.fibm lrl r,r h(s ror llE nh.n .r.qrnn Any v.l,knorScr,n7011.5 brrn,
<br />.rpli..d ror a p.mr rut'jftk rh. +pl,c.nr ro . uvn FMhy .r Bn B)E rh$ t v. hudld &nLn ( tt(x)J.
<br />l. .s owEr oi rhc pn'Fn y, or my .htlott.s s(h w!3cr .s rhctr q,b con{'.nsxon- *dl du (k eolt !n ill {ruh s nn
<br />mrcn]e'i or oll.i.d lnr \rh (SR.. ?0a4, Busms ud Pnr.suF C,nc: Th. Cohr,crtri Lr.ne lj* lmt nor rody h r. owmr ol
<br />rh. DDIr.ry uh) h J! o' qn,hi th.d,n. 'rl rhl (I{i rsh u*l hrnKll r lrrrll or rhnrSh h( or h.r .un cmphyc.s.
<br />ortrv'dcd thd skh sr rEmrkE r d.dlal n ollrnl tu yL l,,h)kE.rhchu !4 or r{n'tmd Rt'lj*ihD.m F{
<br />or orlq)Lr$n, rir O*rr Su ldv h.E rlE h{rlcn ol F,vuB rhi trorntdn mr b,ll ot lIInrEllE F1d, nlr tlE FrIDcol
<br />-L
<br />r! owNr olllE F,Fnt. u.r.luntly @'rr{4 *rfi lFnrrl.rdrdN l{ @n<fur rlr Frrd ISe. ?oa4 6u,Is
<br />.,n h.6!sm Cnl.: Tl* Co.rEioil Lrcn( k* drB fl, .pply ro u o*E o( FoFr, b hu dt q
<br />'nPtoEr rL6L
<br />.[l wlb ddElr lq rh prDF.t *irh. Co'iEirlr lx.n<J lond lo rlE CotrBiqi LEM lrr)
<br />I rm.knd unkr S(|rr .B &P( r,rrhnE.r,n
<br />}}aatrEEl'CIIlIIjMAIlA!
<br />DI(IIAAIION
<br />I hcrcby alatrm uRllr liulryol Frjury.ft ol ttE ttlk'wu3 dc.kiri,ni
<br />-I
<br />h,v. .rn v'll NdM . Ctn rur. or Con$n. ro s.lr InruE r(tr s'rtcB Lln{Ens:rilr a tn)vlal lbr by S&18. l70O ot r,r
<br />t hd Cdk, rd ttE Isri,rrer otllE *it 16 *ti(t rlt Fon n uo.J.
<br />t h.E .d *nl E!i.m hrrd coriYENr.n $uBn., .. r.qur.1l 6y Ssrpn l7d) of rlr trrrtr Ork. tu rli Ffmr ol
<br />rlE n'rt ror *hrh rh! Fmr B !un. My eort6 coqrnqlnn ho,u. ffir.,n PoLy nuhtE el
<br />A-c.-o, t. *)a
<br />lrcl. aol>I
<br />I (c,rilirh.r inrh. Fdtrrtunc.ol lhc *Dr* lor whahlhs D.isr r it\ocJ,I rhII hdt.q)Ly lny !.rru in rny.mftt
<br />$ 11to hc.onE tubrtr ro rlr u,t6 c.hFnerion lNsi orcrl'r.m!, $rl.8E.lh.l iLt snruu ltlom ruhict lo lrE
<br />hr*.ia dr{Eht, on lnryBnnr of Sal $n l7O0 o{ lh. l:ti, (.vL, I !h.ll, r nhwnh omoly wiri 'h,r rntvr.nr.
<br />WARNINC: Fxlur. b sR qxt
<br />^ co'rederx,n u'Fne. tr unL*lut .,n rhtll stbFr u .rrllr,yd ro dr ul FdtB {d
<br />(rrl fhcr !p b .B hu Eal llr)fi.8l lllrls (ll(tr,Ux,).
<br />'h
<br />rllldrr o rlE @i oa.ooFnorDn, drma.t .t I'ivrki ao, rlt
<br />S..rin {?6 ol rlE lrh, (irj.. d.rcr ]n ltmr'r f€\
<br />n", 'lf n{F
<br />I h.rby afftrm lndcr p.mlryol Jrr]ury rh, l ln lltt...d uiJ.r !t,vrr,n ol Chrrrq 9 (.onmet8 e{h si!nn ?rxr(,ror lrrrrn r
<br />I rh$ Bu!tr.$ rnJ lr'or($os( 'nl!. !d my l(.n\. s tr, h'Llntr(. trrl.llrlr
<br />/'o/z
<br />I ro!
<br />4(..t
<br />">7tl
<br />tl
<br />I lEEby .frm urtr F..Iy ol Fr!r! rhc rlErc is..$n!urnn l.Bjn!.!4t rd rlE Fn(mt ({ rh. k*t tu. rtBh
<br />'hs
<br />p6n. .
<br />NkJ tsd. ldrrr, crv. c )
<br />AIIIUANLDEII.AMIIg!
<br />I h.r.t'y rflim uo,l.. n nrlry ol t lllry nm ol rh. folbrht d.cl&r tr'ntl
<br />rhmhrion Pcrn $A\lr{os Nox,rdo. F.d..rl Rcpuhtr'.\iI{L 4).I'lnol
<br />R.qu!.J lrlcr o! N<r'li.rnn
<br />-l
<br />cnri rhr rtr rd.r.l E8uLl,r. Eesilins a<tEdor tm*rl ft ftn {,Pl..bL to rhir !r'Fr
<br />-l(nrfyihdIhlEEdrh!rml..rnnrnn.r.th!rtE.hrEmfini)ntrdfrtIr8rehurqyrtihrllCry.rnCoudvonliEft.s arn sl!r. L,*r EEt!'s kr ht'Llo8 otrtuti)tr .,rl h.Eh,.urhnu. r.lEr rtiEr ol lh! c'ry .,n G,rdy ro ..ts upon llE
<br />ih,vc mnrsrcd J'o!. y htr r{r.rN'n purFxcs
<br />Atdi(r l orAAenl Si[n{hrn -Tr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Reporl
<br />FINAL
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc
<br />Flood Zone Cerlif .
<br />lrfr---)
<br />lrnd..s Addr.$l
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