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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWIIEI BUILDEA DELCANAT|ON
<br />I rEEl,, .rm u'ns Ffl!, or Fpry 0!.1 I d.i.qll tud! rlE Clfu6 Lte trw ld lll iolb*ng rur (S6.7011.J
<br />AutiFr .d P,rt6t!n C.d.l Any Ch, or ClMy qnah 'q!i6 . !6ri ro cdN. .Ia, lrt oE. &mlilr d EFir -,
<br />!r,rtG, Firb ils ttu,rliorqliEtrlE.rt{t!rad.ahFdb[1.sti.dilrMlrhlldiiilicnEdF,{rr
<br />ro rlE tmviiod of d! CdrrEror'. Li6€n L.e (Ch.prd 9, Cbnmrin! rat SGriJn ?(lD of DivnEn 3 or df, BBiEs !n
<br />Pmfc$ioN Cod., or rllr lE o nE i! G!.,r{'r rlE!6.h rd rE b.!i lor rlE dl8.d.r.rp.ion. Any vi,Llion of S..rion '70.1 L5 by uy
<br />lpplkstr' Ior r pdnil shi* llE .r?li.. lo r civil p.dhy of nor mE rhd nt hudErl dolliB (t5m)
<br />-1.
<br />.r owEr ol rhc FoFny. or my cqrhFct *irt $asB $ tlj.ii oL 6n{Enrrkln, wiu do tlE wolt .,n dE rErrlE is ml
<br />inrod.rl or otr r.d for slc (S8.r0,i4, auirsi Md P,DfBsioB Cd. TIE c(dr*rors Li.N trw 6.. d .!pl, lo s owF ol
<br />ilr tsfdy *tb hoilrk tr rF!6 !}raa !n who d(E uJr v|t hilEla q lE*lf q dNngh ht lEr 6m .npt
<br />'€1prbvid.d rh, h ingDffie d ir.d.ddoiftr.d ford. If.lfts.llEbildiryrBlrDEEdk$U*tihmF,
<br />olanplli,!rlro*GBdua*illlrGdEhr&rofFlvrt.lEnllldilmlhiBrlrFell!FlllyfdlllF{FEor
<br />_ l. !towE olllE lllrErr. m crbriEly cqrr..rirs ,iih lic.trrd c( drmro6tu E lroF.r (S...7(44. Burirs
<br />!d Pl.ssCo<k:TIEContrslmrLEiELrwde!mrapplyrodD{c,otpioFn,*h.burldrorimpmwirlsmn.
<br />a.d wh onEBfMuhFtrFdrwithrC! r&1ons) lt ni.d N6urr ro rLco tuioa3 Lj..M lrs)
<br />raaf,r&t-c0ltrEtaDa!
<br />DESII8AII|A
<br />I h.r.r'y .0im u,n r Fnrly of F,rry or or rh. folLrei,B &rlfrbm.
<br />._l h.r tld Bill oi.rri. r C.,!'frd. orcoMn'
<br />'o
<br />s.lrlNe fr uit6 6,p.nlri,c B trevildl fd by Sdrb,l7q) orrlE
<br />Lds Gnc. fd rlE F{l)ffi of rlr en ftr *nin lll Fmir ( irru.d.
<br />_l hrw dnd erll minr.in mrkcn .lmpcBifi,n iNErc, .! r.qrt.i 6y Ss! 6. l7m or rh. trhor Co&, fo. llE Ff(xrrm. of
<br />rh. wort ftr whth fiis pcmil k is$sl My wrkdr' mqEn.ri,n i..!64. rri.t !d IbLy numhr G:
<br />EbiEr
<br />-l
<br />ccnir, Utl in rL Ff(x1lIB or rlE hrr fd entn lhir Frni ir i$an. I ndl ml c'qiLy d, FM a! ey nsE
<br />- r ro tE<m qbF ro rlE !ot6 onpcNbn Lrs ol C.lifom! d .aft rh.t Lr I .rrrld h..or rnF lo llr
<br />Ert6 oqENrbn rovtbs of S..tir 17@ of rh Lrru Cod., I tr[ nnhenh orplr ein dE Foviim
<br />WAi.Mllc: F.ilurc ro @ wt rr onpcndbn oE F n unLstul. un rla $bitl d 6rl9LF b oimi.n FMris.rld.Ml nEs up ro oE hldEn rbusn d,ll6 (l10o.0ft), h .ddiri,n ltr tlr con of @rFNrio( d.nrlpr a F.viLd 6r lll
<br />S.cr,n 1076 or dE LilE Crn., hl.Gn !i .rrlmy\ r..s.
<br />D.l.r Applot
<br />r rcE sFn atiiiiiaTrR-
<br />DEClJAlIlll!
<br />I tmby tlim ud.r p.Nlly of Iqrury ilr I .m li(arcd uild Ftvnn. ol CtuFc 9 (omEnls eirlt Sdion 7m) of Ditl3irn l
<br />ol lh. Buiims.rn Prof.sirB Ccl., .d ny lt.m i! b tull l(N !n.,tdr
<br />Late Ntf,t t
<br />r0M:IaucllIrd."LlNllldli-&GENl.a
<br />I h.chy oflio, u lcr Fnrlry ol IEqury rhd rh.E n ! onrMtbn Lrdina !3cry for l hc Frftr'l1tr. r,r rh. sorl f(tr shi.h tht Fnit ic
<br />i\\kd rS( llD7. Civ C I
<br />A.ITI.I TNLDECIJSAIIO!
<br />I hdtr,y .tfm ud.r Frllry ol Fjury oB or tlr tolb*iry &tlr.rr btr:
<br />D.m,lirirn Ptrftil.-Arb.dos Nolificdion F.ddrl R.EuhrhN (Tirk 4. Prr6)
<br />-R.quircd
<br />Lelter olN(rift dbn
<br />_l .giif, rhd rh. f.d.al r3ubr bnr Rs'rdi.! ..lEsor rcnnrrl {c mr qitlilblc ro rht I'tr,rer
<br />-l
<br />cdrify lh.r I lEw @d lni. +pli.,ion !n r{. $, rrE .toE rfonrlhn i! @rral. I .srt lo erply eirh .ll Cty rn Comly
<br />ornimr rld SLk trs Ehrit ro hirring .ddirris ud Hy .lliorie qr.srniB olfit Cny .rn C.unly lo ora l+or dE
<br />.lDr Enrih.d DlDrdry f( iEg.crion pttb6
<br />,tDlli0nl or A*dl Si8dlor
<br />P.mir* Mrrc (pnn0:
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation /l 4r)
<br />Boof Sheathing lru'rlcfl lL'[Y/fril t/,(y
<br />Shear Wall lt
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />It4 aso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL 7 $24A &lur/a b4 r0
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc
<br />Rev. 08 07 2015
<br />lioru\cnfl u cr SccliD .ll & l'(' nnrhN r.n\r
<br />lrlrc l)f,n.r
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