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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER AUILT'ET UEI,CAT TION
<br />I lErcby llfirm lnds FMlly of F Jury rhd I m .rc.{'i rnrm rtE G'iiidrn Li..( tie nn dE nnhwint rct$n (Sc 70.!l 5
<br />Busir< rnl Proacarirn C.d.l Ary Ciry or (bu , *hah Eqlinr r lEmir lo d,n(rcr. rlls. in{'rnv., iLnblirh.r mptn my
<br />ntulu.. Fitr 'o
<br />dr irlm, rko EituiB rh. r!{,ltd fo. qh Fmr rn 6t ! sEEn {r.rd rhll tE 6r rlr ir lirKd purtrd
<br />ro rh. tmvti'r ofrh. Conrd.ttr\ l-r.nrcd ll* ((nBfld 9, C-.mmkin8 p h SNli'n ltxxr of Dilnion 3 oa rh. B!!n.\s r.d
<br />Phr.$hnr (ixL) or rh.! tE or rh.l.r.rpr rrEElmn !.d rrE h.\t for rlE.llcs.rl qcnplnn Anyti lrirotsdion,01I5byiny
<br />!!r'tr. Ior tFmn tut'Fli l,r rlpli.ul lo!ciyiltEfl[yoaftn mr.rt n ft. hundE{t dolhr (5rxD
<br />L r\ ovrr oritE FlFnt. r my.r?bF! snh Er8.! * rhn oh o,Itn\.lbn. *ill & rlr *rt.,ri rlt <tuJe i\ hn
<br />inrdkJ m rlT.sd nr .E ( Sr 7ol.l. Busifts. tnd Pn'f6rbn! ( od. TlE C.nnsro' r l...nt l rr rr.s nr rr,Fly ro rn o|'Er .l
<br />rh. pn,Fn, *lr, ttuillt or nqn,Es rhcBi[ ril uls d(d <u.h *nk hin!(llor h.rrlfor rhFUgh hk or h.r o*n ci{Ly.c!.
<br />ImyiLd lh.r ruh ir{rowd\ m nn ir.drl oroltrcrd f{r sE Il lr,*!w. rh. hoiEil{ d itF.wd E $U *lhh (n ts
<br />of(nltlLiiin. th. orvEr Buitlr *'ll hsE dE lukn of tnrinS trd lE G {E dn ril hrild or inF E 0r rfttEy ntr rhc FrF,c ol
<br />-1.
<br />0s o*mr ol lh. ri.p6ly. .m cxchrn!, conrBdins *irh licn{t .onrdnF h onnrud rh. ImF ( Sa. 7on. Bu{m$
<br />rnl l\rr(srir Cek Th. Contr&ror'1 Lic.ns trf, drEl mr {r?1, to n o*ns ol nmFn y wh. t uild3 ur impov.t rturcd.,
<br />an<l sto $nrdr nr sh rmjc:rt *irh. Co.rEr,{n lt.n-J nunu.r h ih. codrdc\ l-irne liw,
<br />I itr,.rcnrpr unJ{ Ss.'ri.r
<br />Drlr
<br />!3rBtrE&l-rLlulasarla!lrFcl {RArlo\
<br />I h...hyallrnrundcrr.Dilryorp.rlur,o coliM lnlk,rnEdorl.nrri{,n\
<br />-l
<br />h,r! !d *ill minli. . (tnl.r.r. of CoBn! t' s.lr lNlr ftr 10116' $n{x.u k!.. .r F vii.d nn by Ssri,n l7(i or rlt
<br />ljhn Cod.. lor rh. pcrfomm. ol thc wod( nn *hich lhc p€rmil ir issuql
<br />, hnlr rd e'll tumrr'. r orls coir{'cN.rr,n imur.mt. !\ r.tuirBl hy NLU'n 3?(x} .I th. lrtq Cd!., for rlE Ffurmkc .,
<br />rhc *Drkfor *hi.hrhii Frnil ic kErl My*orl.n c .rFnMrron insuhrcccn q a F'licynlmher (c
<br />-l
<br />rcn iiy rhor in Ih. n rro.nurE ol lh. work nr *hth ihi\ Il.nnir i\ ir\krl. I \hrll ,t'npLydnyF. otrin!trymtrncr
<br />y, rt t, h.\rm \uhFl ti rrr knlh lorrFnu$n bwr nr cll'rdn.. ! ./rN rnd n l rlr'uld r$r $nii I t, rrE
<br />*orlE\'m'ryrn\rrnnpo\n n(nlSdonrttrlnlrlEl.bt(tii]..l{Elt^Mhurh{,mlt rhrlbsF^^x'n\
<br />WARNING: Trilurc r{' Kurc turtcB' con{xngI inn o,vcnr. N -r./L ,a/f,.rr yrilr, * .-pyG, to mnin l Fulrics 0,'rj
<br />civn nms up ro oE hurnEn rhous.d doll!^ r!tm.ul,). ,tr dd i]t'y', rh"/'i y'']t(tFNr,oy'd.ms.. n Fo't.n lo, rrE
<br />SNt.n.!0,6 ',rur l:h{{ Codc. htcrc{ ud. my'!lR\ ,/ l / /,/ l ./
<br />^,,, tcflof tl ^**, XJ WUL V
<br />I raEisED CoNIa.AL-rOq
<br />DECIIAAIITd
<br />I lFEby 'liunund., Fnny.fF,lry rhd I tn liurn un&r Frvilirn oaCIE ( 9 (ml!ftNint *ilh sdi.rn 7ul), of Divi.hn ll
<br />of rh. Bu\n'u$ and l'n,n*tr)n\ Co,lc. uki nrylirrn{ ^ i', rulr nn( 8,xrcffc.r
<br />i.i.""\y'r,7
<br />rulililBlstrl]ll.[}DDiql$ll!(I
<br />I hochyamnnu lcr Ftrdlry Itx4uryrhlr rhcE il!(oniru.ri,'n h n3rg.trcy ttr lhcprnnu'rr ofrhr tro* l(tr rh(h rhil p..rn is
<br />APPL!CAN'f DECI AR,ITION
<br />I lr'rtry dIn, o lfl rn.lrt ol FrJ!', rr of rh. f(nk,$ in8 d& hhr hn\
<br />Dc r'liri,,n fcrnrik A\hc{or Nnrificnii, tudfiil Rcluldion\r'lnlc 4),lt! 6)
<br />Rcqutrd l!(6of N.rLdsn
<br />-l
<br />.d iay lh.l lh. rcd...l Eslld ionr Essdins adE.bs nm,!d rrc nn ryrlr.t'h r, 'ht PmFl
<br />_l \.'r,lyrl r I tuv.krJ ihis,,ftlraritrrrxl{
<br />odiMN6 .,n Sllrc l,u( Ehrfu ro lDildins co
<br />rhr. f,trr(n((l t)nrr t l(n NF.r
<br />lDpli.nnr or 1!rnt'iiln"lu 7 E r,,
<br />h(',nr!l! * h rll ('iry rn'l t\pnrr
<br />, rhh (n\,' lCoudlhfl duFnrll
<br />,,... rcf r "f t/
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framrng
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />uty Final Report
<br />Engineer Final Beport
<br />Flood Zone Certif
<br />FINAL +19 Lu(4i
<br />Certilicate of Occu pancy
<br />Notes, Remarks, Etc
<br />Set Backs
<br />i.r!.d (sd .r{r7, civ c IL,'icr\ Ntr
<br />DF-a 1/ttt*
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