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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Roof Sheathing
<br />Shear Wall \JU V-./
<br />Framing
<br />lnsulation/Energy
<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 />/)
<br />FINAL l/7n4 I
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />OWNER AUILI}ER DEI,(-A RATION
<br />I hq.by .rm u'xia Frly ot Fju.y |r I d <mF ton rlE cd..d6 L'c* tre for rh. lollowila ld&n (sd 70] l.t
<br />B6ilB lrl Prca<i,. Cod.): A.y Ciy or Coud, $hth r.quiG . p-ni lo NlErocl. its, inrp.orq damlih or rq! iy
<br />rlrucl@. Fir ro ils isudc.. dlo r.qun6 thc applicur lor iuch p6m(
<br />'o
<br />nL r 3igncd sidffil thd lE or lhc a licatqj ,leer
<br />io rlE FDlilioN of tlE Conlr.l( r Lir.t d Lrw (Cn E6 9, Comocins $nh Sclion 7000 of Dilllion 3 of llE &BnB ad
<br />PmfsirB Co<h) 6 rt r li or {E ir ddipr rid.6on ,'d lh. b6ir for rlE .lk8.d dmdion. Any vrhin of Sd.. 701 I t ry ay
<br />applicdiaor.Frmirrubjdith..pglicuttor.ivilpdlhrofnotmrcthafir.hu,ttddoll&t{1500)
<br />-1.
<br />B osE of rh. FFty. or my mpLrc rnh q.s6 6 rrEr $L NnrFrEdior rill &,llE {qi td 0E ituE ir mr
<br />idoxb, d ollo.d fn $l (Sd ,o14, Bui6 ed ftDf*ioN ('odc TIE cont.doi. t,tdg lr* do6 d ?p, lo e otrG or
<br />lhc poFly who hiltL m inprovB th@i. !d who do6 sh uolt him.lf or helf or fiDush hh or hG own @ployc,
<br />Fovid.d rh^ iu.h imFD\clld e mr ilai.d or.ltsqi tor rl lt lss6q. rlE hrildi$ or nnFc6d i! $ld eihh @ )r
<br />of oreli:tao,r rlE (}*G &idc rill IEE tlt h,&! olF$tilB E lr d dE dij d hrild c nrsor! d8 FnFy 6r dE Frpoc ol
<br />_1, sorc of itE F.Frt. m.r.lsir.lt.olndinB whh lk.6.d co'rri.loE ro sn tu r rtE Fi{ (se. 7041. 6GlrB
<br />!,n Ploki, Cod. Tn. contrcloii Lr.G Lr* &E @l qrly ro e o*.a of Fopdry $ lF trild! or inFora rhd6..
<br />a.d *no co.r6dr for 3uch Fojds wilh a CortEclo(, licm.d puEuitn b $. ( odr.dor'r l.r.w t,w).
<br />-!
<br />u.rofl uda scdo.-. B &Pc for6n rmn
<br />D.tc: Orr..:
<br />ll oRl(Exs' conlPr-NsaTIoN
<br />DECIJ8AIIgB
<br />I ho.b, .mm und.r !lmh, ol tclory on. of lh. aollos in8 &(knlio6:
<br />-l
<br />h$r tn uill @i!t.i.. Cdiird. of Cl]!E, ro s.laler. fd wt6a @nFqrio[ . FDril6d aor by Sdlbn,70O of llE
<br />Llld Cod., fq rlr Ffd1j@c of rh. Frt for x'tih rhc Fmh i i$.d
<br />Xl h.v. .rd will n.irr.iD *drdr' otrrF!.1ior ilurrcq ! r.quir.d b, scrion lToo olllE L.bor Co<L. for rh. Ffdl]@. of
<br />uhsi lh! lxmi ! Bs,.d M! sfl r dr tan tdr'n,Me. (.lm nn pol.) numbd,(?t;f <-tLhc
<br />4oLSoBc+1 (^
<br />-l
<br />cqliay rtul in rh. Fforu.. 6ath. wort for $hkh this Fnil is ir{.{L I dEll nol dtlo} e} Fsn i. oy hens
<br />r 6bbcor$bdrorh.ro 6 onp.Enion h$! ofcilifoni." tnd.sE rhd if I nFuU hGor stixl lollE
<br />${nd'.omFErkinF$vieioBofs.clhnlT00olrlEt,trr(o&.l.lull,fonhsnh.otrplr$irhrh$pmrtEB.
<br />wARNtN(;: tuilurc ro cu. world .onpo{ion .ovdatl. i! ml.*lul, sd rhlll $bial d dPlo)c lo oimi..l FEhb ed
<br />ctr'l lin6 up to on. hundnd rbutrd of conrE6dion. d,tus6 a Forid.d for fi.
<br />S<l0n 076 oflh.lrtsr(J 2r ,
<br />DISJAAIIO!
<br />I hftby amrn u.do poulry o f pajory thd I m lica*n u.dd lillition o t 6 I (conmd.ms sirh Sdion 7000) oa Dn Bn'n l
<br />of rh. BsllKs ud Pmfdrhd C.&. ai hr lrN r i. aull aor.. &l
<br />L-b4 qu1q1
<br />u.l+o 11t Po et- | *c-
<br />caxuaucuQuLldDlNclcElcl
<br />I ha*, .mm u,r& FEXy oa F4ury ltr llE! i' r oldruclDi Isdiis ,sft, for rlE Ffolrlm of llE wt b. *tih rhii Fni 6
<br />i!.u.d(s( 1097. civ c)
<br />ATIIJCAtrI.0ICIJSAIIO!
<br />I ha!h, arm und6 pa.h) of F jlry om of lh. foltru'iry &( l4.lioB:
<br />IXtulnio" P@G-A.b<ro! Norin.llion f.d6.l R.8ul.tioN ( I nL 40. Ps16)
<br />-R.qur.n
<br />Ldrd of r.olifrdinr
<br />I .d iry r hn rh. a.ddal ,.tuhrioN rBardin8 st6rc r6Rr.l ec nol spplaabl. lo lha D$Jd
<br />I <6iift !ha! I lts\. rql rft .rplicsrhn $d nal. rhd rh. .Ur\. rnlonnahn 6 .ordr I +G b .omplt $ ilh .ll Cily lrd Counly
<br />oid@nc6 ud sral.IrM Ehing ro boilding .otrntudnrtr ed hd.by autbri,c r.!r6dt3ln6 ofrhi Chydd Couniy lo dt6 uBrn lh.
<br />'bo\.6!nn d Foedry fq dyi F,FE
<br />,lpplicinl o' .\qut si8 ilrrc -
<br />. Gtod'd (7.n^7' 5
<br />.," raP'" lg
<br />z.iqgD
<br />Set Backs
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />lviltDl /A arlSl OnJ,ah\
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